Trichophytobezoar duodenal obstruction in New World camelids

OBJECTIVE: To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. STUDY DESIGN: Retrospective study. ANIMALS: Alpacas (7) and 1 llama. METHODS: Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. RESULTS: Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. CONCLUSIONS: Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. CLINICAL RELEVANCE: Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.     

EVALUATION OF SOLID PHASE RADIOLABELS OF DOG FOOD FOR GASTRIC EMPTYING

99mTc-Pertechnetate, 99mTc-mebrofenin, 99mTc-disofenin, 99mTc-sulfur colloid, and 99mTc-Dowex resin beads were evaluated for in vitro stability as a label for both dry extruded, and canned dog food for gastric emptying scintigraphy. A sample of each radiolabeled diet was added to water, gastric juice, intestinal juice, or gastric juice followed by intestinal juice for in vitro digestion. After a 3-hour digestion period, tubes were centrifuged and percentage solid phase retention (%SPR) was calculated. The experiment was repeated three times over a 14-day period to minimize day-to-day variation. For dry dog food, 99mTc-mebrofenin and 99mTc-disofenin had similar %SPR in water (96 and 93%, respectively) and gastric juice (>95% each) and were significantly higher than other labels. For canned dog food, mebrofenin had a 91% SPR for the water or gastric juice digestions, and 99mTc-Dowex had a %SPR of >99%. 99mTc-mebrofenin and 99mTc-Dowex were also tested in vivo, where 99mTc-Dowex had poor stability, and 99mTc-Mebrofenin had excellent stability. 99mTc-Mebrofenin is a suitable label for dog food for gastric emptying scintigraphy.     

Ultrastructure of the hydrophobic gastric surfactant barrier in the dog

OBJECTIVES: To confirm the hydrophobicity of the luminal surface of the canine stomach and to elucidate the ultrastructure of the lining imparting that property. DESIGN AND PROCEDURES: Gastric and duodenal mucosal samples from eight dogs were collected immediately after euthanasia and subjected to contact angle measurement using a goniometer. Other samples were examined by electron microscopy following a fixation procedure known to preserve phospholipids and oligolamellar structures. RESULTS: Contact angles for the canine gastric mucosal surface (85.1 +/- 5.5) were significantly greater (P < 0.0001) than for the duodenum (24.0 +/- 1.7). Electron microscopy revealed the existence of surfactant as abundant osmiophilic phospholipid material within the gastric and duodenal mucosae. CONCLUSION: We have confirmed the hydrophobic nature of the canine gastric mucosa whereas the luminal surface of the duodenum is hydrophilic. We propose that the water-repellent nature of the canine gastric lining contributes to the 'gastric mucosal barrier' and is imparted by an oligolamellar layer of surface-active phospholipid ('gastric surfactant') adsorbed to the surface. Both gastric and duodenal mucosae may also utilise phospholipids as an intercellular defense mechanism in the event that tight junctions are breached by acid. It is tempting to speculate that a deficiency of gastric phospholipids may predispose dogs to ulcers. Further, exogenous administration of phospholipids may be useful in preventing gastric ulceration.     

Improvement of the emulsifying properties of porcine sarcoplasmic proteins with a low-molecular weight surfactant by the two-step emulsification method

The emulsifying properties of porcine sarcoplasmic protein (SP) with or without low-molecular weight surfactants were examined. The emulsifying activity (EA) of SP was weaker than that of sodium caseinate (CA), blood plasma (BP) and whey protein isolates at a protein concentration of 0.5–3%. Sodium chloride decreased the EA of SP. The EA of SP was about one quarter that of CA in the presence of 3% sodium chloride. As homogenization time increased, the EAs of SP and BP decreased. The EA of SP was not influenced by sucrose stearate ester (SE) with a hydrophilic-lipophilic balance (HLB) value of 16 (SE-16) but was decreased by those with HLB values of 5 and 1. Low-molecular weight surfactants such as SE-16, Tween 80 and sodium cholate improved the EA of SP with the two-step emulsification method: corn oil was previously emulsified with the surfactant before addition of SP and homogenization. In the case of the addition of SE-16 as primary emulsifier, the EA was about twice as high as that of SP alone. The same effect was shown in the emulsions formed by CA and soy protein isolate. These results indicate that the emulsifying properties of meat protein would be improved by the addition of a low-molecular weight surfactant in a two-step emulsification.     

