Electromyographic, myomechanical, and intraluminal pressure changes associated with acute extraluminal obstruction of the jejunum in conscious ponies

Bipolar electrodes, strain gauge force transducers, intraluminal pressure recording catheters, and extraluminal intestinal obstructors were surgically implanted in 4 ponies to record myoelectrical and mechanical activity of the distal portion of the jejunum and ileum. After determining normal intestinal activity and pressures, the distal portion of the jejunum was obstructed with an extraluminal obstructor. Myoelectrical and mechanical activity recorded from jejunal segments proximal to the obstruction increased significantly (P less than 0.01), whereas activity distal to the obstruction remained unchanged. Intraluminal pressure increases were recorded during periods of intestinal spasm. Obstruction pressures remained unchanged from preobstruction pressures.     

Chronic upper airway obstruction caused by laryngeal adenocarcinoma in a cat

An eight-year-old spayed female cat developed upper respiratory obstruction, abnormal vocalisation and anorexia over a period of a few months. Examination under general anaesthesia revealed unilateral laryngeal distortion by a soft tissue mass; there was no radiographic evidence of metastatic disease at this time. Over the next four months the upper respiratory obstruction became more severe as a result of progressive laryngeal stenosis and metastatic lung masses were observed radiographically four months after initial examination. Necropsy revealed an infiltrating laryngeal adenocarcinoma with metastases in the upper cervical lymph node and lungs. This case illustrates the value of early biopsy diagnosis to spare the patient the distress of progressive upper respiratory obstruction.     

Naturally occurring nasal obstructions in 11 sheep

Eleven adult sheep of various breeds were examined due to inspiratory dyspnea. Fiberoptic examinations conducted in 8 of the sheep revealed masses to be obstructing the nasal passages. Identification of the masses through histopathologic examination showed 7 to be adenocarcinomas, 1 a papillary adenoma, and 4 were cases of glandular hyperplasia with lymphoplasmacytic infiltration (nasal polyps). One ewe had both an adenocarcinoma and a polyp. Surgical removal of the masses was attempted on 6 of the sheep. Four of the 6 surgically-treated sheep have survived between 2 mo. - 2 years without recurrence of the obstruction.     

Jejunal hemorrhage syndrome in dairy and beef cattle: 11 cases (2001 to 2003)

The medical records of 11 cattle with jejunal hemorrhage syndrome were reviewed. Female and male, lactating and pregnant, dairy and beef cattle were affected. Decreased feed intake and milk production, reduced amounts of dark feces, and abdominal discomfort were common historical findings. Common clinical findings included depressed demeanor, a "ping" and fluid-splashing sounds over the right abdomen, melena, and distended loops of intestine on rectal palpation. Surgery was done on 7 cases, 10 cases were euthanized, and 1 died. Clostridium perfringens type A was isolated from the intestinal contents from 7 of 7 cases. At necropsy, the characteristic finding was a varying length of a dark purple-red distended jejunum with an intraluminal blood clot. Histologically, there was segmental necrosis, ulceration, and mucosal and transmural hemorrhage of the jejunum. This is a sporadic disease of adult cattle characterized by mechanical obstruction of the small intestines by a large blood clot with a case fatality of almost 100%.     

Multifocal eosinophilic enteritis associated with a small intestinal obstruction in a standardbred horse

A seven-year-old standardbred gelding developed marked signs of colic associated with an acute small intestinal obstruction. Surgical exploration revealed three intramural, circumferential constricting lesions in the small intestine, the two most severe of which were in the jejunum and were resected. The horse was euthanased owing to postoperative complications. Histopathological examination confirmed the diagnosis of idiopathic multifocal eosinophilic enteritis.     

Migration of a retained surgical swab into the jejunum in a dog

A two‐year‐old spayed female shih‐tzu was referred with a 10‐month history of lethargy, chronic diarrhoea and weight loss. On presentation, a partial response to antibiotics was noted. Physical examination revealed an abdominal mass, and serum biochemistry and haematology revealed a mature neutrophilia, hypoalbuminaemia and a non‐regenerative anaemia. Contrast radiography and abdominal ultrasound were suggestive of an intraluminal foreign body. Exploratory laparotomy revealed a surgical swab in the lumen of the jejunum that was associated with severe adhesions. Histopathology showed evidence of transmural migration of the swab from the peritoneal cavity to the lumen of the jejunum.     

