Cecal-Colic Volvulus in Two Dogs

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.     

Canine Intestinal Volvulus A Report of Nine New Cases

The records of nine dogs with intestinal volvulus were reviewed. Most were young adult (median 2.6 years) males (6/9) of medium to large breeds. Vigorous activity, dietary indiscretion, or trauma preceded volvulus. Signs included a peracute to acute onset of vomiting, hematochezia, a moderately distended and often painful abdomen, and shock. Normal packed cell volume, altered white blood cell count, hypoproteinemia, hypoalbuminemia, hypokalemia, pathologic bowel dilatation, and serosanguineous abdominal fluid were common clinical findings. Jejunum was most often affected. One dog survived with surgical management.     

Chronic gastric instability and presumed incomplete volvulus in dogs

Chronic gastric volvulus in dogs results in long-standing gastrointestinal signs unlike those of acute gastric dilatation and volvulus. This report describes chronic gastric volvulus in seven dogs. The majority of dogs presented with weight loss, chronic vomiting, lethargy and abdominal pain. A combination of radiographic, ultrasonographic and endoscopic imaging indicated altered positioning of gastric landmarks. Dynamic changes were identified in some cases. Exploratory coeliotomy and surgical gastropexy were performed in all dogs. Clinical signs improved or resolved in six of seven dogs postoperatively. Chronic gastric volvulus is an uncommon condition in dogs, but should be considered as a differential in cases presenting with the above clinical signs.     

Successful treatment of small intestinal volvulus in two cats

BACKGROUND: Mesenteric volvulus describes a torsion of the small intestine around the mesenteric root, which can be partial or complete. In dogs, it is an uncommon condition, with German shepherd dogs showing a predisposition. Chronic mesenteric volvulus has also been described. In cats, previous reports have documented two cases of small intestinal volvulus, both diagnosed at necropsy, and a further case of volvulus of the colon in a patient that died after surgery. CLINICAL SIGNIFICANCE: This report describes two cats with mesenteric volvulus that were successfully treated. To the authors' knowledge, no reports of antemortem diagnosis or treatment of small intestinal volvulus in cats have previously been published. On the basis of the cases presented, it appears that the diagnosis of intestinal volvulus may be more difficult in cats than in dogs, but that the prognosis may not be as poor. Therefore, it is suggested that owners be encouraged to pursue surgery.     

EXPERIMENTAL ACUTE GASTRIC DILATATION AND VOLVULUS IN THE DOG: CHANGES IN BIOCHEMICAL PARAMETERS*

Acute gastric dilatation and volvulus with dilatation were produced in 11 dogs anesthetized with halothane. Blood samples were taken during these procedures for biochemical analyses. Serum potassium did not change significantly during the experimental procedure, but there was a significant increase (p<0.05) after release of the dilatation with volvulus. Renal function was impaired with significant increases (p<0.05) in the serum concentration of urea nitrogen, phosphorus, and creatinine. Evidence of cellular damage was reflected by a significant elevation (P<0.05) in glutamic-oxaloacetic transaminase activity. Serum glucose concentration increased significantly (P<0.05) during experimental gastric dilatation and dilatation with volvulus.     

Intestinal volvulus in dogs: a study of four clinical cases

Four cases of intestinal volvulus in German shepherd dogs are described. A definitive diagnosis was achieved by exploratory laparotomy in three cases and after necropsy in the remaining animal. Clinical signs, laboratory investigations and radiological changes are reported for three of the dogs. These dogs were all euthanased. Treatment of complete intestinal volvulus is difficult. By the time the condition is diagnosed, the pathological changes are irreversible, with consequent poor prognosis.     

