Colorectal hamartomatous polyposis and ganglioneuromatosis in a dog

A 5-month-old female Great Dane puppy was treated for hematochezia, tenesmus, and rectal prolapse by resection of a 10-cm-long segment of colon and rectum. Grossly, the colorectal segment had diffuse mucosal and submucosal thickening with multiple polypoid nodules. The histologic diagnosis was colorectal hamartomatous polyps with ganglioneuromatosis. Duplication of PTEN was detected by quantitative multiplex polymerase chain reaction testing. The presence of 2 hamartomatous colorectal lesions with PTEN mutation is similar to human Cowden syndrome.     

Colonic ganglioneuromatosis in a horse

Ganglioneuromas are complex tumors that arise in peripheral ganglia and are composed of well-differentiated neurons, nerve processes, Schwann cells, and enteric glial cells. The term ganglioneuromatosis (GN) denotes a regional or segmental proliferation of ganglioneuromatous tissue. This report describes an 8-year-old mixed breed horse with GN in a 25-cm segment of small colon. Grossly, the lesion consisted of numerous sessile to pedunculated nodules extending from the serosal surface. Histologic examination revealed the nodules to consist of fascicles of spindle-shaped cells consistent with Schwann cells, clusters of neurons, supporting enteric glial cells, and thick bands of perineurial collagen. Most of the nodules coincided with the location of the myenteric plexus and extended through the outer layer of the tunica muscularis to the serosal surface. Neuronal processes were demonstrated within the lesion with electron microscopy. With immunohistochemistry neurons were positive for neuron specific enolase (NSE) and S-100 and the Schwann cells and enteric glial cells were positive for S-100 and glial fibrillary acidic protein (GFAP). The pathogenesis of GN is poorly understood. GN, although rare, should be included in the differential diagnosis of gastrointestinal tumors in the horse.     

Chronic intestinal pseudo-obstruction in a dog

SUMMARY A three-year-old neutered female Border Collie was presented with in-appetence, vomiting and diarrhoea. Abdominal radiographs revealed an obstructive pattern but no physical obstruction was evident at laparotomy. A diagnosis of chronic intestinal pseudo-obstruction was made based on histopathological changes in intestinal biopsies. Treatment was unsuccessful and the dog deteriorated progressively until euthanased five weeks after presentation.     

Small intestinal adenocarcinoma in a horse

A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.     

Multiple intestinal lymphomatous polyposis in a Jindo dog

A male, 5-year-old Jindo dog underwent enterectomy and enteroanastomosis due to ileus of the intestine at a local veterinary hospital. Grossly, the excised intestine showed markedly thickened multinodular masses in the serosal layer of the upper part, and soft-to-firm, cream-colored neoplastic masses that displayed extensive nodular mucosal protuberances into the lumen. The neoplastic masses were filled with large round cells that were ovoid in shape and they had pale and/or hyperchromatic nuclei. The neoplastic cells had mainly infiltrated into the mucosal and submucosal layers, and they had diffusely invaded the muscular and serosal layers. Therefore, the diagnosis of canine multiple intestinal malignant lymphomatous polyposis was made based on the gross and histopathological findings. The origin of these tumor cells was determined to be B-cells since they were positive for anti-CD20.     

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.     

Immunohistochemical evaluation of a malignant intestinal carcinoid in a dog

An intestinal carcinoid with multiple metastases was identified in a 5-year-old male Shih Tzu with a clinical history of anemia, fatigue, anorexia, vomiting, intermittent diarrhea, intestinal bleeding, and progressive emaciation. There was a yellowish-white mass 15 mm in diameter in the anterior jejunum and white nodules consistent with metastases in many organs. Histopathologically, the mass consisted of neoplastic cells arranged in lobules, trabeculae, or closely interdigitating islands of cells. Neoplastic cells were generally polygonal with round hyperchromatic nuclei, modest amounts of eosinophilic cytoplasm, and eosinophilic cytoplasmic granules. Mitoses were common. Rosette formations of tumor cells were apparent in metastatic tumors. Immunohistochemically, tumor cells stained positive for cytokeratin 13, synaptophysin, protein gene product 9.5, neuron-specific enolase, chromogranin A, calcitonin gene-related peptide, serotonin (5-HT), and Leu-7. Serum 5-HT concentrations for this dog were increased 10-fold compared with those of normal dogs. All findings were consistent with a diagnosis of a malignant intestinal carcinoid.     

Chronic intestinal diseases in the dog: a review

The most commonly encountered chronic enteropathies in dogs are inflammatory bowel disease (IBD), food allergies, and small intestinal bacterial overgrowth. Recent research in the field of immunopathogenesis of IBD and food allergy in human beings have made available new therapeutic options with immunomodulatory drugs. However, the mechanisms involved in the pathogenesis of canine IBD and food allergy have not been elucidated so far. Further studies focusing on the immunological dysregulation in the mucosa as well as clinical trials with new therapeutic modalities are needed to improve our knowledge and approach to these chronic diseases in dogs.     

