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Balducci J, Piedra-Mora C, Jennings S, Anson A, Penninck D. Hyperechogenicity of the pyloroduodenal junction in small dogs: Population prevalence in 175 dogs and histological correlation in 14 specimens. Vet Radiol Ultrasound 2024; 65:238-245. [PMID: 38372070 DOI: 10.1111/vru.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/06/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
At the pyloroduodenal junction (PDJ), an increase in wall echogenicity is frequently observed. A prospective study was performed to assess the PDJ sonographically in 175 adults and small dogs (>1 year old, <11.4 kg (25 lb)) over 12 months to evaluate the prevalence of this finding. Additionally, changes in echogenicity were correlated with histology in 14 postmortem specimens. A scoring system of echogenicity change centered on the mucosa and submucosa of the PDJ was implemented; 0: no change, 1: mild, 2: moderate to marked. Other included parameters were age, sex, breed, gastric distention, gastric contents, and reported vomiting at the time of presentation. Hyperechogenicity of the PDJ was highly prevalent (scores 1 and 2: 85.7%). No statistical association between hyperechogenicity of the PDJ and age, sex, gastric distention, gastric contents, or vomiting was identified. Hyperechogenicity of the PDJ is thought to represent an anatomical transition zone, and based on histology, hyperechogenicity of the PDJ may represent a variation in distribution and amount of fibrous connective tissue, glandular number, and glandular dilation within the submucosa and mucosa.
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Affiliation(s)
- Jamie Balducci
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA
| | - Cesar Piedra-Mora
- Department of Infectious Diseases and Global Health, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA
- Antech Diagnostics, Fountain Valley, California, USA
| | | | - Agustina Anson
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA
| | - Dominique Penninck
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA
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Gori E, Gianella P, Lippi I, Marchetti V. Retrospective Evaluation of Gastrointestinal Signs in Hypothyroid Dogs. Animals (Basel) 2023; 13:2668. [PMID: 37627459 PMCID: PMC10451992 DOI: 10.3390/ani13162668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Few observations about gastrointestinal (GI) signs in hypothyroid dogs (hypo-T dogs) are available. We aimed to evaluate the prevalence and characteristics of concurrent GI signs in hypo-T dogs, describe clinicopathological, hepato-intestinal ultrasound findings in hypo-T dogs, investigate changes in GI signs after thyroid replacement therapy (THRT). Medical records of suspected hypo-T dogs from two hospitals were retrospectively reviewed. The inclusion criteria were: (1) having symptoms and clinicopathological abnormalities related to hypothyroidism (i.e., mild anemia, hyperlipemia); (2) not being affected by systemic acute disease; (3) not having received any treatment affecting thyroid axis. Hypothyroidism had to be confirmed using low fT4 or TT4 with high TSH and/or inadequate TSH-stimulation test response; otherwise, dogs were assigned to a euthyroid group. Clinical history, GI signs, hematobiochemical parameters, and abdominal ultrasound findings were recorded. Hypo-T dogs were assigned to the GI group (at least 2 GI signs) and not-GI group (1 or no GI signs). Follow-up information 3-5 weeks after THRT was recorded. In total, 110 medical records were screened: 31 dogs were hypo-T, and 79 were euthyroid. Hypo-T dogs showed a higher prevalence of GI signs (44%), especially constipation and diarrhea (p = 0.03 and p = 0.001), than euthyroid dogs (24%) (p = 0.04). Among hypo-T dogs, no difference in hematological parameters between GI and non-GI groups was found. Hypo-T dogs had a higher prevalence of gallbladder alterations than euthyroid dogs (20/25; 80% and 32/61; 52% p = 0.04). The hypo-T GI group showed a significant improvement in the GI signs after THRT (p < 0.0001). Specific investigation for concurrent GI diseases in hypo-T dogs was lacking; however, improvement in GI signs following THRT supports this association between GI signs and hypothyroidism.
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Affiliation(s)
- Eleonora Gori
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, PI, Italy; (E.G.); (V.M.)
| | - Paola Gianella
- Department of Veterinary Medical Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy;
| | - Ilaria Lippi
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, PI, Italy; (E.G.); (V.M.)
| | - Veronica Marchetti
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, PI, Italy; (E.G.); (V.M.)
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Holle HM, Ghilagaber G, Drees R. Evaluation of the normal gastrointestinal tract in cats using dual-phase computed tomography. J Small Anim Pract 2023; 64:463-476. [PMID: 36990464 DOI: 10.1111/jsap.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 12/18/2022] [Accepted: 01/24/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES In cats, although ultrasonography remains the preferred modality to evaluate the gastrointestinal tract, computed tomographic (CT) examination of the abdomen is commonly performed. However, a normal description of the gastrointestinal tract is lacking. This study describes the conspicuity and contrast enhancement pattern of the normal gastrointestinal tract in cats using dual-phase CT. MATERIALS AND METHODS Pre- and dual-phase postcontrast (early scan at 30 seconds and late scan mean at 84 seconds) abdominal CT exams of 39 cats without history, clinical signs or diagnosis of gastrointestinal disease were reviewed. The gastrointestinal tract was examined for conspicuity and enhancement pattern using commercially available viewing software (Osirix, v.6.5.2), and diameters of 16 gastrointestinal segments were recorded and compared with published radiographic and ultrasonographic reference values. RESULTS Of the 624 gastrointestinal segments, 530 (84.9%) were identified on precontrast studies and 545 (87.3%) segments on postcontrast studies. Of the gastrointestinal wall segments, 257 (41.2%) were identified on precontrast studies and 314 (50.3%) on postcontrast studies. Gastrointestinal segment diameters correlated well with published normal values, whereas wall thickness measurements usually were smaller compared with sonographic normal values. Early mucosal surface enhancement was frequently seen in the gastric cardia and fundus and ileocolic junction, and a mainly transmural wall enhancement in other gastrointestinal segments. CLINICAL SIGNIFICANCE Dual-phase CT allows for the identification of gastrointestinal tract segments and walls in cats. Contrast enhancement improves conspicuity and demonstrates wall layering in the cardia, fundus and ileocolic junction.
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Affiliation(s)
- H M Holle
- AniCura Small Animal Hospital Albano, Rinkebyvägen 21A, 18236, Danderyd, Stockholm, Sweden
| | - G Ghilagaber
- Department of Statistics, Stockholm University, Albanovägen 12, Building 4, 6th Floor, 106 91 Stockholm, Sweden
| | - R Drees
- Department Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane Hatfield Hertfordshire, AL9 7TA London, UK
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miRNA Profiles of Canine Intestinal Carcinomas, Lymphomas and Enteritis Analysed by Digital Droplet PCR from FFPE Material. Vet Sci 2023; 10:vetsci10020125. [PMID: 36851429 PMCID: PMC9966613 DOI: 10.3390/vetsci10020125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Most canine intestinal tumours are B-cell or T-cell lymphomas or carcinomas. They have to be distinguished from cases of enteritis. Non-invasive biomarkers such as miRNAs would be a step towards faster diagnosis. The aim of this study was to investigate shifts in miRNA expression in tissue samples collected from cases of enteritis, carcinoma and lymphoma of the small and large intestine to better understand the potential of miRNA as biomarkers for tumour diagnosis and classification. We selected two oncogenic miRNAs (miR-18b and 20b), two tumour suppressive miRNAs (miR-192 and 194) and two potential biomarkers for neoplasms (miR-126 and 214). They were isolated from FFPE material, quantified by ddPCR, normalised with RNU6B and compared with normal tissue values. Our results confirmed that ddPCR is a suitable method for quantifying miRNA from FFPE material. Expression of miR-18b and miR-192 was higher in carcinomas of the small intestine than in those of the large intestine. Specific miRNA patterns were observed in cases of enteritis, B-cell and T-cell lymphoma and carcinoma. However, oncogenic miR-18b and 20b were not elevated in any group and miR-126 and 214 were down-regulated in T-cell and B-cell lymphoma, as well as in carcinomas and lymphoplasmacytic enteritis of the small intestine.
