Cecal inversion and subsequent colocolic intussusception in a red wolf (Canis rufus gregoryi).

A 2-yr-old female red wolf (Canis rufus gregoryi) presented with weight loss and diarrhea. Abnormal clinical pathology included low serum calcium, sodium, chloride, globulin, and albumin levels. Differential diagnosis included infectious enteritis, intestinal parasitism, inflammatory bowel disease, hepatic or renal disease, and malnutrition. The wolf was treated empirically, but did not improve. A second examination revealed persistent poor musculature and stool quality. Abdominal palpation revealed a firm mass; contrast radiography confirmed an intussusception. Exploratory laparotomy revealed a colocolic intussusception involving the cecum. Following reduction of the colocolic intussusception, cecal inversion (cecocolic intussusception) was identified. Because the cecal inversion could not be reduced, typhlectomy was performed through a colotomy incision. Bacterial culture of peritoneal fluid yielded two strains of Escherichia coli. Postoperatively, the wolf was placed on antibiotics and a soft diet. The diet was gradually returned to its normal formulation and the wolf progressively gained weight. Physical examination 7.5 mo following initial presentation revealed normal body weight and condition. To our knowledge, this is the first recorded incidence of cecal inversion with concurrent colocolic intussusception.     

Chronic ileocecal intussusception in horses

Ten young horses with signs of simple partial obstruction of the small intestine were found upon surgical exploration of the abdomen to have chronic intussusception of the distal ileum into the cecum. Poor general physical condition, intermittent or continual abdominal pain of varying degree, depression, and poor appetite were consistent clinical findings. Rectal palpation in eight animals was suggestive of an incomplete or intermittent obstruction of the small intestine. Laboratory determinations were not helpful in making a diagnosis. Dilatation and hypertrophy of the distal jejunum and ileum were associated surgical findings indicating chronicity of the problem. Surgical correction utilizing an end-to-side or a side-to-side anastomosis of small intestine to cecum resulted in recovery in 7 of 8 cases which could be followed long term. Failure to resect the abnormal segment of small intestine did not affect the outcome.     

Obstruction of the cecocolic orifice by ileocecocolic intussusception following jejunocecostomy in a horse

A 4-year-old Thoroughbred stallion was referred for signs of mild to moderate colic, anorexia, and decreased water intake of 3 weeks' duration. Ultrasonographic examination revealed an intussusception, the most common of which would be a cecal inversion or ileocecal intussusception. Surgical exploration identified an ileocecocolic intussusception with extension of the intussusceptum into the right ventral colon; however, the cause of the intussusception could not be identified. The intussusception could not be surgically corrected, and the horse was euthanatized. A side-to-side jejunocecostomy that had been performed previously was identified at necropsy. The ileal stump had intussuscepted into the right ventral colon and become hypertrophied, causing partial obstruction of the cecocolic orifice and clinical signs of colic. In horses requiring an ileocecal or jejunocecal anastomosis, the ileal stump may be left to slough within the cecum as part of the treatment for an irreducible ileocecal intussusception or intentionally inverted into the cecum when the ileal stump is necrotic and cannot be exteriorized and resected. Efforts should be made to minimize the size of the ileal stump to reduce the liklihood of intussusception.     

Cecal amputation within the right ventral colon for surgical treatment of nonreducible cecocolic intussusception in 8 horses

