Ultrasonographic and surgical findings of a gastric hyperplastic polyp resulting in pyloric obstruction in an 11-week-old French Bulldog

An 11-week-old male entire French Bulldog was presented with a 3-week history of projectile vomiting after eating that was unresponsive to medical therapy. Ultrasonographic examination revealed a 1 × 2 cm pedunculated polypoid mass in the pyloric antrum. Histopathology showed this to be comprised of a pedunculated hyperplastic proliferation of gastric mucosal epithelium and submucosa, with dilatation of the glandular pits and a moderate degree of submucosal fibrosis and small amount of smooth muscle hyperplasia in the submucosa. The tunica muscularis was not involved in the polyp and appeared to be of normal thickness. Surgical treatment by pylorectomy and end-to-end gastroduodenostomy (Billroth I) was successful.     

Pyloric stenosis caused by hypertrophic gastritis in three dogs

Hypertrophic gastritis of the pyloric antrum is described in an 11-year-old female poodle, a 14-year-old male Maltese terrier and a 13-year-old male mongrel. The dogs suffered from chronic vomiting. Gastroscopic examination revealed mucosal proliferations in dogs 1 and 3. Radiographic examination showed signs of pyloric obstruction in all three dogs. Contrast studies demonstrated thickenings in the region of the pylorus in dogs 1 and 2. Laparotomy was done in all three dogs: in dog 1 a gastro-duodenostomy was performed and in dogs 2 and 3 the circularly thickened mucosa was resected. The mucosa of all three dogs showed hypertrophic gastritis, chiefly due to foveolar hyperplasia, and round cell infiltration, especially in the superficial layers. Herniation of mucosal glands through the muscularis mucosae was found in dog 1. Dogs 1 and 2 recovered well and vomiting ceased. Dog 3 continued to vomit because of a pyloric stenosis, mainly due to muscular hypertrophy.     

A case of canine gastrinoma

The dog of this case was a 10-year-old Shih Tzu with refractory vomiting, diarrhea and anorexia. Endoscopy revealed an unclear at gastric angle, a stenosis at pyloric antrum and congestion in duodenal mucosa. Since abnormal shadows of irregular echo-levels were disclosed by pancreas ultrasonography, serum gastrin level was determined with a suspect of gastrinoma. And an increase of serum gastrin was demonstrated. In addition, postmortem histological examination revealed that the pancreatic cells were positive for gastrin. Based on these findings, the dog was diagnosed as pancreatic gastrinoma.     

Perforated gastric ulcer v associated with pyloroplasty for chronic hypertrophic pyloric gastropathy in a dog

A six-year-old male silkie terrier presented with a history of chronic vomiting. A diagnosis of gastric outflow obstruction was made using contrast radiography of the upper gastrointestinal tract. Surgical examination of the stomach revealed thickened pyloric antral mucosa. A Heineke-Mikulicz pyloroplasty combined with resection of the hypertrophic pyloric mucosa were performed to increase the patency of the pyloric lumen. The dog recovered well from surgery and his condition remained stable until the sixth day postoperatively when his condition deteriorated rapidly resulting in his death that night. At autopsy a perforated gastric ulcer was found in the cardiac region of the pylorus with evidence for a generalised peritonitis. An association between gastric outflow obstruction and gastric ulceration has been reported in human clinical literature and in canine experimental models. No such association has been previously documented in the veterinary clinical literature.     

ULTRASONOGRAPHIC APPEARANCE OF CANINE GASTRIC POLYPS

Benign gastric polyps are uncommon in dogs and most are discovered incidentally. Polyps protruding into the pyloric antrum can cause gastric outflow obstruction. Clinical and ultrasonographic findings in seven dogs with histologically confirmed benign mucosal gastric polyps were reviewed. Sonographic findings such as shape, size, echogenicity, location, evidence of gastric wall thickening, wall layering, and size of regional lymph nodes were recorded. Five sessile and two pedunculated masses of different sizes (range 7–60 mm) and echogenicities were found. They primarily arose from the mucosal layer and protruded into the gastric lumen. Only one dog had a large inhomogeneous mass with a poorly visualized gastric wall layering. The polyps were all single, and were located in the pyloric antrum in six out of seven dogs. Although the ultrasonographic appearance allowed a presumptive diagnosis of mucosal gastric polyp, the final diagnosis was determined from histopathologic examination.     