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Tanaka T, Noguchi S, Wada Y, Nishida H, Akiyoshi H. Preliminary study of CT features of intermediate- and high-grade alimentary lymphoma and adenocarcinoma in cats. J Feline Med Surg 2022; 24:1065-1071. [PMID: 34663124 PMCID: PMC10812299 DOI: 10.1177/1098612x211046847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CASE SERIES SUMMARY The ultrasonographic findings of many feline intestinal tumours are similar. This study evaluated the CT features of intermediate- and high-grade alimentary lymphoma and adenocarcinoma in cats. CT was performed on six cats with adenocarcinoma and 14 cats with lymphoma. Comparisons between tumour types were conducted, focusing on CT features, including obstruction (present or absent), growth patterns of lesions (symmetry or asymmetry), layering enhancement (present or absent), location of the lesion, number of lesions (solitary or multiple), lymphadenopathy (present or absent), location of lymphadenopathy, pulmonary metastasis (present or absent) and maximum thickness (mm) of the lesion. The cats with adenocarcinoma (n = 5/6 [83%]) experienced intestinal obstruction significantly more often than cats with lymphoma (n = 0/14 [0%]; P = 0.0004). Layering enhancement was observed significantly more often in cats with adenocarcinoma (n = 6/6 [100%]) than in cats with lymphoma (n = 1/14 [7%]; P = 0.0002). Lymphadenopathy was detected significantly more often in cats with lymphoma (n = 14/14 [100%]) than in cats with adenocarcinoma (n = 2/6 [33%]) (P = 0.003). In cats with lymphoma, the intestine (12.1 ± 3.9 mm) was significantly thicker than that in cats with adenocarcinoma (6.4 ± 2.3 mm; P = 0.005). RELEVANCE AND NOVEL INFORMATION To the best of our knowledge, no reports have described the characteristics of feline intestinal tumours using CT. Layering enhancement was observed in cats with intestinal adenocarcinomas. No layering enhancement was observed in alimentary lymphoma in cats, but enlarged regional nodes were noted. Lesions with lymphoma were thicker than those with adenocarcinoma. These findings may help differentiate between adenocarcinomas and lymphomas.
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Affiliation(s)
- Toshiyuki Tanaka
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
- Kinki Animal Medical Training institute, Higashiosaka, Osaka, Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, Japan
| | - Yusuke Wada
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, Japan
| | - Hidetaka Nishida
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Hideo Akiyoshi
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
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Pathological Findings in Gastrointestinal Neoplasms and Polyps in 860 Cats and a Pilot Study on miRNA Analyses. Vet Sci 2022; 9:vetsci9090477. [PMID: 36136693 PMCID: PMC9500658 DOI: 10.3390/vetsci9090477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Gastrointestinal masses in cats are of clinical relevance, but pathological studies with larger case numbers are lacking. Biomarkers such as miRNA have not yet been investigated in feline intestinal neoplasms. Methods: A retrospective analysis of pathology reports included 860 feline gastrointestinal masses. Immunohistochemistry was performed on 91 lymphomas, 10 sarcomas and 7 mast cell tumours (MCT). Analyses of miRNA-20b and miRNA-192 were performed on 11 lymphomas, 5 carcinomas and 5 control tissues by ddPCR. Results: The pathological diagnosis identified 679 lymphomas, 122 carcinomas, 28 sarcomas, 23 polyps, 7 MCT and 1 leiomyoma. Carcinomas and polyps were most commonly found in the large intestine, lymphomas were most commonly found in the stomach and small intestine and MCT only occurred in the small intestine. Besides the well-described small-cell, mitotic count <2 T-cell lymphomas and the large-cell B-cell lymphomas with a high mitotic count, several variants of lymphomas were identified. The values of miRNA-20b were found to be up-regulated in samples of all types of cancer, whereas miRNA-192 was only up-regulated in carcinomas and B-cell lymphomas. Conclusions: The histopathological and immunohistochemical (sub-)classification of feline intestinal masses confirmed the occurrence of different tumour types, with lymphoma being the most frequent neoplasm. Novel biomarkers such as miRNA-20b and miRNA-192 might have diagnostic potential in feline intestinal neoplasms and should be further investigated.
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Relationship between Serum Protein Electrophoresis, Endoscopic and Histopathological Scores in 99 Cats with Chronic Enteropathy. Vet Sci 2022; 9:vetsci9090453. [PMID: 36136669 PMCID: PMC9500995 DOI: 10.3390/vetsci9090453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/04/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Serum protein electrophoresis (SPE) is a laboratory test used to separate different protein fractions. It is used to investigate animals with hyperglobulinemia and to distinguish between monoclonal and polyclonal gammopathies. SPE can also highlight acute or chronic inflammation patterns which are useful in disease monitoring. SPE is effective in humans with intestinal bowel disease (IBD) and chronic liver diseases. In addition, hypergammaglobulinemia is a marker of extraintestinal manifestations in human IBD patients, which often includes hepatic and pancreatic disease. Concurrent pancreatic and/or hepatic diseases in cats with chronic enteropathy (CE) have often been found, which may contribute to SPE alterations. The present study investigated the relationship between SPE and endoscopy, histopathology, and hepatic and pancreatic ultrasonographic findings in ninety-nine cats diagnosed with CE. No significant differences were observed between SPE and endoscopic and histopathological severity scores. Cats with concurrent pancreatic and/or hepatic ultrasonographic alterations showed lower albumin, lower α-globulin, and higher γ-globulin levels than cats diagnosed with enteropathy alone. This study suggests that hepatic and/or pancreatic alterations may influence SPE fractions in cats with CE, and should form the basis for further prospective studies on cats with diaditis and triaditis. Abstract Few studies have investigated total protein (TP) and serum protein electrophoresis (SPE) in cats with chronic enteropathy (CE). Cats diagnosed with CE were evaluated to investigate the relationships between TP, SPE and endoscopy, histopathology, and extraintestinal involvement. Medical records were searched for cats with a history of chronic gastrointestinal signs and a final diagnosis of CE. Information on signalment, TP, SPE, endoscopic score, histopathological diagnosis and score, and concurrent hepatic or pancreatic ultrasonographic alterations was collected. Relationships between protein profiles and other variables were investigated. Ninety-nine cats were included in the study, 63 diagnosed with various degrees of bowel inflammation and 36 with small-cell alimentary lymphoma. The most common TP alteration was hypoproteinemia (24%). No significant differences were observed between protein profiles and endoscopic and histopathological severity scores. Forty-five cats showing concurrent pancreatic and/or hepatic ultrasonographic alterations, had significantly lower albumin, lower α-globulin, and higher γ-globulin levels than cats not showing concurrent alterations. Disease severity scores did not seem to influence the protein profile in cats with CE. Extraintestinal involvement may be suspected in cats with lower albumin and α-globulins and higher γ-globulins.
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Fosburg J, Balducci JJ, Fernandez AA, Sato AF. What Is Your Diagnosis? J Am Vet Med Assoc 2022; 260:1780-1782. [DOI: 10.2460/javma.22.04.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Julia Fosburg
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Jamie J. Balducci
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Agustina Anson Fernandez
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Amy F. Sato
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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Cyclosporine Treatment in Cats with Presumed Chronic Pancreatitis-A Retrospective Study. Animals (Basel) 2021; 11:ani11102993. [PMID: 34680012 PMCID: PMC8532754 DOI: 10.3390/ani11102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine, an immunosuppressive drug, has been suggested as an alternative treatment when other drugs that suppress inflammation are ineffective or unsuitable. However, no published studies have investigated its efficacy in cats with CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine as a treatment for pancreatitis in cats with presumed CP. All cats had a history and clinical signs suggestive of CP and blood samples showed abnormally high concentrations of feline pancreas-specific lipase (Spec fPL) on at least two occasions. This is common in CP. All cats were treated with cyclosporine for at least three weeks. Nineteen cats, aged 6.9–17.5 years, were included. Daily treatment with cyclosporine resulted in an improvement of serum Spec fPL concentrations which indicates that the pancreatic inflammation likely had improved. The study has several limitations, including different treatment durations and doses, lack of biopsies to confirm CP and the treatment effect was not compared with an untreated control group. Despite the limitations, our results suggest that cyclosporine treatment decreases serum Spec fPL concentrations and may be effective in the management of feline chronic pancreatitis. Abstract Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine has been suggested as an alternative treatment when other immunosuppressive treatments are insufficient or contraindicated. However, no published studies have investigated its efficacy on feline CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine on supranormal serum feline pancreas-specific lipase (Spec fPL) concentrations in cats with presumed CP. Inclusion criteria were history and clinical signs suggestive of CP, serum Spec fPL concentrations above 5.3 μg/L (reference range 0–3.5 μg/L, equivocal range 3.6–5.3 μg/L) on at least two occasions and treatment with cyclosporine for at least three weeks. Serum Spec fPL was analyzed at Idexx Laboratories, Kornwestheim, Germany. Nineteen cats, aged 6.9–17.5 years (median 11.6), were included. No pancreatic biopsies were available. Median (range) serum Spec fPL concentration was 14.2 μg/L (6.1–43.3) at baseline and 6.7 μg/L (0.9–23.6) at follow-up. Cyclosporine treatment (5.0–7.9 mg/kg orally SID) was associated with a significant reduction in serum Spec fPL concentrations (p < 0.001) at follow-up after 23–206 days (median 35). Body weight decreased significantly between inclusion and follow-up (p = 0.013). Significant improvement of clinical signs could not be measured (p = 0.781). This study has several limitations, including unstandardized treatment length and dose, no control group and lack of pancreatic biopsies. Despite the limitations, our results suggest that cyclosporine treatment reduces supranormal serum Spec fPL concentrations in cats with presumed CP.
