Feline urological syndrome

CASE HISTORY: Torsion of the descending colon was diagnosed by barium enema radiography in an adult Irish Water Spaniel which had presented with tenesmus of 24 h duration. Treatment involved exploratory laparotomy, repositioning of the colon, colopexy and repair of a mesenteric rent. No definitive cause of the torsion could be established. The dog made an uneventful recovery from surgery.

CLINICAL RELEVANCE: Animals presenting with constipation of undetermined cause should have large intestinal obstruction ruled out prior to administering bowel cleansing solutions per os and/or colonic enemas. Colonic obstruction by torsion should be considered as a possible differential diagnosis in all cases of tenesmus.     

Obstruction of the descending colon due to torsion of the cecum through a mesocolic defect in a cow

A cow was evaluated for acute onset of abdominal pain and decreased milk production. Physical examination revealed narrowing of the descending colon. Exploratory laparotomy revealed mesocolic defect and torsion of the cecum around the descending colon. After surgical correction of the cecal torsion, the cow recovered rapidly. The mesocolic defect could not be closed, and the history did not indicate a cause for the mesocolic defect.     

Longitudinal colonic torsion as a cause of tenesmus in an adult Irish Water Spaniel

CASE HISTORY: Torsion of the descending colon was diagnosed by barium enema radiography in an adult Irish Water Spaniel which had presented with tenesmus of 24 h duration. Treatment involved exploratory laparotomy, repositioning of the colon, colopexy and repair of a mesenteric rent. No definitive cause of the torsion could be established. The dog made an uneventful recovery from surgery. CLINICAL RELEVANCE: Animals presenting with constipation of undetermined cause should have large intestinal obstruction ruled out prior to administering bowel cleansing solutions per os and/or colonic enemas. Colonic obstruction by torsion should be considered as a possible differential diagnosis in all cases of tenesmus.     

CT findings in five dogs with surgically confirmed colonic torsion

Colonic torsion is a life‐threatening condition that results in colonic ischemia, necrosis, perforation, sepsis, and eventual death. The aim of this multicenter, retrospective case series study was to describe the CT findings in dogs with surgically confirmed colonic torsion. Medical records were searched for dogs with surgically confirmed colonic torsion following abdominal CT. Five dogs met the inclusion criteria. Three had a history of chronic intermittent diarrhea prior to presentation. Two dogs presented with acute vomiting, diarrhea, and abdominal pain and one dog presented with acute vomiting and lethargy. Computed tomographic findings in all dogs with surgically confirmed colonic torsion include: “whirl sign,” displacement and distension of the cecum and colon, focal narrowing of the colon, and distension of the mesenteric vasculature in all dogs (5/5); streaky peritoneal fat and peritoneal effusion (4/5), pneumatosis coli (2/5), small intestinal distension (2/5), portal vein thrombosis (1/5), and reduced colonic wall contrast enhancement (1/5). In all dogs (5/5), the torsion site was the descending colon and demonstrated an anticlockwise rotation. At surgery, three of the five dogs had a partial colonic torsion with hyperemia at the site of obstruction and two of the five dogs had a complete torsion with marked necrosis of the colonic wall. Displacement of the colon and cecum, segmental distension and focal narrowing of the colon, the presence of a “whirl sign” and distension of the mesenteric vasculature are CT findings highly suggestive of colonic torsion.     

Partial colonic obstruction following ovariohysterectomy: a report of three cases

Partial extramural obstruction of the descending colon was diagnosed in two dogs and a cat as a complication of elective ovariohysterectomy. In each case, the obstruction was caused by fibrous tissue that encircled or crossed the descending colon, severely restricting the organ's normal mobility and luminal diameter. Clinical signs secondary to obstipation were observed in two cases, five weeks and 27 months after elective ovariohysterectomy. In one dog without clinical signs, the adhesion was an incidental finding during a laparotomy performed nine years after the ovariohysterectomy. The fibrous adhesions were removed surgically in all three cases without additional complications.     