Congenital pyloric mucosal fold resulting in an antral valve outflow obstruction in a bull terrier

An under‐sized three‐month‐old female bull terrier was referred with a history of regurgitation since three days of age. Thoracic radiographs were unremarkable, while abdominal radiographs showed a distended stomach, despite a 12 hour fast. Abdominal ultrasonography revealed gastric outflow obstruction of unclear aetiology. Coeliotomy was performed, during which an excessive mucosal fold at the pyloric antrum was excised. Histopathology of the pyloric fold revealed mild oedema and fibrosis of the mucosal tissue. The dog made a complete recovery, with resolution of regurgitation and grew to within the expected breed size. In the authors’ opinion, this is the first canine report of congenital antral mucosal valve resulting in gastric outflow obstruction, and only the second report in any species.     

Scirrhous gastric carcinoma with mediastinal invasion in a dog.

An 8-year-old male Rottweiler was presented for recurrent episodes of dysphagia and vomiting with chronic weight loss. Radiography revealed a mediastinal mass in the heart base region. Necropsy revealed a firm, white mediastinal mass extending along the distal esophagus, through the diaphragm, to the gastric cardia, leftward to the convex visceral aspect of the fundus, and rightward along the lesser curvature of the stomach to the pyloric antrum. The gastric lymph node was enlarged and the omentum contained several nodules. Histologically, deep fundic mucosa contained pleomorphic, vacuolated cells with intracytoplasmic mucin, which was hyaluronidase resistant. Neoplastic cells were cytokeratin positive and vimentin negative. Transmural invasion was evidenced by the presence of cytokeratin-positive cells between smooth muscle bundles of the gastric wall. The mediastinal mass was composed of clusters of neoplastic cells in a stroma of dense and loose connective tissue. Neoplastic cells were also within blood and lymphatic vessels, tracheobronchial and gastric lymph nodes, and around peripheral nerves. This carcinoma most likely arose from the gastric fundus and extended to the cardia, from where it advanced proximally to the mediastinum as well as further rightward along the lesser curvature, demonstrating an anatomic continuity suggestive of a direct invasion. Metastasis, evidenced by the presence of lymphatic, blood, and perineural tumor emboli, also occurred.     

Surgical treatment of gastric leiomyoma in a dog

A 12-year-old entire male Maltese terrier was presented with a 1 month history of vomiting and haematemesis. Microcytic hypochromic anaemia was detected. Abdominal radiography, ultrasonography and gastric endoscopy identified a discrete intramural mass in the pyloric antrum. An ulcerated leiomyoma was removed by a partial-thickness intraluminal resection of the gastric wall. The dog recovered well and is free from clinical signs 20 months after surgery.     

The prevalence and distribution of gastric ulceration in 345 racehorses

OBJECTIVE: To report the prevalence and distribution of gastric ulceration within a group of racehorses and to describe the endoscopic appearance of gastric antrum and pyloric ulceration. DESIGN: Retrospective clinical study. PROCEDURE: Medical records from gastroscopic examinations of 345 racehorses (331 Thoroughbreds and 14 Standardbreds) were reviewed. Prevalence, distribution and severity of gastric ulcers were recorded. Lesions involving the squamous mucosa and the glandular mucosa of the antrum and pylorus were graded and compared. RESULTS: Gastric ulceration was found in 86% of racehorses. The squamous mucosa around the margo plicatus was most commonly affected. The pylorus was examined in 175 horses and 47% were ulcerated. No association was found between presence of lesions of the squamous mucosa and those of the pylorus. Low correlation was found between grade and location of lesions, with the pyloric lesion score being significantly less than the squamous mucosal lesion score. CONCLUSION: Gastric ulceration was present in a large proportion of racehorses. The pylorus was also an important site of ulceration. There was no association between presence of lesion at one site and the other, although there was a low correlation between grade of lesion and location, with the pyloric ulcer grade being lower.     

Effect of Helicobacter sp. infection on the number of antral gastric endocrine cells in swine

The aim of the present study was to evaluate the effect of Candidatus Helicobacter suis (CHS) and other Helicobacter sp. different from Candidatus Helicobacter suis (non-Candidatus Helicobacter suis, non-CHS) infection on the number of endocrine G and D cells and G/D cells ratio in antral gastric mucosa in swine. Twenty nine stomachs were obtained from clinical healthy pigs about 6 months old and weighing approximately 100-120 kg after slaughter at abattoir located in central Poland. From each stomach samples of the antral gastric mucosa were taken for histopathology, and PCR examination for presence of Helicobacter genus and Candidatus Helicobacter suis. Samples for histopathology and immunohistochemistry were fixed in 10% buffered formalin. To reveal the expression of gastrin- and somatostatin-producing cells specific antibodies were used. Selected endocrine cells were counted in the midzone of pyloric glands, the results were expressed as a mean of the number of immunoreactive cells in one microscopic field, and as the ratio of gastrin to somatostatin cells (G/D). It can be concluded that some species of swine Helicobacter can alter the number of endocrine cells in gastric antral mucosa. Some of these alterations, for example increase the number of G cells, decrease of the D cells and especially increase of ratio G to D cells can be responsible for development of gastroesophageal ulcers in swine.     