Squamous gastric ulceration complicated by gastric stenosis in a foal

A 2-month-old Warmblood colt presented with recurrent colic and regurgitation. Gastroscopy, performed on several occasions, and barium-contrast radiography revealed severe squamous gastric ulceration and stenosis at the level of the margo plicatus. Treatment with omeprazole reduced the extent and severity of the gastric ulcers but did not affect the stenosis. The foal was euthanised because of a poor prognosis, and post-mortem examination confirmed the clinical diagnosis. Severe squamous gastric ulceration, granulation tissue formation and cicatrisation of deep gastric lesions were considered to have caused the stenosis. Gastroduodenal outflow obstruction is a recognised disorder in foals, but stenosis at the level of the margo plicatus has not been reported in foals or adult horses. To the authors' knowledge, this is the first case of severe squamous gastric ulceration, complicated by stenosis at the level of the margo plicatus, in a foal. Although rare, gastric stenosis should be considered in foals suffering recurrent colic and regurgitation.     

一氧化氮和内皮素在窒息新生大鼠胃黏膜损伤中的作用

本研究旨在探讨围产期窒息时内皮素( ET)和一氧化氮 ( NO)的变化与急性胃黏膜损伤的关系及 NO的前体 L-精氨酸 ( L-Arg)和NO合成酶抑制剂 L-硝基 -精氨酸甲酯 ( L-NAME)在胃黏膜损伤中的作用。结果显示窒息组血浆 ET和胃壁 NO水平显著高于正常对照组 ( p<0 .0 1 ) ,胃黏膜损伤明显 ;L -Arg组血浆ET水平较窒息组显著下降 ( p <0 .0 1 ) ,血浆和胃壁 NO含量则显著升高 ( p <0 .0 1 ) ,胃黏膜损伤减轻 ;L-NAME组血浆 ET水平和 L I显著高于正常对照组和 L -Arg组 ( p <0 .0 1 ) ,血浆和胃壁 NO含量较 L-Arg组显著下降 ( p <0 .0 1 ) ,表明围产期窒息时 NO和 ET的变化与胃黏膜损伤的程度密切相关。NO在围产期窒息时有保护胃黏膜的作用 ,而 ET则作用相反。L -Arg的保护作用和 L -NAME的损伤作用均是通过 NO的变化来实现的。     

The effect of porcine hydrolysed collagen on gastric ulcer scores,gastric juice pH,gastrin and amino acid concentrations in horses

Gastric ulcers are common in horses. The purpose of this study was to test the effect of porcine hydrolysed collagen (PHC) on gastric ulcer scores and gastric juice pH in horses. We hypothesise that PHC-administration will result in improved gastric lesion scores and act synergistically with omeprazole to improve treatment efficacy. Thoroughbred horses (n = 10) were studied in a 2-period, 2-treatment crossover design, where the PHC (45 g) was administered twice daily. Horses were treated for 56 days. Gastroscopy was performed and gastric juice pH measured on Days 0, 14, 28, 42, 49 and 56. Nonglandular gastric ulcer number (NGN) and severity (NGS) and glandular ulcer number (GN) and glandular severity (GS) scores were assigned by an investigator masked to treatment and serum gastrin and amino acid concentrations. By Day 42, 2 weeks after discontinuing omeprazole treatment, NGN and NGS scores returned to pretreatment values and serum gastrin was higher when compared to values measured on Day 28. By Day 49, after the feed-deprivation period, NGN and NGS were similar to pretreatment values. By Day 56, mean NGN score was significantly lower in PHC-treated horses, compared to controls. Mean gastric juice pH significantly increased in both groups on Day 28 and the pH was significantly (P = 0.0127) higher in the PHC-treated horses. Serum amino acid concentrations were not significantly different 2 h after feeding PHC and hydroxyproline was not detected. Serum gastrin concentration did not increase 2 h after feeding in the PHC-fed horses. The PHC fed to horses enhanced the effects of omeprazole on increased gastric juice pH, inhibited gastrin secretion after feeding and resulted in fewer nonglandular ulcers after long-term feeding (56 days) in stall-confined horses undergoing intermittent feeding.     

Aspiration of barium-impregnated polyethylene spheres by a dog

This case report describes an 11-year-old Belgian Malinois dog with acute onset of cough caused by aspiration of barium-impregnated polyethylene spheres (BIPS) and pneumonia following an episode of suspected gastric dilation. Although bronchoscopic retrieval of the BIPS was largely unsuccessful, the dog recovered uneventfully, with most of the BIPS being coughed out and swallowed over a 1-month period. Aspiration of BIPS should be considered a potential complication of their administration. Furthermore, endoscopic removal of aspirated BIPS is challenging and may not be indicated because of their inert nature and possible self-clearance.