Radiographic findings and clinical factors in dogs with surgically confirmed or presumed colonic torsion

Colonic torsion is a life‐threatening condition in dogs and radiographic findings for this condition have not been well described. The purpose of this retrospective case series was to describe radiographic findings and clinical signs in a group of dogs with colonic torsion. Inclusion criteria were dogs presenting during the period of 2006 and 2016, and that had abdominal radiography and a surgically confirmed or presumed diagnosis of colonic torsion. For each dog, clinical data were recorded from medical records and imaging findings were recorded from retrieved plain radiographs and positive contrast radiographs in which barium enema was performed. Fourteen dogs met inclusion criteria. Of these, nine dogs had colonic torsion confirmed at surgery, with five dogs having surgical confirmation of colonic congestion or mesenteric torsion. Radiographic findings included segmental distention of the colon (14/14), focal narrowing of the colon (11/14), displacement of cecum (11/14), displacement of descending colon (14/14), and mild to no small intestinal distention (14/14). In cases where barium enema was performed, focal narrowing of the colon and longitudinal striations that course in a helical pattern were identified, termed the “torsion sign.” Vomiting was the most common clinical sign observed (12/14), followed by abdominal pain in a small majority of cases (8/14). Severe abdominal pain and hypovolemic shock were uncommon in the patients reported (3/14). Colonic torsion should be considered as a differential diagnosis for dogs with radiographic segmental colonic distention with displacement of the descending colon and cecum. Barium enema is recommended for more definitive diagnosis.     

Obstruction of the Ascending Colon in Cattle: I. Clinical Presentation and Surgical Management

Obstruction of the spiral loop of the ascending colon (spiral colon) due to adhesions causing extraluminal constriction was diagnosed in 8 cows during a 2-year period. The adhesions resulted from intraperitoneal injections in 7 cows and from previous intra-abdominal surgery in the 8th. Surgical correction was performed in 4 of the cows by uniting the bowel proximal and distal to the obstruction, thus creating an intestinal bypass. Approximately half of the large intestine was bypassed in this manner in 3 cows; all but a portion of the descending colon and rectum was bypassed in the 4th. Each of the cows survived surgery, although 1 died 30 days later, possibly as a result of a second obstruction caused by further adhesions. Appetite, general physical condition, and milk production returned after celiotomy and intestinal bypass. Feces were loose after operation but gradually firmed to near-normal consistency in 3 of the cows.     

Sand colic in a mule: A case report

A 25-year-old mule was showing signs of colic. Clinical examination revealed acute pain, bilateral abdominal distention, stretching out and standing in this position. Rectal palpation revealed a hardened mass in the ventral region of the pelvic inlet. Surgical intervention was accomplished and faecaliths removed by colotomy. The mule died unexpectedly and postmortem examination revealed sand masses within the right ventral and right dorsal colon which caused obstruction of the intestinal tract in sternal and diaphragmatic flexures, respectively. This appears to be the first report of sand colic in a mule in Iran.     

Clinical evaluation of serum alcohol dehydrogenase activity in horses with acute intestinal obstruction