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Phipps WB, Rich AF, Rossanese M. Asymptomatic Enteric Duplication Cyst in a Geriatric Cat: Case Report and Review of the Literature. J Am Anim Hosp Assoc 2021; 57:133-138. [PMID: 33770172 DOI: 10.5326/jaaha-ms-7057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2020] [Indexed: 11/11/2022]
Abstract
An 11 yr old female neutered domestic shorthair presented for an 8 mo history of an asymptomatic abdominal mass. Computed tomography described an irregular, cystic structure closely associated with the duodenum, and focal ultrasonography confirmed the mass shared outer layers with the intestinal wall. Coeliotomy revealed the mass was originating from, and firmly adhered to, the antimesenteric border of the duodenum but was not communicating with the intestinal lumen. En bloc mass resection with omentalization was performed without small intestinal resection. Histopathology confirmed an enteric duplication cyst. The cat made a full recovery and remained asymptomatic postoperatively with no evidence of recurrence. A review of the literature confirms the duodenum to be the most common location of enteric duplication cysts in felines and that subtotal excision is curative in most cases. This differential should be considered in cases of cystic gastrointestinal structures in juvenile and adult felines, with or without associated clinical signs. In cases of luminal involvement or malignant transformation, intestinal resection and anastomosis is more appropriate. This report describes the presentation, investigations, and treatment of an asymptomatic duodenal duplication cyst in an adult feline and summarizes and compares current knowledge of the condition between veterinary and human literature.
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Linta N, Pey P, Baron Toaldo M, Pietra M, Felici M, Bettini G, Cipone M, Diana A. Contrast-enhanced ultrasonography in dogs with inflammatory bowel disease. J Vet Intern Med 2021; 35:2167-2176. [PMID: 34432324 PMCID: PMC8478066 DOI: 10.1111/jvim.16202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background Contrast‐enhanced ultrasonography (CEUS) is used to evaluate vascularity of the gastrointestinal wall in neoplastic and inflammatory diseases. Objective To assess the feasibility of CEUS for the evaluation of duodenal perfusion in dogs with inflammatory bowel disease (IBD). Animals Forty‐two dogs with IBD and 20 clinically healthy dogs. Methods All CEUS studies of the duodenum were analyzed to obtain time‐intensity curves and perfusion parameters. The procedure was repeated in 12 IBD dogs 2 months after a standardized treatment. Results On CEUS, the duodenal wall showed a typical perfusion pattern characterized by a radial and simultaneous enhancement of the wall in all dogs. On qualitative assessment, no differences were observed in contrast medium distribution between healthy and affected dogs, or between dogs with IBD before and after treatment. Peak intensity (PI) and area under the curve (AUC) significantly differed between healthy (PI = 3.58 arbitrary units [au; 1.86‐4.93 au] and AUC = 47.63 au seconds [aus, 22.68‐62.15]) and affected dogs (PI = 5.10 au [0.63‐15.16 au] and AUC = 63.62 aus [5.31‐212.20 aus]; P = .03 and .03, respectively). No significant differences were found for the perfusion parameters before and after treatment. Conclusions and Clinical Importance We showed that CEUS allows discrimination between IBD affected dogs and healthy dogs by evaluation of time‐intensity curves, but did not provide useful information for monitoring therapeutic response. The qualitative assessment identified no significant differences between healthy and affected dogs, or between dogs before and after treatment.
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Affiliation(s)
- Nikolina Linta
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Pascaline Pey
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Marco Baron Toaldo
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Marco Pietra
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Manuel Felici
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Giuliano Bettini
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Mario Cipone
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Alessia Diana
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
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B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs. Animals (Basel) 2021; 11:ani11030670. [PMID: 33802392 PMCID: PMC7998525 DOI: 10.3390/ani11030670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasonography is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced ultrasound features of normal, inflammatory, and neoplastic gastric diseases in dogs. Standard and contrast enhanced ultrasound of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated. A total of 41 dogs were included: 6 healthy as the control group; 9 gastritis; 8 adenocarcinoma; 8 alimentary lymphoma; 4 leiomyosarcoma; 2 gastrointestinal stromal tumor; 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked thickening with absent layers definition and possible regional lymphadenopathy and steatitis while gastritis generally shows no/mild thickening and no other alterations on standard ultrasound. During contrast—enhanced ultrasonography, neoplasms show a higher and faster wash in if compared to that of gastritis. B-mode and contrast enhanced ultrasound assessment may be useful in the evaluation of canine gastric disorders for the distinction between gastritis and gastric neoplasms, even if there are no specific aspects able to discriminate between different tumors types. Abstract Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasound (US) is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced US (CEUS) features of normal, inflammatory, and neoplastic gastric wall in dogs. B-mode US and CEUS of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 41 dogs were included: 6 healthy (HEA) as the control group; 9 gastritis (INF); 8 adenocarcinoma (AC); 8 alimentary lymphoma (AL); 4 leiomyosarcoma (LEIS); 2 gastrointestinal stromal tumor (GIST); 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked wall thickness with absent layers definition and possible regional lymphadenopathy (AC and AL) and steatitis (AC) while gastritis generally shows no/mild thickening and no other alterations on B-mode US. On CEUS, neoplasm shows a higher and faster wash in if compared to that of gastritis. B-mode and CEUS assessment may be useful in the evaluation of canine gastric disorders in the distinction between gastritis and gastric neoplasms, even if there are no specific features able to discriminate between the different tumor histotypes.
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Isaya R, Ciccarelli S, Enache D, Specchi S, Pesaresi M, Ferri F, Porporato F, Auriemma E, Contiero B, Coppola LM, Zini E. Gastrointestinal ultrasonographic findings in cats with Feline panleukopenia: a case series. BMC Vet Res 2021; 17:20. [PMID: 33413382 PMCID: PMC7791690 DOI: 10.1186/s12917-020-02720-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022] Open
Abstract
Background Feline panleukopenia virus (FPV) is very resistant and highly contagious and infects domestic cats and other felids. FPV is particularly widespread among sheltered cats, and is associated with high morbidity and mortality, causing severe gastroenteritis characterized by anorexia, lethargy, fever, dehydration, hemorrhagic diarrhea, and vomiting. There is currently no data on the ultrasonographic features of cats affected with FPV. This case series describes abdominal ultrasonographic findings in shelter cats with naturally-occurring FPV, and assesses whether are associated with clinical and laboratory findings. Cats affected by FPV were enrolled in the study if an abdominal ultrasound was performed within 12 hours of diagnosis. Clinical, laboratory and survival data were collected from medical records. Ultrasonographic examinations were reviewed for gastrointestinal abnormalities and their associations with the above data were explored. Results Twenty-one cats were included. Nine cats (42.9%) died and 12 (57.1%) recovered. Based on ultrasonography, the duodenum and jejunum showed thinning of the mucosal layer in 70.6% and 66.6% of cats, thickening of the muscular layer in 52.9% and 57.1% of cats, and hyperechogenicity of the mucosa in 41.2% and 33.3%. Jejunal hyperechoic mucosal band paralleling the submucosa and irregular luminal surface were both observed in 33.3% of the cats. Survival was positively associated with increased jejunal mucosal echogenicity (P = 0.003) and hyperechoic mucosal band (P = 0.003). Peritoneal free fluid was positively associated with vomiting (P = 0.002). Conclusions This study provides ultrasonographic features of naturally-occurring FPV in cats, which, as expected, are compatible with gastroenteropathy. The most frequent findings were diffuse small intestine mucosal layer thinning, muscular layer thickening and mucosal hyperechogenicity, jejunal hyperechoic mucosal band and irregular luminal surface. Ultrasonographic features may be useful to complete the clinical picture and assess the severity of the gastroenteropathy in FPV cats. Prospective studies are needed to confirm ultrasonographic prognostic factors.