Endoscopic Diagnosis of Chronic Hypertrophic Pyloric Gastropathy in Dogs

The endoscopic appearance of chronic hypertrophic pyloric gastropathy (CHPG) in five dogs is described. Several patterns of enlarged mucosal folds that surrounded and obstructed the pyloric canal were observed. Initially, endoscopically obtained biopsy samples of mucosa were judged to be histologi-cally normal. Diagnosis of CHPG was confirmed and relief of pyloric obstruction accomplished at exploratory laparotomy (in four dogs). Retrospective evaluation of pyloric tissue samples, obtained during endoscopy, identified subtle histological characteristics of CHPG. Gastric and duodenal neopla-sia or antral polyps can mimic the endoscopic appearance of CHPG but can be differentiated based on their endoscopic and histological appearance. These cases show that endoscopic examination is a valuable procedure for the diagnosis of CHPG in dogs that chronically vomit. (Journal of Veterinary Internal Medicine 1993; 7:335–341. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

Multiple inflammatory gastric polyps treated by endoscopic polypectomy with argon plasma coagulation in a dog

An 11‐year‐old spayed female miniature dachshund was evaluated for a 2‐month history of chronic vomiting. Abdominal ultrasonography revealed a heterogeneous mass in the pyloric region. Contrast upper gastrointestinal radiography demonstrated impairment of gastric outflow. Endoscopic examination revealed multiple polyps at the gastric pylorus. The pyloric polyps were variable in size, sessile‐shaped and pedunculated. Initially, endoscopic polypectomy was attempted, but all the polyps could not be completely resected. Thus, endoscopic polypectomy with argon plasma coagulation was performed to cauterise the lesions. The histopathological diagnosis of the lesions was inflammatory polyps, and a moderate number of Helicobacter spp. was revealed. After the argon plasma coagulation treatment, the dog did not vomit, and improvement of clinical signs was maintained for 13 months. Endoscopic polypectomy with argon plasma coagulation may be useful for mixtures of sessile and pedunculated polyps. The present report may provide a basis for further studies of argon plasma coagulation treatment for canine gastrointestinal polyps.     

Colorectal basidiobolomycosis in a dog

A 7-year-old castrated male French Bulldog was examined for chronic large intestinal enteropathy. A colonic mass and thickened rectal mucosa were identified, and histopathologic examination of endoscopic biopsy specimens disclosed eosinophilic proctitis with large (5-20 μm), irregularly shaped, pauciseptate hyphae that were Gomori methenamine silver and periodic acid-Schiff positive. Amplification and sequencing of ribosomal DNA extracted from paraffin-embedded tissues yielded a sequence with 97% identity to GenBank sequences for Basidiobolus ranarum. After itraconazole, terbinafine, and prednisone administration, clinical signs resolved rapidly, and sonographic lesions were largely absent after 6 weeks. Treatment was discontinued by the owner 15 weeks after diagnosis. Three weeks later, the dog collapsed acutely and was euthanized. Necropsy identified metastatic islet cell carcinoma and grossly unremarkable colorectal tissues. However, histopathology of the rectum disclosed multifocal submucosal granulomas with intralesional hyphae morphologically similar to those previously observed. This report is the first to describe medical treatment of gastrointestinal basidiobolomycosis in a dog.     

Blue-green endoscopy in a dog presenting chronic vomiting-regurgitation

A 2-year-old male Maremma sheepdog presenting with chronic vomiting-regurgitation was examined at the University Veterinary Teaching Hospital, Camerino University. An oesophagogastroscopy with a single blue + green (BG) filter restricting wavelengths from 400 to 550 nm was carried out. A conventional white light endoscopy showed a dilated oesophagus with mildly diffuse erythematous mucosa (more accentuated proximal to the cardia); some portions of the gastric mucosa were covered with fluids and appeared only slightly erythematous. A blue green endoscopy highlighted the oesophageal lesions in dark blue, which made them appear more clearly defined from the remaining mucosa. In the gastric antrum, a small, slightly darker blue roundish area was visible. This area did not show up under the white light endoscopy. A histopathological assessment of biopsy specimens from the distal oesophagus, antrum (including the area highlighted only by BG endoscopy) and gastric body showed chronic-active hyperplastic esophagitis and superficial squamous epithelial dysplasia, while gastric samples showed severe diffuse hyperaemic gastritis of the antrum and superficial diffuse atrophy of the gastric body. The authors believe that the use of a BG endoscopy could be useful in veterinary medicine to increase the diagnostic potential of endoscopic assessment in animals.     