Objectives – To measure serum alcohol dehydrogenase (ADH) activity in horses with acute intestinal obstruction and to determine the diagnostic and prognostic utility of this analyte. Design – Prospective observational study. Setting – University Veterinary Hospital. Animals – Thirty healthy horses (control group) and 77 horses with acute intestinal obstruction, including 36 horses with nonstrangulating obstruction (23 with left ventral colon impaction and 13 with left dorsal displacement [G1], 22 with small intestinal strangulation [G2], and 19 with colon torsion [G3]). Interventions – Serum ADH activity was assayed spectrophotometerically in all horses. Serum lactate concentration and hepatic enzyme (aspartate aminotransferase, gamma‐glutamyl transferase, glutamate dehydrogenase) activities were measured using an automatic analyzer. Measurements and Main Results – The median [interquartile range] serum ADH activity in healthy horses was 10.5 [8.7 – 11 U/L]. ADH activity was significantly increased (P<0.05) in G1=16.5 [13.8 – 18 U/L], G2=40 [20 – 74.9 U/L], and G3=63.2 [40 – 78 U/L] compared with healthy controls. Aspartate aminotransferase and glutamate dehydrogenase activities were also significantly increased in G3 in comparison with controls. ADH activity was correlated with serum lactate concentration in G1 and G3, respectively (P<0.01, r=0.55 and 0.8). Other liver enzymes did not show any significant correlation with lactate. ADH activity was directly related to the probability of strangulation; odds ratio=1.11. ADH activity >20 U/L had 80.6% specificity and 80.5% sensitivity for discriminating horses with strangulating obstruction. Twelve horses euthanized before surgery were excluded from the outcome analysis. Increasing ADH activity was associated with nonsurvival; odds ratio=1.03. ADH activity <80 U/L had 94.44% specificity and 66.67% sensitivity for survival. Conclusion – Serum ADH activity may be a useful clinical parameter in detecting intestinal strangulation in horses and may provide some prognostic value in horses with acute intestinal obstruction.     

Acute colic possibly caused by phytobezoar derived from napier grass in 5 Japanese black cows reared in the same farm

For 6 years, 5 Japanese Black cows of the same herd showed anorexia, depression, and dehydration with no feces in the rectum. Biomedical examination of 3 animals showed severe hypokalemia and hypochloremia. Although the first 3 animals died or were slaughtered (causes unknown), necropsy results showed that the cow in case 4 had intestinal obstruction due to phytobezoar derived from napier grass, fed mainly to the cattle as roughage. Therefore, farmers were recommended to avoid the hard root-stem portion of napier grass as roughage. Consequently, less phytobezoar was recovered from the fifth cow, and no similar clinical case of intestinal obstruction was observed thereafter. This is the first report on intestinal obstruction caused by phytobezoars derived from napier grass.     

Intestinal atresia and ectopia in a bovine fetus

A 2-year-old Red Holstein cow was presented with uterine torsion at 235 days of pregnancy. The fetus extracted by cesarean section had weak vital signs and marked abdominal distention. An edematous pouch that contained tubular structures with peristaltic activity was associated with the umbilical cord. Because of poor prognosis, both dam and fetus were euthanized. At necropsy, the fetus had severe distention of the forestomachs, abomasum, and proximal small intestine; absence of distal small intestine, cecum, and proximal colon; atresia of the 2 blind ends of the intestine; and atrophy of distal colon and rectum. The tubular structures associated with the umbilical cord were identified as the segments of intestine that were absent in the fetus. Intestinal atresia combined with ectopia may be caused by local ischemia during temporary herniation and rotation of the fetal gut into the extraembryonic coelom. The close connection between ectopic intestine and amniotic sheath of the umbilical cord in this case may have facilitated vascularization and allowed development and viability of the ectopic intestine.     

Intraluminal hemorrhage from small intestinal ulceration in two cows.

Two adult Holstein cows were admitted with signs of acute gastrointestinal hemorrhage. Abomasal ulceration was diagnosed tentatively in both cows, but was later ruled out in 1 cow that had an abomasotomy performed through a right paramedian approach. Both cows failed to respond to treatment of blood loss and hypovolemic shock and became recumbent; one cow died and the other was euthanatized. Post-mortem examination determined the source of hemorrhage in both cows to be ulcerated small intestine with severe intraluminal hemorrhage. The cause of ulceration was undetermined. Small intestinal hemorrhage should be considered in cattle with signs of acute gastrointestinal hemorrhage.     