OBJECTIVES: To report a surgical technique for treatment of nonreducible cecocolic intussusception and outcome in 8 horses. STUDY DESIGN: Retrospective study. ANIMALS: Eight horses with nonreducible cecocolic intussusception treated by cecal amputation through a right ventral colotomy. METHODS: Data were obtained from medical records and telephone conversations by using a standardized questionnaire. The large colon was exteriorized and, if necessary, evacuated of its contents through a pelvic flexure enterotomy. A second colotomy was made on the ventral surface of the right ventral colon (RVC) centered over or immediately distal to the intussusceptum. In most horses, attempts to manually reduce the intussusception by pushing the cecum from within the RVC through the cecocolic orifice were unsuccessful. Invaginated cecum was then pulled into the RVC and amputated; the cecum was either ligated with umbilical tape or sutured proximal to the site of amputation. After amputation, the remainder of the invaginated cecum was reduced. After further resection to healthy tissue, the typhlectomy was closed with a double-inverting suture pattern. RESULTS: The median horse age was 2 years (range, 1 to 8 years). Duration of colic ranged from 6 hours to 6 months. Median surgical time was 180 minutes (range, 135 to 300 minutes). Median duration of antibiotic therapy was 7 days (range, 5 to 14 days). Median duration of hospitalization was 12 days (range, 6 to 21 days). All horses survived to hospital discharge. One horse died 3 months postoperatively; however, the remainder survived (median survival, 30 months; range, 6 to 96 months) and returned to or exceeded previous function. CLINICAL RELEVANCE: Despite some contamination during surgery, horses with nonreducible cecocolic intussusception that underwent this method of surgical treatment had a good prognosis.     

Cecal inversion followed by ileocolic intussusception in a cat

A cat was presented with a history of constipation, tenesmus, and malaise. Ultrasonography revealed an ileocolic intussusception and cecal inversion. Surgical findings included an easily reducible intussusception and an inverted cecum that was moderately difficult to reduce. A typhlectomy and bowel plication was performed. The cat had an uneventful recovery.     

Canine coccidiosis attributed to an Isospora ohioensis-like organism: a case report

Coccidiosis due to an Isospora ohioensis-like organism was diagnosed in a 10-week-old pup. The pup had diarrhea, dehydration, and weight loss before it died 7 days after onset of clinical signs. Lesions were limited to the intestinal tract. Beginning in the distal end of the small intestine and extending through cecum and colon were mild histiocytic proliferation in the lamina propria and multifocal cryptitis. Numerous meronts and gamonts of an unidentified coccidium were in or near the lesions. Parasites were in the villous epithelium, lamina propria, and intestinal glands of the distal one-half of the small intestine, cecum, and colon. It was concluded that infection was due to an unidentified coccidium with oocysts structurally similar to those of I ohioensis.     

Effect of feed particle size and feed processing on morphological characteristics in the small and large intestine of pigs and on adhesion of Salmonella enterica serovar Typhimurium DT12 in the ileum in vitro

A 2 x 2 factorial experiment with pigs was undertaken to investigate the effect of particle size (fine and coarse) and feed processing (pelleted and nonpelleted) on morphological characteristics in the small intestine, cecum, and colon of pigs and on the adhesion of Salmonella enterica serovar Typhimurium DT12 to the ileum in vitro. Ninety-six pigs (average BW = 33 +/- 7 kg) were fed the experimental diets. After 4 wk, 24 pigs were selected (six pigs per diet) and euthanized, and tissue samples were taken from the mid and distal small intestine, cecum, and distal colon. The effects of particle size and feed processing on villus height and crypt depth in the small intestine were minor. Feeding coarse diets increased (P = 0.05) the crypt depth in the colon. The crypt depth was 420 +/- 12 and 449 +/- 12 microm in pigs fed finely and coarsely ground feed, respectively. Pigs fed pelleted diets had a larger (P = 0.01) staining area for neutral mucins, as well as for acidic and sulfomucins on the villi of the distal small intestine than pigs fed nonpelleted diets. The area was 41, 46, and 33% larger for neutral, acidic, and sulfomucins, respectively. The mucin-staining areas of the crypts in the cecum and the colon were not affected by the experimental diets. Examination of lectin binding characteristics of the distal small intestine and the cecum did not reveal any differences between the experimental diets. Using a pig intestine organ culture model, Salmonella adhered less (P < 0.05) to the ileal tissue of pigs fed the nonpelleted diets than to those fed pelleted diets; the adherence was 60% less in these pigs. Results of this study suggest that pigs fed pelleted diets secrete mucins that are capable of binding Salmonella enterica serovar Typhimurium DT12 and thereby allowing for colonization. Therefore, pigs fed a nonpelleted diet are better protected against Salmonella infections than pigs fed a pelleted diet.     