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Affiliation(s)
- Rosaria Isaya
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.
| | - Stefano Ciccarelli
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.,Department of Veterinary Medicine, University of Bari "Aldo Moro", BA, 70010, Valenzano, Italy
| | - Daniela Enache
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Swan Specchi
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Marco Pesaresi
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Filippo Ferri
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Federico Porporato
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Edoardo Auriemma
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy
| | - Luigi M Coppola
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy
| | - Eric Zini
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.,Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy.,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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14
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Bevevino KE, Edwards JF, Cohen ND, de Solis CN. Ex vivo comparison of ultrasonographic intestinal wall layering with histology in horses: A feasibilty study. Vet Radiol Ultrasound 2020; 62:316-330. [PMID: 33368831 DOI: 10.1111/vru.12946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 01/17/2023] Open
Abstract
Ultrasonography is increasingly being used as a clinical and research method for evaluating the gastrointestinal tract in horses, however published studies comparing ultrasonographic and histologic characteristics of equine intestinal wall layers are currently lacking. Objectives of this prospective, observational, methods comparison, case series study were to compare the layering pattern and thickness of the intestinal wall layers determined using ex vivo and in vivo ultrasonography with those determined using histology. For the ex vivo study, twelve horses were euthanized for reasons unrelated to gastrointestinal disease, and samples of the duodenum, jejunum, ileum, cecum, right dorsal colon, and small colon were collected and imaged sonographically ex vivo in an isotonic bath within 1 hour of euthanasia. For the in vivo study, ultrasonography was performed in four clinical cases, and findings were compared with histopathology. A 5-layer pattern of alternating echogenicity was observed in 70 of 72 ex vivo samples. Agreement between histologic and sonographic measurements was deemed good for all segments except the ileum. Formalin fixation did not alter the sonographic appearance or wall measurements. Findings from the four clinical cases illustrated the feasibility of also obtaining ultrasonographic images with sufficient sonographic detail in vivo to recognize wall layering and obtain comparable results to pathologic lesions. Findings from the current study can serve as background for future studies comparing ultrasonographic characteristics of the intestinal wall in horses with different gastrointestinal diseases.
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Affiliation(s)
- Kari E Bevevino
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - John F Edwards
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Noah D Cohen
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Cristobal Navas de Solis
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
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15
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Chávez-Peón Berle E, KuKanich K, Biller D. Ultrasonographic findings of gastrointestinal histoplasmosis in dogs. Vet Radiol Ultrasound 2020; 62:108-115. [PMID: 33146920 DOI: 10.1111/vru.12921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/01/2020] [Accepted: 08/12/2020] [Indexed: 11/30/2022] Open
Abstract
Histoplasmosis, a mycotic infection caused by Histoplasma spp, can infect the gastrointestinal tract of dogs. Clinical signs of gastrointestinal histoplasmosis can include diarrhea, profound weight loss, anorexia, and vomiting. Rectal scrape for cytology can provide a quick diagnosis, but if negative abdominal ultrasound is often pursued. Ultrasonographic abnormalities in dogs with gastrointestinal histoplasmosis have rarely been reported. This retrospective, single-center case series aimed to describe the ultrasonographic features of gastrointestinal histoplasmosis in dogs. Nineteen cases with a diagnosis of gastrointestinal histoplasmosis confirmed with gastrointestinal cytology or histopathology (N = 15) or gastrointestinal lymph node cytology (N = 4) that had undergone an abdominal ultrasound examination from 2005 to 2020 were included. Ultrasound images were reviewed by an American College of Veterinary Radiology (ACVR)-certified veterinary radiologist and diagnostic imaging resident. Eighteen cases had sonographic abnormalities within the gastrointestinal tract. The colon was the most affected organ. Colonic thickening and abnormal wall layering were the most frequent findings (N = 16 dogs); thickening ranged from 0.36 to 1.2 cm. Diffuse, multifocal, and focal thickening patterns were seen. Sixteen patients had abnormal wall layering of the colon (complete loss of layering or altered with partial loss of layering). Other frequent findings included lymphadenopathy, small intestinal thickening with abnormal wall layering and peritoneal effusion. Based on the authors' review of the literature, this is the first description of ultrasonographic findings of gastrointestinal histoplasmosis in a group of dogs. Although abnormal gastrointestinal wall layering seen sonographically is most frequently associated with neoplasia, this is not pathognomonic. Gastrointestinal histoplasmosis should be considered as a differential diagnosis due to the similarities and overlap of ultrasonographic features.
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Affiliation(s)
- Erica Chávez-Peón Berle
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - David Biller
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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16
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Černá P, Kilpatrick S, Gunn-Moore DA. Feline comorbidities: What do we really know about feline triaditis? J Feline Med Surg 2020; 22:1047-1067. [PMID: 33100169 PMCID: PMC10814216 DOI: 10.1177/1098612x20965831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PRACTICAL RELEVANCE Feline triaditis describes concurrent pancreatitis, cholangitis and inflammatory bowel disease (IBD). The reported prevalence is 17-39% in ill referral patients. While the aetiology is poorly understood, it is known to include infectious, autoimmune and physical components. What is not known is whether different organs are affected by different diseases, or the same process; indeed, triaditis may be part of a multiorgan inflammatory disease. Feline gastrointestinal tract anatomy plays its role too. Specifically, the short small intestine, high bacterial load and anatomic feature whereby the pancreatic duct joins the common bile duct before entering the duodenal papilla all increase the risk of bacterial reflux and parenchymal inflammation. Inflammation may also be a sequela of bowel bacterial translocation and systemic bacteraemia. DIAGNOSTIC CHALLENGES Cholangitis, pancreatitis and IBD manifest with overlapping, vague and non-specific clinical signs. Cholangitis may be accompanied by increased serum liver enzymes, total bilirubin and bile acid concentrations, and variable ultrasonographic changes. A presumptive diagnosis of pancreatitis is based on increased serum pancreatic lipase immunoreactivity or feline pancreas-specific lipase, and/or abnormal pancreatic changes on ultrasonography, though these tests have low sensitivity. Diagnosis of IBD is challenging without histopathology; ultrasound findings vary from normal to mucosal thickening or loss of layering. Triaditis may cause decreased serum folate or cobalamin (B12) concentrations due to intestinal disease and/or pancreatitis. Triaditis can only be confirmed with histopathology; hence, it remains a presumptive diagnosis in most cases. EVIDENCE BASE The literature on feline triaditis, pancreatitis, cholangitis and IBD is reviewed, focusing on histopathology, clinical significance and diagnostic challenges. Current management recommendations are provided. Further studies are needed to understand the complex pathophysiology, and in turn improve diagnosis and treatment.