Canine and feline emphysematous gastritis may be differentiated from gastric emphysema based on clinical and imaging characteristics: Five cases

Gastric pneumatosis is an imaging finding defined as the presence of gas foci in the gastric wall. In humans, this imaging feature can result from one of two separate clinical entities: life‐threatening emphysematous gastritis or clinically benign gastric emphysema. This retrospective case series study describes the clinical and imaging features in five animals diagnosed with spontaneous gastric pneumatosis without gastric dilatation‐volvulus. Three canine and two feline cases of spontaneous gastric pneumatosis were identified on radiographic and ultrasonographic examinations. In addition to gastric pneumatosis, one dog and two cats presented concomitant systemic signs such as lethargy, hematemesis, anemia, or leukocytosis. Two dogs remained asymptomatic or presented mild gastrointestinal signs. Portal gas was described in two dogs and one cat, and pneumoperitoneum in one dog. These features were not considered clinically significant. The dog and two cats with systemic signs were euthanized due to clinical deterioration and diagnosed with emphysematous gastritis. The gastric pneumatosis of both dogs without systemic signs resolved while on medical management without antibiotic therapy. These latter cases were interpreted as consistent with gastric emphysema. Findings from the current study indicated that gastric pneumatosis can occur without gastric dilatation‐volvulus in cats and dogs and that a combination of clinical and imaging characteristics may help to differentiate between potentially life‐threatening emphysematous gastritis and relatively benign gastric emphysema. More studies are needed to determine the etiology and risk factors associated with these conditions.     

COMPARISON OF RADIOGRAPHY AND ULTRASONOGRAPHY FOR DIAGNOSING SMALL‐INTESTINAL MECHANICAL OBSTRUCTION IN VOMITING DOGS

A cross‐sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small‐intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small‐intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small‐intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small‐intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small‐intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small‐intestinal dilatation. The ultrasonographic presence or absence of moderate‐to‐severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small‐intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small‐intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography.     

Intestinal volvulus and stricture associated with a leiomyoma in a green turtle (Chelonia mydas).

A previously stranded 30-kg female green turtle (Chelonia mydas) was referred to the Veterinary Medical Teaching Hospital at the University of Florida following a 2-mo history of anorexia, intermittent regurgitation, decreased fecal production, and positive buoyancy of the right side. Radiographs confirmed gaseous distension of bowel loops suggestive of intestinal obstruction. The coelom was surgically approached through a plastron osteotomy, and a 540 degrees volvulus of the small intestine was identified and derotated. An intestinal stricture was present at the site of the volvulus, and segments of bowel orad to the stricture were greatly distended. Following resection of abnormal bowel, the osteotomy was stabilized using self-tapping screws and figure-eight wire, and the defect was sealed with fiberglass cloth and fast-drying epoxy resin. A leiomyoma associated with the focal stricture was identified by histology. Appetite and defecation returned to normal. Six months after surgery, the turtle had regained normal buoyancy and showed no further clinical signs of gastrointestinal obstruction.     

Gastric dilatation and volvulus in a brachycephalic dog with hiatal hernia

A brachycephalic dog was presented with an acute onset of retching and abdominal discomfort. The dog had a chronic history of stertor and exercise intolerance suggestive of brachycephalic airway obstructive syndrome. Radiographs were consistent with a Type II hiatal hernia. The dog was referred and within hours of admission became acutely painful and developed tympanic abdominal distension. A right lateral abdominal radiograph confirmed gastric dilatation and volvulus with herniation of the pylorus through the hiatus. An emergency exploratory coeliotomy was performed, during which the stomach was derotated, and an incisional gastropexy, herniorrhaphy and splenectomy were performed. A staphylectomy was performed immediately following the exploratory coeliotomy. The dog recovered uneventfully. Gastric dilatation and volvulus is a potentially life‐threatening complication that can occur in dogs with Type II hiatal hernia and should be considered a surgical emergency .     

The Effect of 360° Gastric Volvulus on the Blood Supply of the Nondistended Normal Dog Stomach

Eighteen dogs were divided into three groups, each containing three volvulus and three control dogs. The stomachs of the volvulus dogs were rotated 360°, sutured in position, and kept decompressed by a Foley catheter placed in the fundus. Control dogs underwent the same manipulation, except that the stomach was replaced to normal position. One dog in each group was evaluated at 4, 8, and 12 hours. Evaluation consisted of SC⁴⁶ microsphere injection to determine percent cardiac output to various stomach regions, and gross and microscopic changes in the stomach and other tissues drained by the portal system. Cardiac output to the control stomachs exceeded the volvulus stomachs by fivefold. Time was not a significant factor. Edema was present throughout the volvulus stomach. The most severe histologic changes, such as hemorrhage, were seen in the greater curvature of volvulus stomachs. Other portal tissues were grossly and histologically normal. Three additional dogs were evaluated 1 week after creation and reduction of a 12 hour volvulus; the stomachs were normal indicating reversibility of pathologic changes. This study demonstrates abnormal blood flow in rotated nondistended stomachs. Anatomic repositioning should take place as soon as possible in the treatment of gastric dilation volvulus.     