Use of cecal bypass via side-to-side ileocolic anastomosis without ileal transection for treatment of cecocolic intussusception in three horses

CASE DESCRIPTION: 3 horses were evaluated for signs of colic; cecocolic intussusception was detected. CLINICAL FINDINGS: Abnormalities detected included diminished intestinal sounds, inflammatory leukogram, dehydration, unremarkable fi ndings via rectal palpation, and ultrasonographic evidence of large intestine intussusception. Laparotomy revealed cecocolic intussusception. TREATMENT AND OUTCOME: Cecal bypass via side-to-side ileocolic anastomosis without ileal transection was performed in each horse by use of an intraluminal anastomosis stapler device. Postoperative complications were minimal, and all horses recovered rapidly and were clinically normal at > 12 months after surgery. CLINICAL RELEVANCE: Cecal bypass via side-to-side ileocolic anastomosis without ileal transection seemed to offer 2 potential advantages over traditional surgical techniques for treating this condition. The risk of abdominal contamination was far less than with techniques in which the colotomy is needed to enable resection of the cecum or techniques in which the ileum is transected. Also, it was technically simpler to perform because there was no need to transect the ileum, oversew the ileal stump, perform cecal resection, or close the mesenteric space created by relocating the jejunal stump to the right ventral colon.     

Variability in the localization of cryptosporidia in the intestines of spontaneously infected calves

31 to 37 localities were examined in the small and large intestines of 48 calves spontaneously infected with cryptosporidiosis. It was found that cryptosporidia occurred the most frequently in the distal part of small intestine, within the range of six metres of small intestine, in front of the ostium ileocecale (OIC); at the ileocecal valve the incidence of cryptosporidia dropped rapidly. In none case were the protozoans revealed in duodenum and in the adjacent four to six metres of proximal jejunum. The small intestine was invaded by cryptosporidia in a variable manner, in some cases a major part was continuously invaded, in other cases only one or two metres of distal jejunum without any changes in the ileum and vice versa. Approximately half the calves had cryptosporidia in the cecum, fewer cryptosporidia were found in the transverse colon. Cryptosporidia in the rectum were found in about 25% of cases. Some calves had cryptosporidia only in the large intestine. The intensity of the mucous membrane invasion varied: mass incidence of cryptosporidia was found only in caudal parts of small intestine, with high variability of the extent and with sudden cases of negative findings. In the large intestine only the cecum was invaded more intensively and in a diffusive manner, in the transverse colon and in the rectum the groups of parasites were usually found at the openings and in the wall of Lieberk uhn 's crypts.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM

A 3‐year‐old spayed female dog was presented with 3‐month history of severe bilateral uveitis subsequent to previous ovariohysterectomy. Physical examination revealed moderate abdominal pain. Computed tomography showed a nonobstructive heterogeneous mass‐like lesion with a speckled gas pattern (spongiform pattern) within the cecum. Exploratory laparotomy revealed a surgical swab in the lumen of the cecum with severe adhesions. Histopathological examination demonstrated a chronic inflammatory pyogranulomatous reaction to the retained swab embedded within the intestinal wall, consistent with transmural migration of the swab from the peritoneal cavity into the cecum.     

Double intussusception fatally complicated by clostridial infection in a dog (a case report)

A 10-month-old Alsation dog with history of anorexia, diarrhoea, dehydration and vomition developed a double intussusception which affected the distal jejunum and proximal ileum. Necropsy revealed the intussusception to be swollen and congested with fibrinous adhesions between the intussusceptum and intussuscepiens. Two pieces of bone believed to be the inciting cause were found within the intussusceptum. Clostridium welchii and Clostridium bifermentans were isolated from the lesions.     

Jejunal myxoma as a cause for jejunoileo‐caecal intussusception in a horse

A 17‐year‐old gelding was presented with mild to moderate signs of colic. Exploratory laparotomy revealed an intussusception of ileum and jejunum into the caecum. The starting point of the intussusception was an intramural mass in the jejunum. Half a metre of jejunum was resected and the horse recovered without complications. Histopathology and immunohistochemistry revealed a myxoma with no myogenic or neurogenic origin.     

