Partial Gastric Obstruction Caused by Cajarana (Spondias cytherea Sonn) in Puppies - Imaging Techniques for Diagnosis

Background: Ingestion of foreign bodies is one of the most common cases seen among puppies of dogs in the medical clinics of small animals which may be related to their curious behavior. The diagnosis is based on the patient’s history, clinical signs, and complementary diagnostic imaging tests. The present case report describes the use of complementary imaging tests, showing a partial gastric obstruction caused by cajarana (Spondias cytherea Sonn) in a puppy.Case: At the Veterinary Hospital of the Federal Rural University of the Semi-Arid Region, a 4-month-old male Yorkshire dog was treated. The guardian reported having witnessed the ingestion of a cajarana stone by the animal. During the physical examination, the animal was active, with good nutritional status, normocorated mucosae, and a moderate degree of dehydration, besides a slight pain on palpation in the epigastric region. Hematological examinations included blood counts, blood urea, creatinine, and alkaline phosphatase. A moderate degree of polycythemia was observed, which may be explained by the dehydration caused by the episodes of vomiting. The patient had frequent episodes of vomiting after the reported event and was then referred to the diagnostic imaging sector. During the sonographic examination, a concave echogenic interface associated with a posterior acoustic shadowing was observed in the region of the stomach. The animal was sent for simple radiographs and positive contrast based on barium sulfate due to the suspicion of the presence of a foreign body. On simple radiography, in the left laterolateral view, a little radiopaque structure of circular format with poor definition was observed in the pyloric region. After the simple radiography, approximately 10 mL of barium sulfate contrast was administered orally followed by a new left lateral radiographic imaging. On performing sequenced radiographs, a discrete barium contrast contour, oval in structure, located in the pyloric region was observed, even after gastric emptying for about 1 h, reinforcing the clinical suspicion of cajarana stone ingestion. In view of these results, the animal underwent a gastrostomy for the removal of cajarana, which measured about 2.5 cm in diameter. After the surgical procedure, the animal had a good clinical recovery.Discussion: The history of the animal along with clinical signs and imaging tests are of great assistance in the investigation of gastric foreign bodies. The most common type of foreign bodies found in the gastrointestinal tract of small animals are bones, but other atypical structures may also be found, as shown in this report. Radiography (simple and with contrast) is an imaging method widely used in veterinary medicine because of its low cost and clinical accessibility. It is important for the investigation of gastrointestinal obstructions, being of fundamental importance in the management of this case. Ultrasound examination also provides crucial information when foreign bodies are suspected since the formation of intense posterior acoustic shadow (described in this case) is one of the characteristic findings of this condition. Finally, the associated radiography and ultrasonography as diagnostic imaging for the investigation of foreign bodies in the gastrointestinal tract complement each other. Depending on the nature of the foreign body, a single imaging examination may not be satisfactory to suggest the presence of a foreign body with certainty.

Evaluation of Pyloroplasty repair by Single layer Simple Interrupted Extra Mucosal technique in Dogs

In this study a pyloroplasty technique was designed by using a single layer simple interrupted extra-mucosal suture pattern on pyloric region in dogs. Nine adult dogs were used to induce longitudinal surgical incision in the pyloric region under general anesthesia using a combination of 15mg/kg B.W. ketamine hydrochloride 5% and 5 mg/kg B.W Xylazine hydrochloride 2%. The incision was closed by pyloroplasty technique (longitudinal incision for whole layers with transverse suturing) using single layer simple interrupted extra mucosal technique. The examination achieved by daily clinical observation, radiological finding, at the end of 21st day post operation, macroscopical and histopathological examination at the period 3rd, 7th, and 21st days post operation. The results showed no significant clinical changes in body temperature and physiological activity. The radiological findings showed good patency of the pyloric canal after 21st days post operation. The macroscopic finding shows heavy amount of the omentum adhered around the site of incision. The microscopic finding showed good healing process by re-epithelization of the mucosal layer associated with granulation tissue proliferation, angiogenesis, and less infiltration of mononuclear inflammatory cells. The conclusion indicated that single layer simple interrupted extra mucosal suture pattern technique can be used successfully in repair the pyloric stenosis in dog.