Small intestinal pseudodiverticulosis in a pony mare

A 14-y-old pony mare was referred after 30-d duration of intermittent pyrexia, anorexia, weight loss, and change in manure consistency. Physical examination revealed a palpable but reducible ventral abdominal mass. Transabdominal ultrasonography revealed multiple distended, hypomotile, and thickened small intestinal loops in close approximation with numerous, well-defined, hyperechoic masses. There was a large amount of echogenic peritoneal fluid; abdominocentesis revealed a neutrophilic and macrophagic inflammatory exudate, and a mixed bacterial population was cultured. Given the poor prognosis, the mare was euthanized. The autopsy findings included a large abdominal abscess, serosanguineous peritoneal fluid with fibrin strands, and ~50 outpouches communicating with the lumen and extending from the anti-mesenteric aspect of the duodenum, jejunum, and ileum. These structures were classified as pseudodiverticula based on the histologic absence of the tunica muscularis layer of the intestinal wall. Pseudodiverticula should be included as a differential etiology in horses when clinical signs consistent with colic, diarrhea, or weight loss are recognized and, when on examination, one or more organized masses are palpated or visualized on transabdominal ultrasound, as well as visualization of small intestinal loops with thickened walls.     

Pancreatic adenocarcinoma with metastasis in two ferrets.

Exocrine pancreatic adenocarcinoma with carcinomatosis was diagnosed in 2 ferrets. Clinical signs included abdominal distention and hind limb weakness. Ultrasonography revealed moderate ascites in both ferrets, an irregular abdominal mass in 1 ferret, and multiple abdominal masses in the other ferret. The ferrets were euthanatized, and necropsy of 1 ferret revealed carcinomatosis without visceral metastasis.     

Serosal injury in the equine jejunum and ascending colon after ischemia-reperfusion or intraluminal distention and decompression

OBJECTIVE: To document morphologic changes that occur in equine intestinal serosa after experimentally induced ischemia and subsequent reperfusion (jejunum, ascending colon) or after intraluminal distention and decompression (jejunum). STUDY DESIGN: Morphologic effects of ischemia-reperfusion or intraluminal distention-decompression determined on the serosal layer of the equine jejunum. The large colon serosa was evaluated after ischemia-reperfusion injury. ANIMALS OR SAMPLE POPULATION: Seven adult horses. METHODS: After induction of general anesthesia and ventral median celiotomy, ischemia was created by arteriovenous (AVO) and lumen occlusion of a 20-cm segment of jejunum and ascending colon for 70 minutes, followed by a 60-minute reperfusion period. Intraluminal distention (25 cm H2O) was created in a second 20-cm jejunal segment and maintained within the abdomen for 120 minutes, followed by a 120-minute decompression period. Seromuscular biopsies were obtained upon entering the abdomen and after the ischemic and reperfusion periods, and after the distention and decompression periods along with corresponding control seromuscular biopsies. Samples were processed and examined by light microscopy, transmission electron, and scanning electron microscopy. RESULTS: Ischemia and reperfusion, and intraluminal distention and decompression, resulted in severe morphologic changes in the seromuscular layer of equine jejunum. A similar period of ischemia-reperfusion caused minimal changes in the ascending colon serosa. CONCLUSION: Adult equine jejunum sustains more serosal damage than the ascending colon after similar periods of ischemia-reperfusion injury. Intraluminal distention and subsequent decompression causes serosal damage in the equine jejunum. CLINICAL RELEVANCE: The small intestine is more susceptible to seromuscular layer damage than the ascending colon.     

