A Study on the Diagnostic Approach Using Real-Time Video Capsule Endoscopy in Dogs with Acute Vomiting

This study aimed to evaluate the efficiency and sensitivity of real-time video capsule endoscopy (RT-VCE) when detecting surgical and nonsurgical gastric lesions in dogs that presented with acute vomiting. Additionally, the patient tolerance and the utility of the RT-VCE data for clinical decision-making were assessed. Eleven client-owned dogs with an acute onset of vomiting were included. Each dog received an antiemetic and antacid before undergoing an RT-VCE (MC1200, MiroCam®, Intromedic, Seoul, Republic of Korea). We independently reviewed the RT-VCE images to assess the image quality, detect gastric lesions, and make clinical decisions. The time taken to reach a diagnosis and the inter-clinician agreement were evaluated. RT-VCEs were successfully completed in all the dogs, with a mean time to diagnosis of 21.82 ± 15.26 min (range: 1-48 min). Both clinicians reached unanimous agreement on the RT-VCE findings. Five dogs were diagnosed with gastric foreign bodies and underwent surgical removal, while the remaining six were diagnosed with gastritis, a gastric ulcer or erosion, or hemorrhages, which were managed medically. No adverse effects, including vomiting, were observed after the capsule administration. RT-VCE proved to be an effective, accurate, and well-tolerated diagnostic method for evaluating gastric conditions in dogs with acute vomiting. Its rapid diagnostic capability and non-invasive nature make it a valuable modality in emergency veterinary settings.

The Use of Intra-Operative Endoscopy in Dogs and Cats for the Removal of Gastrointestinal Foreign Bodies: Five Cases (2014-2015)

OBJECTIVES

We report the use of intra-operative endoscopy, termed here 'surgically-assisted endoscopy'. The procedure spares a gastrotomy, therefore, shortening anaesthetic time, minimising potential complications and resulting in a quicker and less painful recovery.

METHODS

Four dogs and one cat requiring surgical celiotomy for various conditions were treated. In all animals, a gastrointestinal foreign body (FB) was located at surgery. During the surgery, with the patient still in dorsal recumbency and the abdomen still open, in lieu of gastrotomy, the animals had their FBs removed via endoscopy, sparing a gastrotomy procedure and its potential complications.

RESULTS

In all five cases, a gastrotomy was avoided and the FBs were successfully extracted using the endoscope. Only one minor complication was seen intra-operatively and none at short-term follow-up.

CLINICAL SIGNIFICANCE

Although prognosis after gastrotomy is considered excellent, potential complications still exist and include haemorrhage, intra-operative spillage, peritonitis and post-operative dehiscence. Alternatively, endoscopy negates many of those possible complications and shortens anaesthesia time. In many cases of gastric FBs, or where intestinal FBs can be safely manipulated into the stomach, surgically assisted endoscopy could be considered a viable and potentially preferred option to gastrotomy.

Evaluating Disease Patterns of Military Working Dogs in the Republic of Korea: A Retrospective Study

The purpose of this study was to evaluate disease patterns among military working dogs (MWDs) at the Armed Forces Medical Research Institute (AFMRI) to provide basic medical data on Korean MWDs. The medical records of procedures performed at AFMRI between November 2017 and March 2021 were reviewed. Physical examination, diagnostic imaging, and laboratory tests were performed according to the status of each dog. A total of 353 MWDs (215 males and 138 females; mean age, 6 ± 3 years) were analyzed in this study. Among Korean MWDs, gastrointestinal (GI) disorders are the most frequently diagnosed, followed by dental and musculoskeletal disorders. Foreign body (FB) ingestion had the highest prevalence of GI disorders, with the most common FB being a leather collar or leash. General and dental surgeries, including removal of gastric FB and tooth extraction, were routinely performed at the AFMRI. Preventative care focusing on dental disease and FB ingestion may be helpful for effective performance and good quality of life in MWDs, with the regular assessment and prevention of environmental factors that may contribute to behavioral problems such as FB ingestion, coprophagy, and anorexia.