Intoxication by Lornoxicam in Two Dogs

Background: The indiscriminate use of drugs is routinely observed in the field of veterinary medicine. Nonsteroidal antiinflammatory drugs (NSAIDs) are the class of drugs that most commonly cause intoxication in pet animals. Lornoxicam, an NSAID, is a cyclooxygenase COX-1 and COX-2 inhibitor and is only recommended for human treatment. Here we present cases involving two dogs who presented with Lornoxicam intoxication following administration without veterinary prescription.Cases: 1) - A 1-year-old female Rottweiler was presented for clinic with claudication, profuse vomiting, and fetid blackish diarrhea. The owner reported administer two tablets of oral Lornoxicam. Physical examination revealed lethargy, a bulging abdomen and pale mucous membranes. Contrast-enhanced imaging of the gastrointestinal tract revealed decreased stomach flow. The ultrasound revealed predominantly gaseous contents in the stomach with normal walls, a large amount of accumulated gas in the pyloric region. Therefore, exploratory laparotomy was held and a nonperforated ulcer was observed in the pyloric region. There were hemorrhagic areas in the stomach mucosa and enlarged lymph nodes in the duodenum. The ulcer was resected without complications. Medications included after surgery were intravenous fluid, antibiotic, analgesic, antiemetic, histamine H2-receptor antagonist and Cytoprotective drugs. The day after the surgical procedure, no episode of vomiting or diarrhea was observed and the food and water were introduced gradually in the following days. 2) - An 11-yearold male Old English Sheepdog came to the clinic with a history of vomiting, blackish diarrhea, and loss of appetite. The owner reported that first was administered deltamethrin for tick infestation and approximately 3 days after, the amitraz. The animal began vomiting, limping, and lost its appetite. Because of the limping, the owner administered Lornoxicam in a single dose and the animal start vomiting and manifested fetid, blackish diarrhea. On physical examination, the patient showed 7.0% dehydration and tenderness on palpation in the epigastric region. For diagnostic screening was performed: hematological and biochemical evaluation; the Canine Test SNAP 4DX; and total abdominal ultrasound. The results only showed leukocytosis and predominantly gaseous contents in the stomach. Then, pyrethroid and formamidine intoxication with hemorrhagic gastroenteritis secondary to Lornoxicam administration was suspected. Intravenous fluid therapy was performed with Ringer’s lactate solution. In addition, metoclopramide, ranitidine, sucralfate and sulfamethoxazole/trimethoprim were administered along the gradual insertion of food and water. The patient showed complete clinical recovery after 7 days of hospitalization and was discharged.Discussion: The clinical signs presented by the both cases were similar to those described in the literature on NSAID intoxication in animals. In the two cases, none of the exams confirmed the presence of the ulcer, but they helped to suspect. Blood tests performed for the second animal revealed findings similar to previously reported nonspecific laboratory findings for gastric ulcers. In both cases, ultrasound did not identify any changes that proved the existence of gastric ulcers. However, this test is necessary to rule out complications such as perforation or peritonitis. In the first case, exploratory laparotomy was required for a definitive diagnosis because of suspected obstruction in the pyloric region. For the second animal, surgery was not planned because all the performed tests only raised a suspicion of hemorrhagic gastritis, and the suspected diagnosis was confirmed by the positive response to the treatment. The underlying etiology in both cases was identified as Lornoxicam intoxication due to administration without veterinary medical prescription.Keywords: nonsteroidal anti-inflammatory drug, gastritis, gastric ulcer.

YU Pyloroplasty for the Correction of Chronic Hypertrophic Pyloric Gastropathy in Canines

Background: One of the causes of delay gastric emptying is the chronic hypertrophic pyloric gastropathy, unusual disease that can occur in acquired or congenital form. It is characterized by hypertrophy of the antral mucosa, by thickening of the muscular layer, or by hyperplasia of the pylorus. The animals are presented with a history of chronic intermittent vomiting. Treatment is based on surgical correction through techniques such as pyloromyotomy or transverse or Y-U pyloroplasty. Thus, the aim was report three cases of pyloric stenosis by hypertrophy in dogs of the breeds, Fila Brasileiro, English Bull Terrier and American Pitbull Terrier, emphasizing the diagnosis and therapy instituted.Cases: All animals in this study reached the Veterinary Hospital of the Federal University of Mato Grosso with a history of chronic intermittent vomiting. The findings of physical and laboratory examinations in all animals were unspecific, with those important to rule out other causes of vomiting. Contrast radiographic evaluation revealed marked stomach distension and delayed gastric emptying, indicated gastric outflow obstruction. In one case, a video endoscopy was performed. The images reveal hyperemia of the gastric mucosa with small areas of bleeding around the stomach. It was observed intense production of gastric juice and the presence of the same reflux. In the pyloric antrum, a thick fold reddish gastric mucosa, which partially obstructed the pyloric ostium. There was very little motility during the examination. As therapeutic approach for all cases, we opted for performing the surgical technique of pyloroplasty in Y-U, consisting of enlarging the diameter of the antral pyloric region in an attempt to create a broader pylorus, what make possible an emptying a gastric rapidly. All the pacients remained in hospital in the postoperative period receiving medications intravenously. Postoperative fluid based on Ringer’s lactate solution and administration of ondansetron (0.2 mg/kg every 8 h), sucralfate (30 mg/ kg every 12 h), sulfadoxine to trimethoprim (20 mg/kg every 12 h) and meloxicam (0.2 mg/kg every 24 h). Twelve h of fasting after the surgical procedure without vomiting, the dog received light past food. An average of three to four days post-surgical discharged with recommendations to keep antibiotic therapy for ten days and light diet. The fifteenth day of surgery, the patients returned for removal of skin spots, with good general condition and satisfactory healing. No cases of vomiting were reported. As the case one returned to perform the monitoring gastograma. The dog was anesthetized and giving the contrast. On radiographs, there was a slight delay in gastric emptying, which can be explained by the anesthesia used for contrast administration, as described in the literature. The images showed stomach and intestines in size, shape and normal position. The technique was satisfactory in reducing clinical signs in all these cases, confirmed by the absence of vomiting in the post-operative period.Discussion: The surgical technique used, pyloroplasty Y-U consists of traspor a part of the antral wall to the pyloric region in an attempt to create a broader pylorus, and possibly a time soon gastric emptying. It was possible to demonstrate with only three cases the pyloroplasty Y-U proved to be a simple and effective technique for the treatment of hypertrophic pyloric stenosis with a favorable prognosis in all cases. Thus, disease should be considered in the differential diagnosis in cases of gastric outflow obstruction, regardless of patients age.Keywords: dog, hypertrophy, pylorus.