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Affiliation(s)
- Petra Černá
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, and Small Animal Clinic, The University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | | | - Danielle A Gunn-Moore
- The Royal (Dick) School of Veterinary Studies, and The Roslin Institute, University of Edinburgh, UK
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17
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Simeoni F, Terragni R, Rubini G, Tamburro R, Del Signore F, Falerno I, Aste G, Russo M, Mastromatteo G, Vignoli M. B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Cats. Animals (Basel) 2020; 10:ani10081444. [PMID: 32824834 PMCID: PMC7460435 DOI: 10.3390/ani10081444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Alimentary lymphoma is the most common neoplasm of the feline gastrointestinal tract. In most cases, standard ultrasonography may not be able to discriminate between a neoplastic and inflammatory infiltrate at this level. The aim of this prospective study is to establish the value of conventional ultrasound and contrast enhanced ultrasonography in describing specific features of normal, inflammatory, and neoplastic gastric diseases in feline species. A total of 29 cats were included in the study: six healthy cats as the control group; nine with gastric inflammation; three with low-grade alimentary lymphoma; 10 with high grade alimentary lymphoma. High-grade lymphoma usually appears as a severe wall thickening with absent layer definition, regional lymphadenopathy and local steatitis on a conventional ultrasound and shows a high-contrast uptake and a homogeneous enhancement with comb teeth-like vessels on contrast-enhanced ultrasound, while gastric inflammation and low-grade alimentary lymphoma showed a large overlap on both of those two ultrasonographic techniques. Diagnostic accuracy and cut-off value were calculated and found to be relevant for thickness (3.8 mm) for inflammation vs. low-grade lymphoma and “benign” vs. “malignant” as well as peak enhancement (34.87 dB) for “benign” vs. “malignant”. Thickness and peak enhancement can be useful parameters in the characterization of gastric infiltrates in cats. Abstract Alimentary lymphoma (AL) is the most common malignancy of the feline gastrointestinal tract and may cause variable mild to severe alteration of the gastric wall on ultrasonography (US) that can be very similar to those caused by inflammation (INF). The aim of this prospective study is to establish the value of B-mode and contrast-enhanced US (CEUS) in describing specific features of normal, inflammatory, and neoplastic gastric diseases in feline species. B-mode US and CEUS of the stomach were performed in anesthetized cats with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 29 cats were included: six healthy (HEA) cats as the control group; nine INF; three low-grade lymphoma (LGAL); 10 high-grade lymphoma (HGAL). On B-mode US, there were significant differences in thickness, the wall’s layer definition and echogenicity between HGAL and all the other groups (<0.001). For CEUS, statistical differences between groups were found in the following: HGAL vs. HEA, HGAL vs. INF; HGAL vs. LGAL; INF vs. HEA. Diagnostic accuracy (AUC) and cut-off value were calculated and found to be significant for thickness (3.8 mm) for INF vs. LGAL (AUC > 0.70) and “benign” vs. “malignant” (AUC > 0.90) as well as peak enhancement (34.87 dB) for “benign” vs. “malignant” (AUC > 0.70). INF and LGAL showed an overlap of qualitative and quantitative parameters both on B-mode and CEUS, while HGAL usually appears as a severe wall thickening with absent layer definition, high-contrast uptake, a specific enhancement pattern, regional lymphadenopathy and local steatitis. Thickness and peak enhancement can be useful parameters in the characterization of gastric infiltrates in cats.
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Affiliation(s)
- Francesco Simeoni
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
- Correspondence: (F.S.); (G.A.)
| | - Rossella Terragni
- Pet Care Veterinary Clinic, via Marzabotto ½ M-N, 40133 Bologna, Italy;
| | - Giuseppe Rubini
- UltraVet Diagnostic, via Enrico Fermi 59, San Giovanni, 40017 Persiceto, Italy;
| | - Roberto Tamburro
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
| | - Francesca Del Signore
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
| | - Ilaria Falerno
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
| | - Giovanni Aste
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
- Correspondence: (F.S.); (G.A.)
| | - Marco Russo
- Department of Veterinary Medicine and Animal Production, University of Naple, via Federico Delpino 1, 80137 Napoli, Italy;
| | - Giovanni Mastromatteo
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
| | - Massimo Vignoli
- Faculty of Veterinary Medicine, University of Teramo, SP 18, 64100 Teramo, Italy; (R.T.); (F.D.S.); (I.F.); (G.M.); (M.V.)
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18
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Grandis A, Canova M, Tagliavia C, Spiteri J, Fagnoli H, De Silva M, Mazzoni M, Diana A, Bombardi C. The distribution of the jejunal arteries in the cat. Anat Rec (Hoboken) 2020; 304:372-383. [PMID: 32396681 DOI: 10.1002/ar.24421] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 03/06/2020] [Indexed: 11/07/2022]
Abstract
The arterial supply of the cat jejunum was studied by gross dissection and polyurethane corrosion cast. The results showed that the jejunal arteries, which originate from the cranial mesenteric artery, varied from 5 to 15 in number. Their number was independent of the length of the cranial mesenteric artery as well as of the length of the jejunum. These arteries divided into branches giving rise to a series of orders of division from a minimum of 1 to a maximum of 7. The last orders of division terminated in a series of anastomosing arcades which resulted in a marginal artery coursing only a few millimeters from the mesenteric margin of the jejunum. This artery gave rise to straight arteries (vasa recta), whose mean number was 450 ± 60. According to their length, the vasa recta can be differentiated into short (vasa brevia) and long (vasa longa) branches. The vasa brevia ended branching into the mesenteric side of the jejunum whereas the vasa longa coursed beneath the serosa on the lateral jejunal surfaces, and reached the antimesenteric border. During their course, the vasa recta ramified and anastomosed with each other. Numerous antimesenteric anastomoses between opposing vasa longa were also observed. Based on the literature consulted, due to the large number of vasa recta (approximately one vessel per 2.9 mm of jejunal length) and the rich anastomotic network, the cat jejunum might have a better intramural distribution of blood flow and would seem less predisposed to ischemic phenomena than that of other mammals.
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Affiliation(s)
- Annamaria Grandis
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Marco Canova
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Claudio Tagliavia
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Julie Spiteri
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Helen Fagnoli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Margherita De Silva
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Mazzoni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Alessia Diana
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Cristiano Bombardi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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19
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract. J Feline Med Surg 2019; 21:1047-1060. [PMID: 31648606 PMCID: PMC10814209 DOI: 10.1177/1098612x19880434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease. AIM This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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20
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The normal gastrointestinal tract. J Feline Med Surg 2019; 21:1039-1046. [PMID: 31648604 PMCID: PMC10814204 DOI: 10.1177/1098612x19880433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats, providing information on intestinal wall thickness and the presence or absence of intestinal dilation and peristalsis, among other factors. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination and appearance of the normal GI tract; the diseased GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review describes where findings contrast with those typically seen in dogs. It is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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21
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Fox PR, Keene BW, Lamb K, Schober KE, Chetboul V, Luis Fuentes V, Payne JR, Wess G, Hogan DF, Abbott JA, Häggström J, Culshaw G, Fine‐Ferreira D, Cote E, Trehiou‐Sechi E, Motsinger‐Reif AA, Nakamura RK, Singh M, Ware WA, Riesen SC, Borgarelli M, Rush JE, Vollmar A, Lesser MB, Van Israel N, Lee PM, Bulmer B, Santilli R, Bossbaly MJ, Quick N, Bussadori C, Bright J, Estrada AH, Ohad DG, del Palacio MJF, Brayley JL, Schwartz DS, Gordon SG, Jung S, Bove CM, Brambilla PG, Moïse NS, Stauthammer C, Quintavalla C, Manczur F, Stepien RL, Mooney C, Hung Y, Lobetti R, Tamborini A, Oyama MA, Komolov A, Fujii Y, Pariaut R, Uechi M, Yukie Tachika Ohara V. Long-term incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy. J Vet Intern Med 2019; 33:2572-2586. [PMID: 31605422 PMCID: PMC6872868 DOI: 10.1111/jvim.15609] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/20/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Epidemiologic knowledge regarding noncardiovascular and all-cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence-based healthcare guidelines. OBJECTIVES To characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all-cause mortality in AH and pHCM cats. ANIMALS A total of 1730 client-owned cats (722 AH, 1008 pHCM) from 21 countries. METHODS Retrospective, multicenter, longitudinal, cohort study. Long-term health data were extracted by medical record review and owner/referring veterinarian interviews. RESULTS Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .48). Cancer, chronic kidney disease, and conditions characterized by chronic weight-loss-vomiting-diarrhea-anorexia were the most frequently recorded noncardiovascular causes of death. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All-cause death proportions were greater in pHCM than AH (65% versus 40%, respectively; P < .001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH, 9.8 years; pHCM, 8.6 years; P = .10), but all-cause survival was significantly shorter in pHCM (P = .0001). CONCLUSIONS AND CLINICAL IMPORTANCE All-cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death.