Surgical treatment of noncommunicating duplication of the colon in a dog

A 4-month-old sexually intact male Jack Russell Terrier was evaluated because of stranguria and tenesmus. A tubular abdominal mass was palpable abdominally and rectally. Radiographic examination of the abdomen revealed a soft tissue mass located laterally and to the left of the descending colon, which was associated with extraluminal colonic obstruction and urethral compression. During abdominal exploratory surgery, a large cystic mass that was adhered to the antimesenteric border of the descending colon was removed. Porcine small intestinal submucosa was used to reinforce repair of the excision site. Histologic examination of samples of excised tissue identified normal colonic epithelium supported by submucosa and muscular tunics, which was consistent with duplication of the colon. The embryologic etiology of alimentary duplication is poorly understood, and colonic duplication is an extremely rare congenital anomaly.     

Torsion and volvulus of the transverse and descending colon in a German shepherd dog

A German shepherd dog was presented two months after surgery for correction of acute gastric dilatation volvulus. The dog had been diagnosed with exocrine pancreatic insufficiency. Radiographs revealed marked gaseous distension of one loop of intestine with a generalised increase in intestinal gas content. A 360 degrees anticlockwise rotation of the descending and transverse colon, around the longitudinal axis of the mesocolon, was diagnosed at exploratory coeliotomy. The transverse and descending colon appeared uniformly necrotic and an end-to-end colo-colic resection and anastomosis was performed. The dog initially made satisfactory postoperative progress but was euthanased on the third postoperative day after it developed an intestinal intussusception.     

Results of surgical treatment of colic in miniature breed horses: 11 cases

OBJECTIVE: To report on the outcome of surgical treatment of acute abdominal crises in miniature breed horses. DESIGN: Retrospective case series of miniature horses presented to the University Veterinary Centre, Camden with an acute abdominal crisis. METHODS: Hospital records of all miniature horses that underwent ventral midline laparotomy for acute abdominal crisis between 1997 and 2001 were reviewed. The signalment, history, clinical signs, results of ancillary diagnostic procedures, location and type of intestinal lesion, treatment and outcome were retrieved from each case record. Long-term survival was determined by telephone interview of owners. RESULTS: Eleven miniature horses including five females and six males underwent ventral midline laparotomies for acute abdominal crisis during the study period. Ages ranged between 1 month and 19 years. Surgical findings included faecalith obstruction (seven horses), enterolith (one horse), strangulating lipoma of the descending colon (one horse), jejunal infarction (one horse), and caecal infarction (one horse). Long-term survival rate (minimum 12 months post surgery) was 55%. Six of eight horses with simple intraluminal obstructions survived, while the three horses with gastrointestinal lesions associated with vascular compromise were euthanased either at surgery (caecal infarction), or postoperatively, due to complications (strangulating lipoma of the descending colon, jejunal infarction). Postoperative complications in this study included impaction of the descending colon (two horses), diarrhoea (two horses), peritonitis (one horse), hyperlipaemia (two horses), incisional infection (two horses) and abdominal adhesions (one horse). Hyperlipidaemia was present in five of seven horses in which serum triglycerides were measured at presentation. CONCLUSIONS: Simple intraluminal obstructions of the large intestine were frequently encountered during exploratory laparotomy in miniature horses presented for acute abdominal crises, and their surgical treatment was associated with a good prognosis. In contrast, this study suggested that abdominal pain associated with vascular compromise of gastrointestinal tissues in miniature horses was associated with a poorer prognosis, consistent with reports in other horse breeds. Possible contributing factors to faecalith formation, including poor quality roughage, dental disease, and inadequate water consumption, should be recognised and avoided in miniature horses. Serum triglyceride concentrations should be measured in miniature horses presented for acute abdominal pain. If elevated, nutritional supplementation should be provided.     

CONTRAST RADIOGRAPHY OF THE GASTROINTESTINAL TRACT IN SEA TURTLES

Intestinal obstruction by radiolucent foreign bodies is common in sea turtles. The absence of clinical signs and the extended fasting periods in these animals means that intestinal obstructions may not be diagnosed early. Digestive tract radiographic contrast procedures were performed to evaluate the gastrointestinal transit time and intestinal obstructions in loggerhead sea turtles. Barium sulfate and nonionic iodinate contrast medium were used for radiographic contrast procedures. Contrast medium was administered via a gastric tube or into the colon. These procedures are often necessary and are useful to document intestinal obstruction and foreign objects. The diagnostic procedures were not easily performed in some turtles, but often they were adequate for the diagnosis.     