Morphological characteristics of the digestive tract of Schizodon knerii (Steindachner, 1875), (Characiformes: Anostomidae): An anatomical, histological and histochemical study

The digestive tracts of 44 specimens of Schizodon knerii were studied using anatomical, histological and histochemical techniques. The mouth has terminal position, the lip epithelium is squamous stratified with mucous, claviform cells and taste buds, teeth have an incisive form and the tongue has a stratified squamous epithelium with mucous cells and taste buds. The oropharynx cavity is formed by gill apparatus and pharyngeal teeth. The oesophagus presented pleated mucosa, a stratified squamous epithelium with mucous cells, oesophageal glands and taste buds. The stomach presented cardiac, fundic and pyloric regions, simple prismatic epithelium with tubular glands, with none in the pyloric region. The intestine contains 11-15 pyloric caeca, a simple prismatic epithelium with brush border, goblet cells and lymphocytes. Mucosal cells, oesophageal glands and goblet cells reacted positively to PAS, amylase + PAS, Ab pH 2.5 and Ab pH 0.5. Gastric prismatic cells reacted positively to PAS, amylase + PAS, but only those in the pyloric region reacted positively to Ab pH 2.5 and Ab pH 0.5. The results improve the understanding of the anatomy of S. knerii feeding habits and the presence of mucosubstances in the epithelium, highlights the importance of glycoproteins for passing food through the digestive tract.

INFANTILE HYPERTROPHIC PYLORIC STENOSIS (IHPS)

AbstrakInfantile hypertrophic pyloric stenosis (IHPS) adalah kelainan anatomi pada bayi dengan terjadinya hipertropi pada region pilorik yang menimbulkan obstruksi. Diagnosis dapat ditegakkan berdasarkan manifestasi klinis. Pada kasus yang tidak khas dibutuhkan pemeriksaan lebih lanjut. Dilaporkan sebuah kasus IHPS di RS. M. Djamil Padang, anak laki-laki usia 2 bulan. Pasien datang dengan keluhan utama muntah yang tidak proyektil setiap selesai menyusui. Pada pemeriksaan fisik tidak ditemukan massa di abdomen sebagai tanda obstruksi. Dari pemeriksaan barium meal sesuai dengan IHPS dan terbukti saat operasi. Pasien pulang dalam keadaan baik.Kata Kunci : Infantile hypertrophic pyloric stenosis, barium mealAbstractInfantile hypertrophic pyloric stenosis (IHPS) is misleading anatomic in infant with hypertrophy muscle in the pyloric region leads to gastric obstruction. Diagnosed can determine based on the clinical manifestation. In the case that not characterized such as examination in early onset, onset in the younger ex neonate needs more examination to determine the case as IHPS. Reported a case IHPS in Dr. M. Djamil Hospital in infant, boy, 2 month old. He came with chief complain non projectile vomiting after feeding. In physical examination there was no palbable mass on the abdominal as manifestation of obstruction. The result of Barium meal appropriate with IHPS and was improved in operation. The patient was discharged in good condition.Key word : Infantile hypertrophic pyloric stenosis, barium mealLAPORAN KASUS

Comparative study of pyloromyotomy by laparoscopic and conventional surgery in dogs

Pyloromyotomy is a procedure to increase the diameter of pyloric region, routinely performed during pyloric stenosis to prevent delayed emptying of stomach content. The aim of this study was to evaluate the pyloromyotomy by conventional and laparoscopic techniques. Ten adult healthy dogs were used. Five animals underwent the pyloromyotomy by conventional and the same number laparoscopic technique. The clinical radiological and laparoscopic results of two techniques revealed that both were successive for achieved this purpose, but the laparoscopic pyloromoytomy characterized by small abdominal incision minimal adhesion and rapid healing.