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Affiliation(s)
| | - Bruce W. Keene
- College of Veterinary Medicine, North Carolina State University, Department of Clinical SciencesRaleighNorth CarolinaU.S.A.
| | | | - Karsten E. Schober
- Department of Veterinary Clinical Sciences, The Ohio State UniversityColumbusOhioU.S.A.
| | - Valérie Chetboul
- Alfort Cardiology Unit, École Nationale Vétérinaire d'AlfortMaisons‐Alfort CedexFrance
| | - Virginia Luis Fuentes
- Department of Veterinary Clinical Sciences and Services, Royal Veterinary CollegeHatfieldUnited Kingdom
| | | | - Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig‐Maximillians UniversityMunichGermany
| | - Daniel F. Hogan
- Department of Veterinary Clinical Sciences, Purdue UniversityWest LafayetteIndianaU.S.A.
| | - Jonathan A. Abbott
- Department of Small Animal Clinical Sciences, Virginia‐Maryland Regional College of Veterinary MedicineBlacksburgVirginiaU.S.A.
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural SciencesUppsalaSweden
| | - Geoffrey Culshaw
- Division of Veterinary Clinical Sciences, R(D)SVS Hospital for Small Animals Easter Bush Veterinary Centre, The University of EdinburghMidlothianUnited Kingdom
| | | | - Etienne Cote
- Atlantic Veterinary College, Univertisy of PEI—Department of Companion AnimalsCharlottetownPrince Edward IslandCanada
| | - Emilie Trehiou‐Sechi
- École Nationale Vétérinaire d'Alfort, Cardiology Unit of Alfort—Université Paris‐EstMaisons‐AlfortFrance
| | | | - Reid K. Nakamura
- Advanced Veterinary Care Center—CardiologyLawndaleCaliforniaU.S.A.
| | - Manreet Singh
- Veterinary Cardiac Referrals—CardiologySydneyNew South WalesAustralia
| | - Wendy A. Ware
- Department of Veterinary Clinical Sciences, Iowa State UniversityAmesIowaU.S.A.
| | | | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia‐Maryland Regional College of Veterinary MedicineBlacksburgVirginiaU.S.A.
| | - John E. Rush
- Department of Clinical Sciences, Tufts University Cummings School of Veterinary MedicineNorth GraftonMassachusettsU.S.A.
| | | | | | | | - Pamela Ming‐Show Lee
- Department of Veterinary Clinical Sciences, Washington State UniversityPullmanWashingtonU.S.A.
| | - Barret Bulmer
- Tufts Veterinary Emergency Treatment & SpecialtiesWalpoleMassachusettsU.S.A.
| | - Roberto Santilli
- Department of Cardiology, Clinica Veterinaria MalpensaVareseItaly
| | | | - Nadine Quick
- Ludwig‐Maximilians‐University Munich, Clinic of Small Animal MedicineMunichGermany
| | | | - Janice Bright
- Department of Clinical Sciences, Colorado State UniversityFort CollinsColoradoU.S.A.
| | - Amara H. Estrada
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary MedicineGainesvilleFloridaU.S.A.
| | - Dan G. Ohad
- The Koret School of Veterinary Medicine, The Hebrew University of JerusalemRehovotIsrael
| | | | | | | | - Sonya G. Gordon
- Department of Small Animal Clinical Sciences, Texas A&M UniversityCollege StationTexasU.S.A.
| | - SeungWoo Jung
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn UniversityAuburnAlabamaU.S.A.
| | - Christina M. Bove
- Department of Clinical Sciences, Colorado State UniversityFort CollinsColoradoU.S.A.
| | | | - N. Sydney Moïse
- Department of Clinical Sciences, Cornell UniversityIthacaNew YorkU.S.A.
| | | | | | - Ferenc Manczur
- Department of Internal Medicine, University of Veterinary MedicineBudapestHungary
| | - Rebecca L. Stepien
- Department of Medical Sciences, University of Wisconsin Madison School of Veterinary MedicineMadisonWisconsinU.S.A.
| | - Carmel Mooney
- University College Dublin Veterinary Hospital, University College DublinDublinIreland
| | | | - Remo Lobetti
- Bryanston Veterinary HospitalBryanstonSouth Africa
| | - Alice Tamborini
- Department of Small Animal Medicine, University College Veterinary Hospital, University College DublinDublinIreland
| | - Mark A. Oyama
- Department of Clinical Studies, University of PennsylvaniaPhiladelphiaPennsylvaniaU.S.A.
| | | | - Yoko Fujii
- Laboratory of Surgery 1, Azabu UniversitySagamiharaJapan
| | - Romain Pariaut
- Department of Veterinary Clinical Sciences, Cornell UniversityIthacaNew YorkU.S.A.
| | - Masami Uechi
- Jasmine Animal Cardiovascular CenterYokohamaJapan
| | - Victoria Yukie Tachika Ohara
- Department of Medicine, Surgery and Zootechnics for Small Species, Universidad Nacional Autónoma de MéxicoMexico CityMexico
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22
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Norsworthy GD. Results of histopathology, immunohistochemistry, and molecular clonality testing of small intestinal biopsy specimens from clinically healthy client-owned cats. J Vet Intern Med 2019; 33:1567-1568. [PMID: 31099082 PMCID: PMC6639529 DOI: 10.1111/jvim.15524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/07/2019] [Indexed: 11/30/2022] Open
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Guttin T, Walsh A, Durham AC, Reetz JA, Brown DC, Rondeau MP. Ability of ultrasonography to predict the presence and location of histologic lesions in the small intestine of cats. J Vet Intern Med 2019; 33:1278-1285. [PMID: 30847975 PMCID: PMC6524111 DOI: 10.1111/jvim.15471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/20/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Diagnosis of infiltrative small intestinal (SI) disease in cats is challenging, and debate continues regarding optimal biopsy techniques. Ultrasonography may facilitate selection of biopsy type and location. HYPOTHESIS/OBJECTIVES Assess ability of ultrasonography to predict histologic lesions by SI segment and tissue layer. ANIMALS One-hundred sixty-nine cats that had abdominal ultrasonography and full-thickness SI biopsies performed. METHODS Ultrasonographic images and full-thickness biopsy samples were retrospectively reviewed, and each SI wall layer evaluated for lesions according to published standards. RESULTS Ultrasonographic SI lesions were present in 132 cats (63 duodenum; 115 jejunum; 71 ileum). Samples were obtained at laparotomy (60) or necropsy (109). Ultrasonographic abnormalities had high positive predictive value (PPV) for histologic lesions (duodenum, 82.0%; 95% confidence interval [CI], 68.6-91.4; jejunum, 91.0%; 95% CI, 81.5-96.6; ileum, 88.1%; 95% CI, 74.4-96.0), but poor negative predictive value (duodenum, 27.1%; 95% CI, 17.2-39.1; jejunum, 27.3%; 95% CI, 10.7-50.2; ileum, 40.4%; 95% CI, 26.4-55.7). The ability of ultrasonography to predict histologic lesions in this population, which had high disease prevalence (SI histologic lesions in 78.1% of cats) was high for mucosal lesions (PPV, 72.7%-100%) but low for submucosal or muscularis lesions (PPV, 18.9%-57.1%). CONCLUSIONS AND CLINICAL IMPORTANCE In a population with high disease prevalence, most cats with SI mucosal ultrasonographic lesions will have mucosal histologic lesions. Small intestinal submucosal and muscularis ultrasonographic lesions are not predictive of histologic disease in those layers, suggesting that full-thickness biopsy may not be essential in these cats. Ultrasonography may help guide decisions about biopsy type in individual cats.
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Affiliation(s)
- Talia Guttin
- Department of Small Animal Medicine and Surgery, St. George's University School of Veterinary Medicine, Grenada, West Indies
| | - Audra Walsh
- VetPath Laboratories, Perth, Western Australia, Australia
| | - Amy C Durham
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
| | - Jennifer A Reetz
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
| | | | - Mark P Rondeau
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
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Paulin MV, Couronné L, Beguin J, Le Poder S, Delverdier M, Semin MO, Bruneau J, Cerf-Bensussan N, Malamut G, Cellier C, Benchekroun G, Tiret L, German AJ, Hermine O, Freiche V. Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease. BMC Vet Res 2018; 14:306. [PMID: 30305106 PMCID: PMC6180644 DOI: 10.1186/s12917-018-1635-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions. RESULTS A total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. 130 studies were found from the veterinary literature and 46 from the human medicine literature. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. CONCLUSIONS The pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine.