Small intestinal adenomatous polyps resulting in chronic obstruction in a 3-year-old Quarter Horse gelding

A 3-year-old, Quarter Horse gelding was admitted to Kansas State University Veterinary Health Center with a primary complaint of colic. The horse had a 3-month history of recurrent colic and progressive weight loss. On physical examination, the horse was quiet, alert and responsive. The horse's mucous membranes were pink and capillary refill time was 2 s. His rectal temperature was 37.6°C (99.6°F), heart rate was 56 beats/min and respiration rate was 16 breaths/min. Rectal palpation revealed an approximately 5 cm dilated, firm, tubular, mass traversing from left caudal abdomen to mid abdomen. Nasogastric intubation obtained 6 L net reflux. A 5 cm diameter small intestinal intraluminal mass was detected by abdominal ultrasound. Complete blood count, serum chemistry and peritoneal fluid analysis were performed and all results were unremarkable. The horse was humanely euthanised due to pain and financial constraints. Post-mortem examination and histopathology revealed a 15 × 5 × 5 cm polyp with multiple smaller satellite polyps that obstructed the distal duodenum. Colic was considered secondary to small intestinal obstruction and luminal distension caused by the adenomatous polyps. To the authors’ knowledge, this is the first report to include ultrasound images of a small intestine adenomatous polyp that caused small intestinal obstruction and colic in a 3-year-old horse.     

Jejunal hemorrhage syndrome in 2 Canadian beef cows

Two beef cows were presented with a history of anorexia and abdominal pain. Both cows were euthanized. Necropsy revealed the presence of a segmental area of ulceration, necrosis, and intraluminal blood clots in the jejunum. Jejunal hemorrhage syndrome is an emerging disease and has not been reported previously in beef cattle.     

Cross-Sectional Imaging Characteristics of Pituitary Adenomas, Invasive Adenomas and Adenocarcinomas in Dogs: 33 Cases (1988–2006)

Background: Pituitary tumors in dogs can be adenomas, invasive adenomas, or adenocarcinomas. In people, invasive adenomas and pituitary adenocarcinomas carry a worse prognosis than adenomas.
Hypothesis/Objective: To identify differentiating features on cross-sectional imaging in dogs with pituitary adenomas, invasive adenomas, and adenocarcinomas.
Animals: Thirty-three dogs that had computed tomography (CT) or magnetic resonance imaging (MRI) performed and a necropsy diagnosis of pituitary adenoma ( n = 20), invasive adenoma ( n = 11), or adenocarcinoma ( n = 2).
Methods: Medical records were retrospectively reviewed for signalment, history, and diagnosis. CT and MR images were reviewed for characteristics of pituitary tumors.
Results: Mean (± standard deviation) age for dogs with pituitary adenomas (10.6 ± 2.9 years) was greater than that of those with invasive adenomas (8.3 ± 2.7 years, P = .04). Eighteen out of 20 (90%) dogs with adenomas had contrast-enhancing masses. Thirteen out of 20 (65%) had homogeneous enhancement. Mean adenoma height was 1.2 ± 0.7 cm. Eight out of 20 (40%) adenomas were round and 8/20 (40%) compressed surrounding brain. Eleven out of 11 dogs (100%) with invasive adenomas had contrast-enhancing masses. Seven out of 11 (64%) masses were homogeneous. Mean invasive adenoma height was 1.8 ± 0.7 cm, which was significantly greater than adenomas ( P = .03). Mass shape varied from round to oval to irregular. Six out of 11 (55%) masses compressed surrounding brain. Clinical and imaging features were variable for 2 dogs with adenocarcinomas.
Conclusions and Clinical Relevance: Invasive adenoma should be suspected if a dog with a pituitary tumor is <7.7 years of age and has a mass >1.9 cm in vertical height. Adenocarcinomas are uncommon and metastatic lesions were not seen with imaging.     

CT features of malignant tubular genital tract tumors in seven goats

Neoplasia of the tubular genital tract in goats, while rarely described, is most commonly reported as uterine adenocarcinoma, leiomyoma, or leiomyosarcoma. In this retrospective, single-center, case series, medical records were searched for goats with a computed tomography (CT) diagnosis of tubular genital mass and a definitive histologic (surgical biopsy or necropsy) diagnosis of malignant neoplasia. Data recorded from CT images were presence of peritoneal/retroperitoneal fluid, urinary tract obstruction, abdominal lymphadenomegaly, additional abdominal nodules/masses, and pulmonary nodules. For masses, maximum cross-sectional area, contrast enhancement, and uterine luminal fluid accumulation were also recorded. Seven goats met the inclusion criteria (leiomyosarcoma n = 5, adenocarcinoma n = 2). Both goats with adenocarcinoma had upper urinary tract obstruction, moderate to severe regional lymphadenopathy, peritoneal fluid, and peritoneal or hepatic nodules/masses; one goat with adenocarcinoma was discharged and subsequently euthanized, and the other had palliative mass debulking and was lost to follow up. Goats with leiomyosarcoma had infrequent, mild peritoneal fluid and mild sublumbar lymphadenopathy. Of the goats with leiomyosarcoma, two were euthanized at or near the time of CT imaging, two were euthanized at the time of surgery due to perceived mass non-resectability, and one had mass regression approximately four months post ovariohysterectomy but was subsequently lost to follow up. Five goats had pulmonary nodules, three of which had pathologic confirmation (pulmonary metastasis in a single patient with adenocarcinoma, and lungworm granulomas in two goats with leiomyosarcoma). Severe sublumbar lymphadenopathy and obstructive uropathy were sequelae in the two caprine patients with genital adenocarcinoma, and in none with leiomyosarcoma.     