Gastric dilatation and enterotoxemia in ten captive felids

CASE DESCRIPTION 10 large felids at 8 facilities were determined or suspected to have developed gastric dilatation with or without enterotoxemia over a 20-year period. Four felids were found dead with no premonitory signs. CLINICAL FINDINGS 4 felids (2 male snow leopards [Uncia uncia], 1 male Amur tiger [Panthera tigris altaica], and 1 male Sumatran tiger [Panthera tigris sumatrae]) were found dead or died before they could be evaluated. Six felids had hematemesis (1 male and 1 female African lion [Panthera leo] and 1 male jaguar [Panthera onca]) or abdominal distention and signs of lethargy with or without vomiting (1 male African lion, 1 male Malayan tiger [Panthera tigris jacksoni], and 1 female Sumatran tiger). Gastric dilatation was radiographically and surgically confirmed in the male Malayan and female Sumatran tigers and the jaguar. TREATMENT AND OUTCOME In 3 felids with an antemortem diagnosis, the gastric dilatation resolved with decompressive laparotomy but then recurred in 1 felid, which subsequently died. Three others died at various points during hospitalization. Although Clostridium perfringens type A was recovered from 3 of the 5 felids for which microbial culture was performed, and 2 felids had a recent increase in the amount fed, no single factor was definitively identified that might have incited or contributed to the gastric dilatation. CLINICAL RELEVANCE Gastric dilatation was a life-threatening condition in the large felids of this report, causing sudden death or clinical signs of hematemesis, abdominal distention, or vomiting. Even with rapid diagnosis and surgical decompression, the prognosis was poor. Research is needed into the factors that contribute to this emergent condition in large felids so that preventive measures might be taken.

A Prospective Evaluation of a Modified Belt-Loop Gastropexy in 100 Dogs with Gastric Dilatation-Volvulus

Gastropexy is a surgical technique performed to prevent and decrease the recurrence rate of gastric dilatation and volvulus (GDV). The objective of this prospective, a descriptive cohort study on 100 client-owned dogs who were presented with GDV, is to describe a modified belt-loop gastropexy and determine its intraoperative complications and long-term efficacy. The transversus abdominis muscle was used to make an oblique belt-loop. A seromuscular antral fold, instead of a seromuscular antral flap, was passed through the belt-loop, and then, the passed portion of the antral fold was sutured to the dissected edge of the abdominal wall. Intraoperative complications related to gastropexy were recorded, and the incidence of GDV recurrence was determined a minimum of 1 yr postoperatively via telephone with the referring veterinarians and the owners. There were no intraoperative complications related to the modified belt-loop gastropexy technique. Based on follow-up conversations, none of the dogs presented signs of GDV recurrence during the follow-up period. Based on the results, there is strong clinical evidence that a modified belt-loop gastropexy prevents recurrence of GDV in dogs surviving an acute episode.

Assessment of the Prevalence of Gastric “Gravel Sign” in Dogs with Acute Gastric Dilatation-Volvulus

Radiological examination of gastric “gravel sign” was retrospectively conducted in 60 dogs presented with acute gastric dilatation-volvulus (GDV) syndrome. Other radiographic findings including loss of peritoneal serosal detail, presence of radiopaque foreign bodies, gastric pneumatosis, splenomegaly, and megaesophagus, were also examined in these patients. “Gravel sign” was detected on the pre-operative radiographs of 17 dogs with acute GDV (28.3%), suggesting that these patients could be suffering from chronic partial gastric obstruction before examination. German Shepherd dogs were significantly over-represented in this group (10/17, 58.8%). Dogs with acute GDV showing “gravel sign” should be carefully investigated for the presence of underlying gastrointestinal processes that might be associated with chronic partial obstruction.

Spontaneous gastric dilatation-volvulus in two cats

OBJECTIVES

To describe 2 cases of gastric dilatation-volvulus (GDV) in cats. To describe 2 unique clinical settings in which the disease occurs in cats, and to highlight the differences between GDV in cats and dogs.

CASE SERIES SUMMARY

Two neutered female Persian cats were presented for evaluation of respiratory distress. Initial physical examination revealed tachypnea, dyspnea, and a markedly distended and painful abdomen in both cats. Radiographs revealed a gas-dilated stomach and gastrointestinal (GI) tract in both cats but were only diagnostic for GDV in 1 case. Gastric dilatation-volvulus was confirmed during exploratory laparotomy and gastropexy was performed in each case. Both cats were successfully discharged from the hospital.

NEW AND UNIQUE INFORMATION PROVIDED

Gastric dilatation-volvulus in cats is a rare event and appears to occur in 2 clinical settings: in combination with traumatic diaphragmatic hernia (as previously reported) and without a history of trauma or diaphragmatic hernia, as in the 2 cases reported here. Clinicians should consider GDV in the list of differentials for cats with respiratory distress and abdominal distension, even if classic radiographic findings are not present.