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Affiliation(s)
- Mathieu V Paulin
- Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Lucile Couronné
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Jérémy Beguin
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Sophie Le Poder
- UMR 1161 Virologie, INRA-ENVA-ANSES, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Maxence Delverdier
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Marie-Odile Semin
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Julie Bruneau
- Pathology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM 1163, Institut Imagine, Site Hôpital Universitaire Necker - Enfants Malades, Paris, France
| | - Nadine Cerf-Bensussan
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,UMR 1163, Laboratory of Intestinal Immunity, INSERM, Paris, France
| | - Georgia Malamut
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Christophe Cellier
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Ghita Benchekroun
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Laurent Tiret
- Inserm U955-E10 BNMS, IMRB, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 94000, Maisons-Alfort, France
| | - Alexander J German
- Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - Olivier Hermine
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Valérie Freiche
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France.
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25
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Morgan KRS, North CE, Thompson DJ. Sonographic features of peritoneal lymphomatosis in 4 cats. J Vet Intern Med 2018; 32:1178-1184. [PMID: 29572942 PMCID: PMC5980441 DOI: 10.1111/jvim.15099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/17/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
Background The metastatic spread of feline lymphoma to the peritoneum (“lymphomatosis”) has been rarely reported in the literature. The sonographic features specific to this rare disease manifestation have not been described and have important treatment and prognostic considerations prompting definitive diagnosis. Objectives To describe the ultrasonic features of feline peritoneal lymphomatosis. Animals Four cats with alimentary lymphoma and peritoneal metastasis confirmed using cytology, histology, or both. Results The sonographic features described include either a nonobstructive, focally diffuse, and circumferential intestinal mass, or an eccentric, focally diffuse, gastric mass. The intestinal and gastric lesions exhibited hypo‐to‐anechoic transmural wall thickening with loss of wall layering in association with discrete‐to‐coalescing plaques or sheets of thickened, hypoechoic tissue throughout the mesentery or omenta. All cases exhibited only small volumes of anechoic free peritoneal fluid. Three of the 4 cats also had multiple small hypoechoic nodular foci on the parietal and/or visceral peritoneal surfaces. Two cats had bilateral renomegaly because of lymphoma invasion (2/4) and 1 cat had local lymphadenopathy secondary to lymphoma invasion (1/4). Conclusions and Clinical Importance Peritoneal lymphomatosis is a rare manifestation of lymphoma metastasis and to date appears to be associated specifically with B‐cell alimentary lymphoma.
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Affiliation(s)
- Keaton R S Morgan
- Veterinary Specialist Group, 97 Carrington Road, Mt Albert, New Zealand
| | - Courtney E North
- Veterinary Specialist Group, 97 Carrington Road, Mt Albert, New Zealand
| | - Devon J Thompson
- Veterinary Specialist Group, 97 Carrington Road, Mt Albert, New Zealand
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Mitze S, Moser K, Teske E, V Bomhard W, Stockhaus C. Correlation between the FCEAI and diagnostic parameters in chronic enteropathies in 147 cats (2006-2012). TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:170089. [PMID: 29099902 DOI: 10.15654/tpk-170089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The Feline Chronic Enteropathy Activity Index (FCEAI) has been established as a quantitative index for disease activity in chronic enteropathies in cats. A definite diagnosis is aimed at histology with initial exclusion of extraintestinal causes by laboratory examinations, diagnostic imaging and endoscopy. The study aimed to examine diagnostic parameters and FCEAI in chronic gastroenteropathies. MATERIALS AND METHODS A retrospective case review of 147 cats with chronic enteropathies was performed. In all patients, the FCEAI was established and endoscopy performed including biopsies and duodenal cytology. Histopathologic reports were reviewed for the diagnosis of lymphoma and architectural changes (epithelial integrity, villi/gland atrophy, intestinal crypt atrophy, lymphangiectasia, epitheliotropism/infiltration of intraepithelial lymphocytes). A cytopathologic score (CS) and histopathologic score (HS) regarding lymphocytic intestinal infiltration were assigned. Statistical dependency analysis was used to determine correlations between the FCEAI, lymphoma, architectural changes, CS, HS, serum concentrations of cobalamin, folate and albumin. RESULTS The 147 cats consisted of predominately European Shorthair cats (n = 126), were mostly castrated (n = 127) and had a mean age of 9.8 (1-17) years. For the proven lymphoma group (12.2%; n = 18) and the non-lymphoma group a mean FCEAI of 7.3 (4-17) and 6.6 (2-13), respectively, was established. The FCEAI showed a low correlation with the CS (p = 0.010; R = 0.22) and intestinal villous atrophy (n = 121; p = 0.035; R = 0.19). Cats with a CS of 0 had a significant lower FCEAI score (p = 0.015) than cats with all other CSs. The histo- and cytopathologic scores were highly related (p < 0.001; R = 0.43). The gastric intraepithelial lymphocytic infiltration (n = 131) was significantly correlated to serum folate (p = 0.014; R = -0.56) and albumin (p = 0,048; R = -0.20). CONCLUSION The FCEAI showed only a few correlations. Not only the grade of inflammation, but also the histologic architectural changes are of importance.
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Affiliation(s)
- Stefanie Mitze
- Dr. Stefanie Mitze, Tierklinik Haar, Keferloher Strasse 25, 85540 Haar,
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27
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Mapletoft EK, Allenspach K, Lamb CR. How useful is abdominal ultrasonography in dogs with diarrhoea? J Small Anim Pract 2017; 59:32-37. [PMID: 29105088 DOI: 10.1111/jsap.12780] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/12/2017] [Accepted: 09/15/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the utility of abdominal ultrasonography in the diagnostic work-up of dogs with diarrhoea. METHODS Retrospective cross-sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work-up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records. RESULTS Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work-up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound-guided fine-needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive. CLINICAL SIGNIFICANCE These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea.
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Affiliation(s)
- E K Mapletoft
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, UK
| | - K Allenspach
- College of Veterinary Medicine, Iowa State University, Ames IA 50011-1134, USA
| | - C R Lamb
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, UK
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28
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Hauck SR, Gisselman K, Cordner A, Nicholson AG. Chronic Vomiting in Cats: Etiology and Diagnostic Testing. J Am Anim Hosp Assoc 2016; 52:269-76. [PMID: 27487349 DOI: 10.5326/jaaha-ms-6290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic vomiting in cats is a common presenting problem seen in veterinary practice today. The initial step when presented with a vomiting patient is to differentiate between vomiting and regurgitation or dysphagia. There are numerous causes for chronic vomiting in cats, and therefore a detailed and comprehensive patient history and a systematic diagnostic approach are key steps in determining the cause for vomiting and the most appropriate treatment plan. Common causes for chronic vomiting in cats may include inflammatory bowel disease, food allergy, gastrointestinal motility disorders, neoplasia, and extra-gastrointestinal diseases, such as renal disease, hepatobiliary disease, and hyperthyroidism.