Gastroduodenal intussusception in a young dog

A 21-month-old German shepherd crossbreed presented with a nine-month history of intermittent vomiting, anorexia and melaena interspersed with periods of clinical normality. Investigations suggested recurrent pancreatitis and the vomiting resolved with supportive therapy but recurred two weeks later. Abdominal radiographs revealed evidence of an intermittent abdominal mass which, on uitrasonography, had the typical appearance of an intussusception. At laparotomy, a gastroduodenal intussusception was found obstructing the pancreatic and bile duct outflows with perforation of the duodenal wail. The dog was euthanased. Postmortem examination and histology showed no obvious cause for the intussusception but confirmed pancreatic involvement. This is believed to be the first case of gastroduodenal intussusception reported in an animal.     

Ileocecal intussusception corrected by resection within the cecum in two horses.

Irreducible ileocecal intussusceptions pose a difficult surgical problem. Strangulating ileocecal intussusceptions involving the ileum and jejunum were identified in 2 horses undergoing exploratory laparotomy because of colic. Surgical correction in both horses was achieved by amputation of the ileocecal intussusception from within the cecal lumen, via typhlotomy. The inverted ileal stump was blindly stapled near the ileocecal orifice after pulling the intussusceptum into the cecum. A jejunocecostomy was performed to reestablish intestinal continuity.     

Rectal prolapse of an ileocaecal neoplasm associated with intussusception in a cat

Intussusception associated with lymphoma of the ileocaecocolic junction was diagnosed in a 12-year-old female domestic short-haired cat that presented with a 3-week history of diarrhoea and a protruding anal mass. Surgical exploration revealed an ileocolonic intussusception proximal to the mass at the ileocaecal junction which was excised. A diagnosis of ileocaecocolic lymphosarcoma was made and euthanasia was later performed. This is an unusual case of an ileocaecal junction tumour that manifested as a rectal prolapse associated with intussusception in a cat.     

Small colon intussusception in a broodmare

A 9-year-old pregnant Standardbred broodmare was evaluated for signs of mild abdominal pain, failure to defecate, and mild abdominal distention. Rectal examination revealed the leading edge of a small colon intussusception, and peritoneal fluid analysis indicated suppurative peritonitis. Surgical management, including reduction of the intussusception and small colon resection with end-to-end anastomosis, resulted in successful outcome (1-year follow-up evaluation). Postoperative complications including dehiscence of the ventral midline surgical incision and simple obstruction at the anastomosis site necessitated a second surgical procedure. Small colon intussusception is an uncommon cause of signs of abdominal pain and is similar to type-IV rectal prolapse.     

Pylorogastric intussusception in the dog: a case report and literature review

A 10-month-old, neutered male Saint Bernard presented for evaluation of acute, severe vomiting. A soft-tissue mass was noted within the stomach on survey abdominal radiographs. The diagnosis of pylorogastric intussusception was made during exploratory celiotomy. The intussusception was manually reduced at surgery, the pyloric antrum was enlarged, and the duodenum was permanently affixed to the abdominal wall in an attempt to prevent recurrence of the intussusception. The dog recovered, has gained weight (5 kg), and has had only one isolated episode of vomiting during the one year since discharge from the hospital. This report documents the fourth reported case of pylorogastric (i.e., duodenogastric, gastrogastric) intussusception in the veterinary literature and is the first report that details the surgical management of the disease.     

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.     

GASTROGASTRIC INTUSSUSCEPTION IN A DOG

A three-year-old, intact male, Rottweiler is presented with a gastrogastric intussusception. This is one of only two known reports of gastrogastric intussusception in the dog. Lateral and ventrodorsal radiographs and ultrasound revealed a gastric mass, however the diagnosis of gastrogastric intussusception was made during surgery. The patient in this report had no associated tumor and the pyloric antrum was the intussusceptum. Cause of the intussusception is unknown.