Ultrasonographic comparison of adhesions induced by two different methods of gastropexy in the dog

Ultrasonography was used to compare adhesions induced by two different methods of gastropexy in 16 dogs. An incisional gastropexy technique was used in eight dogs (group 1) and a 'modified' gastropexy technique in the remaining eight (group 2). The length and thickness of the gastropexy and the peristaltic activity of the stomach were measured ultrasonographically and compared between groups. Measurements for the two groups were taken in the early postoperative interval (two to four days), intermediate postoperative interval (eight to 20 days) and late postoperative interval (57 to 79 days). Both techniques were equally successful in forming permanent adhesions at two months postoperatively and there was no recurrence of gastric dilatation and volvulus. The length and thickness of the gastropexy were similar for both groups at two months postoperatively and there were no surgical complications with either technique. The modified gastropexy provides a technique that can easily be performed by a single surgeon , with no increased operative time or duration of anaesthesia, and with the formation of a permanent adhesion.     

Volvulus of the colon in four dogs

Four dogs were examined because of vomiting of 7 to 48 hours' duration. Gas-distended segments of intestine were identified radiographically in all dogs, but the affected portion of the intestinal tract could not always be identified as the colon. Volvulus of the colon was diagnosed during surgery in all 4 dogs. Gastrocolopexy was performed following derotation of the colon in 3 of the dogs. In 1 dog, a colectomy and an ileorectal anastomosis were performed. All 4 dogs survived. Volvulus of the colon should be considered as a cause of vomiting of short duration in dogs for which there is radiographic evidence of intestinal dilatation.     

Prognostic value of small intestinal dilatation in dogs with protein-losing enteropathy

To date, little is known about the prognostic significance of ultrasonographic findings in dogs with protein-losing enteropathy (PLE). The aim of this retrospective study was to examine the prognostic value of ultrasonographic findings in dogs with PLE. A total of 26 dogs with PLE were included: 20 dogs with chronic enteropathy and 6 dogs with gastrointestinal lymphoma. The presence of small intestinal dilatation was associated with shorter survival time in dogs with PLE (P=0.003). The presence of hyperechoic intestinal mucosal striations was associated with longer survival time in dogs with PLE (P=0.0085). The results of the current study indicate that the presence of small intestinal dilatation might be associated with poor prognosis in dogs with PLE.     

A Retrospective Study of Inguinal Hernia in 35 Dogs

Inguinal hernia was associated with trauma in five dogs and was considered nontraumatic in 30 dogs. There were 11 males, 13 intact females, and six spayed females with nontraumatic inguinal hernia. Six dogs had bilateral hernias. Five dogs were younger than 4 months at the time of diagnosis. In 11 older dogs with nontraumatic inguinal hernia, the hernias were identified less than 7 days before surgical repair; in 14 older dogs, the hernias had been recognized for 1 to 60 months. Clinical signs in dogs without small intestinal incarceration were usually limited to a visible or palpable mass without pain or systemic illness. Hemiorrhaphy approaches included inguinal, midline with contralateral ring evaluation, and celiotomy with or without inguinal exposure. Fat and omentum were the most common hernial contents. Small intestine was within the hernias of 12 dogs. Six dogs had nonviable small intestine. Postoperative complications included two incisional infections, one incisional dehiscence, two cases of peritonitis and sepsis associated with bowel leakage after intestinal resection and anastomosis, and one hernia recurrence. The overall prevalence of postoperative complications was 17%, and the mortality rate was 3%. Vomiting for 2 to 6 days was predictive of nonviable small intestine. Dogs younger than 2 years were at 11 times greater risk for nonviable small intestine than dogs older than 2 years. Four of five dogs with nontraumatic inguinal hernia and nonviable small intestine were intact males, whereas none of 13 intact females were affected. Only one of 14 dogs with longstanding hernias had nonviable small intestine.     