Hemorrhagic bowel syndrome in dairy cattle: 22 cases (1997-2000)

OBJECTIVE: To determine signalment, history, and clinical, necropsy, and microbiologic findings in dairy cows with hemorrhagic bowel syndrome. DESIGN: Retrospective study. ANIMALS: 22 adult dairy cows from a single farm in Colorado. PROCEDURE: Medical records were reviewed for information on signalment, medical and reproductive history, the owner's chief complaints, results of physical examinations and ancillary diagnostic tests, treatment and response to treatment, results of microbiologic testing, and, if applicable, postmortem findings. RESULTS: Common clinical signs were acute signs of profound depression, decreased milk production, tachycardia, ruminal stasis, abdominal distention, and dark clotted blood in the feces. Rectal examination revealed distended loops of small intestine in 7 of 14 cows. Transabdominal ultrasonography revealed small intestinal ileus and distention in 12 of 12 cows and homogeneous echogenic intraluminal material compatible with intraluminal hemorrhage and clot formation in 4. Seven of 8 cows treated medically died; 9 of 13 cows that underwent surgery died or were euthanatized. Clostridium perfringens was isolated from fecal samples from 17 of 20 cows. The most common morphologic diagnosis at necropsy was severe necrohemorrhagic enteritis or jejunitis with intraluminal hemorrhage or blood clots. The most prominent histologic finding was severe, segmental submucosal hemorrhage and edema of the small intestine. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirm that in adult cattle, hemorrhagic bowel syndrome is a sporadic acute intestinal disorder characterized by intraluminal hemorrhage and obstruction of the small intestine. Clostridium perfringens was consistently isolated from the feces of affected cows. The prognosis for affected cows was grave.     

Intestinal carcinoid in a mare: an etiologic consideration for chronic colic in horses

Intestinal carcinoid, or argentaffinoma, should be an etiologic consideration for horses with chronic colic. A mare was referred with a history of chronic colic. Previously, the signs of colic had subsided in response to impiric treatment, but recent episodes of colic did not. Clinical signs and results of physical examination supported the finding of strangulating obstruction of the small intestine. Exploratory celiotomy revealed internal herniation with simultaneous volvulus of the jejunum and accompanying carcinoid.     

Intestinal adenocarcinoma in a goat

A 5-year-old Toggenburg doe was examined because of wasting, decreased milk production, and progressive abdominal distention. Abdominal percussion disclosed a prominent fluid wave crossing the abdomen. Physical examination revealed no cardiac abnormalities. Abdominal paracentesis yielded 21 L of modified transudate (protein concentration, 3.6 g/dl; sp gr 1.013; 0.6 X 10(3) nucleated cells/ml) over a 2-hour period. During surgical exploration of the abdomen, dilated loops of intestine covered with 1- to 3-mm firm masses and a larger mass associated with extensive adhesions were found. At necropsy, an annular tumor causing partial obstruction was found in the distal portion of the ileum. The histopathologic diagnosis was adenocarcinoma.     

IMAGING DIAGNOSIS—ULTRASONOGRAPHIC APPEARANCE OF SMALL BOWEL METASTASIS FROM CANINE MAMMARY CARCINOMA

A 10‐year‐old entire female Beagle dog was evaluated for an acute history of lethargy, anorexia, and diarrhea. Mammary tumors were detected during physical examination. Ultrasonographic scanning revealed the presence of a unique pattern of multiple, well‐defined and well‐marginated hypoechoic nodules in the muscularis layer of the jejunum. These nodules were not associated with changes in the rest of the normal intestinal layering and were not causing signs of intestinal obstruction. Mammary carcinoma metastases to the intestinal muscularis layer were diagnosed based on histopathological examination.     