Associations between gastric dilatation-volvulus in Great Danes and specific alleles of the canine immune-system genes DLA88, DRB1, and TLR5

OBJECTIVE To determine whether specific alleles of candidate genes of the major histocompatibility complex (MHC) and innate immune system were associated with gastric dilatation-volvulus (GDV) in Great Danes. ANIMALS 42 healthy Great Danes (control group) and 39 Great Danes with ≥ 1 GDV episode. PROCEDURES Variable regions of the 2 most polymorphic MHC genes (DLA88 and DRB1) were amplified and sequenced from the dogs in each group. Similarly, regions of 3 genes associated with the innate immune system (TLR5, NOD2, and ATG16L1), which have been linked to inflammatory bowel disease, were amplified and sequenced. Alleles were evaluated for associations with GDV, controlling for age and dog family. RESULTS Specific alleles of genes DLA88, DRB1, and TLR5 were significantly associated with GDV. One allele of each gene had an OR > 2 in the unadjusted univariate analyses and retained a hazard ratio > 2 after controlling for temperament, age, and familial association in the multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE The 3 GDV-associated alleles identified in this study may serve as diagnostic markers for identification of Great Danes at risk for GDV. Additional research is needed to determine whether other dog breeds have the same genetic associations. These findings also provided a new target for research into the etiology of, and potential treatments for, GDV in dogs.

Food engorgement in 35 dogs (2009-2013) compared with 36 dogs with gastric dilation and volvulus

The clinical features and management of food engorgement (FE) in dogs have not been previously described. This retrospective observational study describes characteristics and outcome of 35 dogs with FE, and compares features on presentation to 36 dogs with gastric dilation and volvulus (GDV). Cases were retrospectively reviewed for history, clinical findings and outcome. Gastric distension was measured by caudal gastric margin (CGM), level with lumbar vertebrae, on a lateral abdominal radiograph. Frequent characteristics of dogs with FE included tachycardia, tachypnoea, hyperproteinaemia, increased base excess (BE), mild hypernatraemia and hyperlactataemia. There was overlap in CGM between dogs with GDV (CGM range L3 to >L6) and dogs with FE (CGM range <L2 to L5-L6). In contrast to dogs with GDV, lactate concentration in dogs with FE was not associated with CGM or BE. Dogs with FE mostly received medical intervention consisting of fluid therapy and analgesia, and all dogs survived to discharge. In conclusion, dogs with FE frequently presented with acid-base and electrolyte derangements, including hyperlactataemia. While dogs with FE can have gastric distension as severe as that seen with GDV, outcome with supportive care only is excellent.

Gastric dilation-volvulus in dogs attending UK emergency-care veterinary practices: prevalence, risk factors and survival

OBJECTIVE

To report prevalence, risk factors and clinical outcomes for presumptive gastric dilation-volvulus diagnosed among an emergency-care population of UK dogs.

METHODS

The study used a cross-sectional design using emergency-care veterinary clinical records from the VetCompass Programme spanning September 1, 2012 to February 28, 2014 and risk factor analysis using multivariable logistic regression modelling.

RESULTS

The study population comprised 77,088 dogs attending 50 Vets Now clinics. Overall, 492 dogs had presumptive gastric dilation-volvulus diagnoses, giving a prevalence of 0·64% (95% Confidence interval: 0·58 to 0·70%). Compared with cross-bred dogs, breeds with the highest odds ratios for the diagnosis of presumptive gastric dilation-volvulus were the great Dane (odds ratio: 114·3, 95% Confidence interval 55·1 to 237·1, P<0·001), akita (odds ratio: 84·4, 95% Confidence interval 33·6 to 211·9, P<0·001) and dogue de Bordeaux (odds ratio: 82·9, 95% Confidence interval 39·0 to 176·3, P<0·001). Odds increased as dogs aged up to 12 years and neutered male dogs had 1·3 (95% Confidence interval 1·0 to 1·8, P=0·041) times the odds compared with entire females. Of the cases that were presented alive, 49·7% survived to discharge overall, but 79·3% of surgical cases survived to discharge.

CLINICAL SIGNIFICANCE

Approximately 80% of surgically managed cases survived to discharge. Certain large breeds were highly predisposed.