Surgical Removal of a Descending (Small) Colon Foreign Body through a Secondary Paramedian Approach

Intestinal obstruction due to foreign body ingestion is one cause of colic in horses. Although it occurs more frequently in juveniles, adult horses also may be affected. The small colon is a common location in which foreign bodies can be found. Depending on the location of the obstruction in the small colon, different techniques to dislodge the foreign body toward areas where it can be safely exteriorized and removed can be attempted. Alternatively, different approaches to the abdomen can be performed to facilitate exteriorization of the obstructed segment and removal of the foreign body. This paper describes a case of large and small colon obstruction in an adult horse caused by two distinct foreign bodies. The large colon obstruction was removed through a pelvic flexure enterotomy using the ventral midline approach, and the small colon obstruction was removed through a small colon enterotomy using a paramedian approach. Information regarding signalment, history, clinical signs, surgical treatment, and follow-up status of the horse are described.     

Salmonellosis in a herd of beef cows

Two postparturient beef cows in a herd of 30 developed acute enteritis, with pyrexia and bloody diarrhea containing intestinal casts. Salmonella typhimurium phage type 66 was isolated from feces of both animals; both recovered after treatment with tetracycline. A third cow had died without treatment after showing similar signs.     

Obstruction of the small intestine by a trichobezoar in cattle: 15 cases (1992-2002)

OBJECTIVE: To determine historical and clinical findings, treatment, and outcome for cattle with small intestinal obstruction caused by a trichobezoar. DESIGN: Retrospective case series. ANIMALS: 15 cattle. PROCEDURES: Medical records of cattle with a diagnosis of small intestinal obstruction by a trichobezoar from 1992 to 2002 were reviewed. Information pertaining to various aspects of diagnosis, treatment, and outcome was collected from records. RESULTS: Trichobezoars were more common in young cattle, and affected cattle did not deteriorate clinically as rapidly as cattle with other types of intestinal obstruction. The most common initial owner complaints included decreased or absent fecal output, inappetance, abdominal distension, and signs of abdominal pain. Common clinical findings were dehydration, decreased or absent rumen motility, signs of depression, splashing sounds during succussion of the abdomen, and a pinging sound on percussion of the abdomen. The jejunum was obstructed in 10 cattle. Hypochloremic metabolic alkalosis and chronic inflammation were common laboratory findings. All 4 cattle that underwent abdominocentesis had peritonitis. The obstructing trichobezoar was removed surgically in 9 cattle, of which 7 survived and 2 died. The 6 cattle treated medically died or were euthanized. CONCLUSIONS AND CLINICAL RELEVANCE: Obstruction of the small intestine by a trichobezoar is uncommon, but it should be considered as a differential diagnosis in cattle with signs of intestinal obstruction, particularly if they are younger than 4 years of age and have a history of nonacute signs of intestinal obstruction. Surgical removal appears to be a favorable method of treatment and should be considered when this condition is suspected.     

Redgut in sheep: A disease with a twist

Redgut is a condition of sheep characterised by sudden death. Post-mortem findings are reddened small and large intestines, which are usually displaced. Sheep are predisposed to the condition by a combination of circumstances, including a small rumenoreticulum because of the nature of the feed (usually highly digestible forage), and increased large intestinal size and function. To accommodate this, and because there is not a large rumenoreticulum to stabilise the gut position, the intestinal mass moves to an unstable position in the peritoneal cavity. Some unknown event precipitates a further change in intestinal position, resulting in accidental torsion of the intestinal mass, with resultant obstruction of the mesenteric blood vessels and death from shock.

The condition can be prevented by careful attention to feeding regimes that prevent development of the predisposing feature of small forestomachs and an oversized large intestine, resulting in a displaced intestinal mass. This is achieved by intermittent grazing of “dangerous” pastures.