Cecal dilatation and volvulus in dairy cows: 84 cases (1977-1983)

The records of 84 cows with cecal dilatation or cecal volvulus were reviewed. The diagnosis was made by exploratory laparotomy or necropsy in 21 cows with cecal dilatation, and in 45 cows with cecal volvulus. Eighteen of the cows with cecal dilatation responded to medical management and the diagnosis was made by physical examination alone. The most useful criteria for determining that surgery was necessary were the presence of a high heart rate, apparent abdominal pain, scant or absence of feces, and the apex of the cecum rotated cranially on rectal examination. The prognosis for cattle with cecal dilatation and volvulus was good following medical therapy or decompression at surgery unless there was severe vascular compromise of the cecum. There was a 10% recurrence rate, and in these cows a partial typhlectomy was performed.     

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.     

Mesenteric volvulus in the dog: a retrospective study of 12 cases

Mesenteric volvulus was diagnosed in 12 dogs over a nine-year period. Each case was presented with abdominal distension and shock. Haematochezia, which is frequently reported in association with mesenteric volvulus, was present in only two of the dogs. The diagnosis, which in all cases was based on radiography, was followed by immediate treatment for shock and surgical intervention whenever possible. In five of the 12 cases, the volvulus was treated successfully and these patients survived. This indicates that the prognosis for mesenteric volvulus might be better than is currently believed, and immediate laparotomy is recommended if mesenteric volvulus is suspected.     

Tube gastrostomy in dogs

Tube gastrostomy was performed in 19 dogs over a period of 36 months. Indications for tube gastrostomy included non-oral feeding for the management of oesophageal injuries (nine cases) and dysphagia resulting from oral or pharyngeal trauma (two cases) and decompression and, or, gastropexy for gastric diseases including gastric dilatation volvulus (four cases), gastric outflow diseases (three cases) and gastric neoplasia (one case). All the tubes were placed surgically and left in situ for periods of up to 14 days. Feeding was by frequent bolus administration of a proprietary enteral food initially followed by homogenised commercial dog food. The tubes were readily managed and patency maintained in all cases. Gastric stomata granulated within three days of tube removal. Fourteen dogs recovered and returned to normal oral feeding while three died as the result of their presenting condition. A fourth was euthanased four months after surgery because of recurrence of a gastric malignancy. This review indicates that surgically placed tube gastrostomy is readily performed and is an effective means of providing non-oral alimentation and, or, gastric decompression.     

Ultrasonographic intestinal muscularis thickening in dogs with histologically confirmed inflammatory bowel disease: 13 cases (2010–2021)

Ultrasonographic intestinal muscularis thickening has not been described as an imaging feature of canine inflammatory bowel disease. In this retrospective case series, patients were identified by searching sonographic reports for “muscularis” and/or “muscular layer.” Patients were included if small intestinal muscularis thickening was reported, and sonographic images and histopathological samples of the small intestine were available for review. Cases with small intestines nodules, masses, or complete loss of wall layering were excluded. Sonographic images were retrospectively evaluated for jejunal muscularis layer thickness, and ratios of intestinal layer measurements were performed. Histological samples were retrospectively reviewed. Thirteen dogs met inclusion criteria: all dogs had sonographic intestinal muscularis thickening relative to the submucosa (>1.0, range of 1.3–2.5), and most dogs had muscular layer thickness above normal published ranges (11/13; all 13/13 above the weight-specific mean). More than half of the patients had overall normal wall thickness (11/13) and several had normal mucosal echogenicity (6/13). Therefore, in some dogs, the only sonographic abnormality in the small intestine was muscularis thickening. No dogs had lymphadenomegaly. Endoscopic partial-thickness (n = 11, duodenum and/or ileum) or surgical full-thickness (n = 2) samples confirmed inflammatory bowel disease. Direct comparison between jejunum sonographic characteristics and histology features was limited due to both partial thickness biopsies and lack of direct comparison between anatomical locations of ultrasonographic assessment and biopsy site. However, no cases that met the inclusion criteria had normal small intestinal histology. Comparable to cats, dogs with ultrasonographic intestinal muscularis thickening may have inflammatory bowel disease, and further workup for enteropathy is indicated.