ULTRASONOGRAPHIC DETECTION OF ADRENAL GLAND TUMOR AND URETEROLITHIASIS IN A GUINEA PIG

A 5-year-old guinea pig was presented to the University of Berne Small Animal Radiology Department for an ultrasound examination of the abdomen to confirm a suspected diagnosis of Cushing's syndrome. The patient had bilateral alopecia, was apathic and obese. Ultrasonographically, a tumor of the left adrenal gland, obstruction of the left ureter by an ureterolith, as well as hydronephrosis of the left kidney were detected. During surgery to relieve the ureteral obstruction the adrenal gland tumor was removed. The guinea pig died post-operatively due to blood loss. The left adrenal gland tumor was found histopathologically to be an adenoma and the right adrenal gland also had multiple small adenomas, but grossly appeared normal. The ureterolith was analyzed and found by x-ray diffraction to consist of calcium carbonate.     

Circumferential mural bands in the small intestine causing simple obstructive colic: a case series

REASONS FOR PERFORMING STUDY: Circumferential mural band (CMB) in the small intestine is an emerging condition in Ireland. The clinical presentation is a simple obstruction of the small intestine of unknown aetiology. HYPOTHESIS: Horses affected with CMB in the small intestine have a good prognosis following surgical decompression into the caecum. METHODS: A retrospective study was carried out and 28 cases identified from 559 colic surgeries performed over a 5.5 year period. An exploratory celiotomy was performed in every case. A simple obstruction at the mid or distal jejunum was identified caused by a CMB, which was multiple in some cases. All of the horses except 2 had undergone a regular anthelmintic programme. RESULTS: Manual decompression of the small intestine into the caecum resulted in resolution of the simple jejunal obstruction. A constricted segment of small intestine was resected in one case, as the degree of constriction was severe. A full thickness biopsy was taken from another case. Histopathology was performed on both samples. All horses recovered from surgery and were discharged from the hospital 7-32 days post operatively. Short-term complications were observed. Survival rate was 100% at long-term follow-up. Histopathology showed inflammatory infiltration in the submucosa, muscularis and serosa with eosinophils predominating. Parasites were not detected. CONCLUSION AND POTENTIAL RELEVANCE: Small intestine circumferential mural bands have a good prognosis after surgical decompression of the small intestine into the caecum.     

Use of an extracorporeal circuit to evaluate effects of intraluminal distention and decompression on the equine jejunum

OBJECTIVE: To use an extracorporeal circuit to evaluate effects of intraluminal distention on the jejunum of healthy horses. SAMPLE POPULATION: 2 jejunal segments from each of 5 horses. PROCEDURE: Jejunal segments were harvested and maintained in an extracorporeal circuit. One segment was subjected to distention (intraluminal pressure, 25 cm H2O) followed by decompression, and 1 segment was maintained without distention. The influence of distention-decompression on vascular resistance was calculated. Mucosal permeability was evaluated by measuring the clearance of albumin from blood to lumen. After distention and decompression, tissue specimens were collected for histomorphologic evaluation. In addition, the contractile response of the circular smooth muscle layer was determined following incubation with 3 prokinetic agents. RESULTS: Intestinal vascular resistance increased during intraluminal distention and returned to baseline values after decompression. Albumin clearance rate increased after distention, compared with baseline and control values. Histologic examination of the distended segments revealed grade-1 and -2 lesions of the mucosal villus. Edema and hemorrhage were evident in the submucosa and muscular layers. Mesothelial cell loss, edema, and hemorrhage were also evident in the serosa. Mucosal surface area and villus tip height decreased and submucosal volume increased in the distended tissue. Compared with responses in control specimens, distention decreased the contractile response induced by cisapride, erythromycin, and metoclopramide. CONCLUSIONS AND CLINICAL RELEVANCE: Intraluminal distention of the jejunum followed by decompression increased mucosal permeability and injury and decreased responses to prokinetic agents. Horses with intraluminal intestinal distention may have a decreased response to prokinetic agents.