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Affiliation(s)
- Shannon Ryan Hauck
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Kelly Gisselman
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Amy Cordner
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Angela Gasser Nicholson
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
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29
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Le Roux AB, Granger LA, Wakamatsu N, Kearney MT, Gaschen L. EX VIVO CORRELATION OF ULTRASONOGRAPHIC SMALL INTESTINAL WALL LAYERING WITH HISTOLOGY IN DOGS. Vet Radiol Ultrasound 2016; 57:534-45. [DOI: 10.1111/vru.12392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 04/01/2016] [Accepted: 04/25/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Alexandre B. Le Roux
- Department of Veterinary Clinical Sciences - Section of Diagnostic Imaging (Le Roux, Granger, Gaschen)
| | - L. Abbigail Granger
- Department of Veterinary Clinical Sciences - Section of Diagnostic Imaging (Le Roux, Granger, Gaschen)
| | - Nobuko Wakamatsu
- Department of Pathobiological Sciences - Section of Pathology (Wakamatsu)
| | - Michael T. Kearney
- Statistical Services Unit (Kearney); School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences - Section of Diagnostic Imaging (Le Roux, Granger, Gaschen)
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30
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Gaschen L, Granger LA, Oubre O, Shannon D, Kearney M, Gaschen F. THE EFFECTS OF FOOD INTAKE AND ITS FAT COMPOSITION ON INTESTINAL ECHOGENICITY IN HEALTHY DOGS. Vet Radiol Ultrasound 2016; 57:546-50. [DOI: 10.1111/vru.12384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 05/02/2016] [Accepted: 05/09/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - L. Abbigail Granger
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - Olivia Oubre
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - Dylan Shannon
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - Michael Kearney
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
| | - Frederic Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine; Louisiana State University; Baton Rouge LA 70803
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Geesaman BM, Whitehouse WH, Viviano KR. Serum Cobalamin and Methylmalonic Acid Concentrations in Hyperthyroid Cats Before and After Radioiodine Treatment. J Vet Intern Med 2016; 30:560-5. [PMID: 26934857 PMCID: PMC4913605 DOI: 10.1111/jvim.13918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/24/2015] [Accepted: 02/09/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hyperthyroidism, the most common endocrine disorder in cats, has been associated with low serum cobalamin concentrations. Whether this is a functional cobalamin deficiency of clinical importance has not been assessed. HYPOTHESIS/OBJECTIVES Cats with hyperthyroidism experience a functional cobalamin deficiency which correlates with their clinical catabolic state and is reversible with return of the euthyroid state. ANIMALS Thirty-nine client-owned hyperthyroid cats. METHODS Prospective observational study. Serum cobalamin, methylmalonic acid, and clinical scores were determined in each hyperthyroid cat at enrollment and when euthyroid (60 days after radioiodine treatment). RESULTS Five of the 39 hyperthyroid cats (13%) had a low serum cobalamin concentration ranging from <150 to 290 ng/L. Serum cobalamin concentrations normalized to >350 ng/L in 2 of the hypocobalaminemic cats once euthyroid. None of the hyperthyroid/hypocobalaminemic cats had increased serum methylmalonic acid concentrations (175-601 nmol/L). In cats with clinical and biochemical hyperthyroidism, there was no correlation between serum cobalamin concentrations with total T4 concentration (P = .12) or clinical scores including body weight (P = .11) and BCS (P = .54). CONCLUSIONS AND CLINICAL IMPORTANCE In this population of hyperthyroid cats, the prevalence of hypocobalaminemia was low. Specifically, hyperthyroid cats, in which concurrent gastrointestinal disease is unlikely. Hypocobalaminemia is not a functional deficiency requiring supplementation in hyperthyroid cats without gastrointestinal disease.
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Affiliation(s)
- B M Geesaman
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
| | - W H Whitehouse
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
| | - K R Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
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32
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Di Donato P, Penninck D, Pietra M, Cipone M, Diana A. Ultrasonographic measurement of the relative thickness of intestinal wall layers in clinically healthy cats. J Feline Med Surg 2014; 16:333-9. [PMID: 24174500 PMCID: PMC11383109 DOI: 10.1177/1098612x13509080] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
The normal sonographic thickness of the individual layers (ie, mucosa, submucosa, muscularis and subserosa-serosa) of the intestinal wall was evaluated in 20 clinically healthy cats. The mean thickness of the wall was 2.20, 2.22, 3.00 and 2.04 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively. The mean thickness of the mucosal layer was 1.27, 1.20, 0.46 and 0.49 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was significantly greater than that of the other layers in the duodenum (57.7%) and jejunum (55.2%). The mean thickness of the submucosal layer was 0.36, 0.36, 1.49 and 0.53 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was greater than that of the muscularis in the duodenum (16.3%), jejunum (16%) and ileum (fold) (49.8 %). The mean thickness of muscularis was 0.28, 0.35, 0.66 and 0.65 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 12.7 %, 14.4%, 22% and 31.6%. Finally, the mean thickness of serosa was 0.29, 0.31, 0.38 and 0.38 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 13.3%, 14.4%, 12.7 % and 18.7%. These values can provide baseline information that might be useful in evaluating intestinal disorders affecting preferentially some of the intestinal layers.
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Affiliation(s)
- Pamela Di Donato
- 1Department of Veterinary Medical Sciences, University of Bologna, Italy
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Norsworthy GD, Scot Estep J, Kiupel M, Olson JC, Gassler LN. Diagnosis of chronic small bowel disease in cats: 100 cases (2008–2012). J Am Vet Med Assoc 2013; 243:1455-61. [DOI: 10.2460/javma.243.10.1455] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Domínguez E, Anadón E, Espada Y, Grau-Roma L, Majó N, Novellas R. Imaging diagnosis--ultrasonographic appearance of small bowel metastasis from canine mammary carcinoma. Vet Radiol Ultrasound 2013; 55:208-12. [PMID: 23763430 DOI: 10.1111/vru.12061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 05/04/2013] [Indexed: 11/28/2022] Open
Abstract
A 10-year-old entire female Beagle dog was evaluated for an acute history of lethargy, anorexia, and diarrhea. Mammary tumors were detected during physical examination. Ultrasonographic scanning revealed the presence of a unique pattern of multiple, well-defined and well-marginated hypoechoic nodules in the muscularis layer of the jejunum. These nodules were not associated with changes in the rest of the normal intestinal layering and were not causing signs of intestinal obstruction. Mammary carcinoma metastases to the intestinal muscularis layer were diagnosed based on histopathological examination.
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Affiliation(s)
- Elisabet Domínguez
- Fundació Hospital Clínic Veterinary, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain
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Jergens AE. Feline idiopathic inflammatory bowel disease: what we know and what remains to be unraveled. J Feline Med Surg 2012; 14:445-58. [PMID: 22736679 PMCID: PMC10822384 DOI: 10.1177/1098612x12451548] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Feline idiopathic inflammatory bowel disease (IBD) denotes one form of chronic enteropathy that is immunologically mediated and characterized by persistent or recurrent gastrointestinal (GI) signs and histologic inflammation. Signs of vomiting, diarrhea and weight loss generally predominate, and mucosal inflammation may occur in any portion of the GI tract (especially the small intestine). Affected cats may also have concurrent inflammation in other organs, such as the pancreas and liver, which may impact clinical disease severity. CLINICAL CHALLENGES The exact etiologies of this heterogeneous group of disorders have yet to be determined, though results from basic science and clinical studies suggest that interplay between genetic factors and enteric bacteria is crucial for disease development. The diagnosis is one of exclusion and requires intestinal mucosal biopsy to characterize the type and severity of the inflammatory infiltrate, and to differentiate IBD from other disorders, including alimentary lymphoma. Controversy exists concerning the relative diagnostic accuracy of endoscopic versus full-thickness specimens for the diagnosis of IBD and its differentiation from alimentary lymphoma. AUDIENCE This article is intended to provide veterinary practitioners with a comprehensive clinical update on idiopathic IBD in cats. It reviews the current evidence-based data, the diagnostic approach, the evolving histologic criteria, and treatment options and outcome for feline patients with this syndrome.
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Affiliation(s)
- Albert E Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
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Barrs VR, Beatty JA. Feline alimentary lymphoma: 1. Classification, risk factors, clinical signs and non-invasive diagnostics. J Feline Med Surg 2012; 14:182-90. [PMID: 22370860 PMCID: PMC10822432 DOI: 10.1177/1098612x12439265] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Alimentary lymphoma (AL) occurs commonly in cats and exists as distinct subtypes that differ in their clinical course, response to treatment and prognosis. Accurate diagnosis is important to guide appropriate treatment. CLINICAL CHALLENGES Differentiation of low-grade alimentary lymphoma from lymphoplasmacytic enteritis can be challenging, especially where endoscopic intestinal biopsies, which sample only the mucosa and submucosa, are used. The major differentials for intermediate- and high-grade alimentary lymphoma are other neoplastic and non-neoplastic intestinal mass lesions. The diagnosis of large granular lymphocyte lymphoma requires vigilance as it may be missed with routine diagnostics. PATIENT GROUP AL affects predominantly middle- to old-aged domestic crossbred cats (median age 10-13 years). EVIDENCE BASE The evidence supporting this review is grade II, III and IV, derived from prospective studies, retrospective case series, reviews, extrapolation from other species, pathophysiological justification and the combined clinical experience of those working in the field.
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Affiliation(s)
- Vanessa R Barrs
- Valentine Charlton Cat Centre, University of Sydney, Sydney NSW 2006, Australia.
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