Nephrogenic diabetes insipidus in a dog with intestinal leiomyosarcoma

Nephrogenic diabetes insipidus was diagnosed in a dog with an intestinal leiomyosarcoma. The diagnosis of nephrogenic diabetes insipidus was made on the basis of results of serum biochemical tests, urinalyses, and a water-deprivation test, along with a lack of response to exogenous administration of vasopressin following the water-deprivation test. The temporal association between resection of the intestinal mass and resolution of clinical signs of diabetes insipidus (i.e., polyuria and polydipsia) and between recurrence of clinical signs and detection of metastatic disease suggests that there may have been a causal relationship, and nephrogenic diabetes insipidus may have developed as a paraneoplastic syndrome in this dog.     

Caecal impaction and chronic intestinal pseudo-obstruction in a dog

A 10-year-old female neutered cross-breed dog presented with a 4-month history of chronic intermittent diarrhoea and vomiting. Abdominal ultrasound showed dilated loops of small intestine and a suspected faecolith. Exploratory surgery revealed a caecal impaction and a typhlectomy was performed. Histopathological examination of caecal and full thickness small intestine sections demonstrated atrophy of smooth muscle fibres as well as an influx of plasma cells, lymphocytes and macrophages, and mild lymphoplasmacytic and eosinophilic enteritis. This combination of caecal impaction and chronic intestinal pseudo-obstruction has not been reported previously in the dog.     

Large granular intestinal lymphosarcoma and leukemia in a dog

A rare, large granular lymphocyte (LGL) tumor causing a protein-losing enteropathy and thrombocytopenia was diagnosed in an Irish wolfhound. The case had an aggressive clinical course, like most LGL tumors in humans. Immunophenotyping suggested that the LGL tumor in this dog was derived from a natural-killer cell.     

Paraneoplastic hypereosinophilia in a dog with intestinal T-cell lymphoma

A 9-year-old, intact male Doberman Pinscher was examined because of anorexia and weakness. Results of a CBC showed severe, microcytic, hypochromic anemia with mild eosinophilia (2944 cells/microL, reference interval 100-1250/microL) and thrombocytosis. Hypoferremia, hypoferritinemia, and a positive fecal occult blood test supported a diagnosis of iron deficiency anemia secondary to chronic intestinal hemorrhage. Abdominal ultrasound evaluation showed a thickened small intestinal loop, of which representative specimens were obtained during exploratory laparotomy. Histologically, the intestinal wall was infiltrated by a neoplastic population of large, round, lymphoid cells with vesicular chromatin, 1 or more prominent nucleoli, and a high number of mitotic figures. The cells were closely admixed with mature eosinophils, but were negative for metachromatic granules with toluidine blue. Immunohistochemically, tumor cells were positive for CD3, and negative for CD21, Pan B, and CD79a. A diagnosis of intestinal T-cell lymphoma was made. Chemotherapy was begun, with 30 mg/m;2 of doxorubicin administered intravenously every 3 weeks. Eosinophil concentration was 880/microL 2 weeks after surgery (on day 15 after presentation) but increased markedly to 62,914/microL on day 30, 62,400/microL on day 37, and 39,444/microL on day 58 after presentation. An association between hypereosinophilia and T-cell lymphoma is well established in human patients, in whom production of IL-5 by neoplastic T cells has been demonstrated. Hypereosinophilia has been reported only rarely with intestinal lymphoma in cats and horses, and with T-cell lymphoma in dogs.     

Functional intestinal hypomotility in association with neuronal damage in a dog

A young, crossbred dog with a 13-month history of progressively worsening, recurrent episodes of vomiting, anorexia, depression and dehydration was diagnosed as having a functional hypomotility disorder of the small Intestines. During hospitalisation, the dog's condition Improved only when total parenteral nutrition was administered. When fed orally, the dog developed severe gastric dilatation. Intestinal motility was minimal, but was Induced by neostigmine. Post mortem findings Included dilatation of the duodenum and progressive narrowing of the small bowel up to the lleum. Histopathology revealed various grades of neuronal degeneration and necrosis of the myenteric plexuses throughout the small Intestine. Microscopic changes resembled those reported In dysautonomia, but were limited to small intestinal myenteric plexuses. A locallsed congenital neuronal defect causing a lack of parasympathetic tone Is suspected.     

Small intestinal carcinoma in cattle

The pathology of carcinoma of the small intestine in six adult cattle is described. The lesions were similar to those of carcinoma of the small intestine of sheep although a slightly less fibrous stroma and a greater tendency to metastasise was observed. Initial findings suggest the disease resembles small-intestinal carcinoma of sheep and cola-rectal carcinomas of man in having a higher prevalence in New Zealand than most other countries. This highlights the need to investigate common environmental factors which may be responsible for the induction and promotion of these tumours in both grazing ruminants and man.     

Chronic small intestinal disease in the dog

New approaches to the investigation of chronic small intestinal disease have facilitated the identification and characterization of three enteropathies in the dog. The main features of these diseases are presented and diagnostic problems are discussed.