Intermittent gastric dilatation after gastropexy in a dog.

Gastroperitoneal adhesions, which developed after tube gastrostomy in a 3-year-old dog, caused an inverted L configuration of the pyloric antrum and duodenum, resulting in periodic episodes of gastric dilatation. The dog had undergone tube gastrostomy for treatment of gastric dilatation/volvulus, but gastropexy adhesions broke down 27 months later, necessitating a second pexy procedure. Adhesions then developed, constricting gastric outflow and trapping gas in the stomach and proximal duodenum. When the ventral row of adhesions was surgically dissected, the angle between the pyloric antrum and the duodenum was straightened, facilitating flow of digesta. Gastropexy rarely causes the degree of adhesion formation and the complications reported in this dog.     

GASTRIC LYMPHOSARCOMA IN A DOG: A CASE REPORT

A 9-year-old female spayed mixed-breed dog was presented with a ten-week history of vomiting. A survey abdominal radiograph showed a soft tissue mass on the lesser curvature of the stomach and an adjacent thickened greater curvature. A barium contrast study confirmed the presence of this mass. The radiographic diagnosis was gastric tumor. Radiographic signs of gastric neoplasia include soft tissue masses or thickening of the stomach wall, delayed gastric emptying, immobility of portions of the stomach wall, and residual stomach-wall staining by barium. Necropsy revealed a gastric lymphosarcoma that had infiltrated the entire circumference of the pyloric antrum. The most common gastric malignancy in the dog is adenocarcinoma. Gastric lymphosarcoma is considered rare.     

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.     

Gastric retention associated with a pyloric mass in two horses

Partial pyloric obstruction causing gastric retention is described in 2 young female horses. Gastric retention was confirmed by contrast radiography of the upper gastrointestinal tract. In both horses a large mass was palpated in the wall of the pyloric antrum at exploratory laparotomy. Post-mortem examination of the first case confirmed that this mass was associated with chronic gastric ulceration. Gastric ulceration was not confirmed in the second case but this horse recovered after the pylorus and duodenum were bypassed by gastro-jejunostomy.     

Unrecognized difficult airway management during anesthesia in two brachycephalic dogs with narrow cricoid cartilage

Difficulty in airway management during anesthesia was noted in a 10-year-old, castrated, male Pekingese dog and a 13-year-old male French Bulldog. They showed strong resistance during tracheal tube insertion through the subglottic lumen. Therefore, the airway was secured by using a small endotracheal tube or supraglottic airway device. Computed tomography scan revealed a markedly narrower vertical dimension of the cricoid cartilage compared to that seen in common brachycephalic breeds. Posterior glottis was relatively more accessible for translaryngeal intubation in the present cases. Our findings showed that brachycephalic airway syndrome may be associated with narrow cricoid cartilage. To the best of our knowledge, this is the first clinical case report of airway management during anesthesia in dogs with narrow cricoid cartilage.     

Pyloric outflow obstruction secondary to sclerosing encapsulating peritonitis in a dog

A 6-year-old, male neutered mixed breed dog was presented emergently with a three-week history of hyporexia, vomiting, diarrhoea and weight loss. Upon examination, the patient was dull, had generalised muscle atrophy, moderate abdominal pain and a mild amount of peritoneal effusion. A fluid-filled, distended, corrugated small bowel with marked gastroparesis and moderate peritoneal effusion was noted on abdominal ultrasonography. Endoscopy revealed hyperaemic and friable mucosa and a subjectively narrowed pylorus. Emergency exploratory celiotomy was performed due to worsening patient condition and revealed thick, diffuse, fibrous adhesions of the abdominal cavity. Based on these findings, sclerosing encapsulating peritonitis (SEP) was suspected. A large mass of omentum adjacent to the greater curvature of the stomach had caused a pyloric outflow obstruction. Adhesiolysis was attempted but was unsuccessful due to the friability of the small intestines. The dog was humanely euthanased under anaesthesia. A diagnosis of SEP was confirmed via necropsy. No underlying cause was identified. This is the first known case of a pyloric outflow obstruction secondary to SEP in a dog. Although rare, this condition should be considered as a differential for dogs with signs of a pyloric outflow obstruction with concurrent ascites and abdominal pain, hyporexia, vomiting and diarrhoea.