Recurrence and survival in dogs with excised colorectal polyps: A retrospective study of 58 cases

BACKGROUND

Compared to humans, colorectal polyps are relatively rare in dogs. Epidemiological and prognostic data remain accordingly sparse, although they could help veterinary clinicians in the management of these cases.

OBJECTIVES

To report the epidemiological data of dogs with colorectal polyps and identify factors associated with recurrence and survival.

ANIMALS

Fifty-eight client-owned dogs with colorectal polyps admitted to 7 veterinary hospitals (53 dogs from France, 5 dogs from Spain, and 4 dogs from Portugal) were included.

METHODS

Retrospective multicentric cohort study. Medical records and long-term outcome of the dogs were reviewed. When available, histological samples were reassessed by 2 board-certified pathologists according to the revised Vienna classification (RVC).

RESULTS

The West Highland White Terrier (WHWT) breed was significantly associated with the presence of colorectal polyps (OR: 20; 95% CI: 7.5-52; P < .001). The overall median time to recurrence was not reached after 2000 days. The overall estimated median survival time was 1640 days. WHWT breed and larger polyps were significantly associated with a shorter time of polyp recurrence after surgical removal (respectively, P = .05 and P = .01).

CONCLUSIONS AND CLINICAL IMPORTANCE

The probability of recurrence of colorectal polyps in dogs is low, but increased in WHWTs and larger polyps, which might benefit from routine screening after removal. No effective predictors of polyp recurrence and survival were identified using the RVC.

Use of serum biomarkers in staging of canine hepatic fibrosis

Accurate staging of hepatic fibrosis (HF) is important for treatment and prognosis of canine chronic hepatitis. HF scores are used in human medicine to indirectly stage and monitor HF, decreasing the need for liver biopsy. We developed a canine HF score to screen for moderate or greater HF. We included 96 dogs in our study, including 5 healthy dogs. A liver biopsy for histologic examination and a biochemistry profile were performed on all dogs. The dogs were randomly split into a training set of 58 dogs and a validation set of 38 dogs. A HF score that included alanine aminotransferase, alkaline phosphatase, total bilirubin, potassium, and gamma-glutamyl transferase was developed in the training set. Model performance was confirmed using the internal validation set, and was similar to the performance in the training set. The overall sensitivity and specificity for the study group were 80% and 70% respectively, with an area under the curve of 0.80 (0.71-0.90). This HF score could be used for indirect diagnosis of canine HF when biochemistry panels are performed on the Konelab 30i (Thermo Scientific), using reagents as in our study. External validation is required to determine if the score is sufficiently robust to utilize biochemical results measured in other laboratories with different instruments and methodologies.

Congenital duodenocolic fistula in a dog

A one-year-old female cocker spaniel presented with a 6-month history of persistent diarrhoea. Abdominal ultrasonographic examination revealed mild diffuse thickening of the intestinal wall coupled with mesenteric lymphadenopathy. A connection between the duodenum and the colon was observed during an endoscopic procedure and confirmed by computed tomography. Surgical resection of the communication allowed remission of the diarrhoea. Histology showed a normal duodenal epithelium and muscular layer. A duodenocolic fistula is an abnormal connection within the digestive tract, which in humans is usually considered a complication of a local pathological condition. Due to the absence of a predisposing cause and, in view of the dog's age and histological results, a congenital origin was suspected.

Focal intestinal lipogranulomatous lymphangitis in 10 dogs

OBJECTIVES

To describe the clinical and pathological features of canine focal lipogranulomatous lymphangitis, to evaluate its underlying infectious cause and to compare it with human Crohn's disease.

METHODS

Retrospective review of case records with a histopathological diagnosis of focal lipogranulomatous lymphangitis. Bacterial and fungal colonisation was evaluated using fluorescence in situ hybridisation and histochemical staining, respectively. A comparison with Crohn's disease was performed by a human pathologist.

RESULTS

Ten dogs were evaluated. The historical complaints were predominantly chronic diarrhoea (10/10) and vomiting (5/10). The biochemical abnormalities included hypoalbuminaemia (6/10) and hypocobalaminaemia (4/6). Abdominal sonography revealed a thickened distal ileum±ileocolic junction. Colonoscopy showed a swollen caecal ostium and oedematous caecum in 7/10 dogs. A stenotic ileo-colic opening prevented endoscopic intubation in all dogs. Histology from the resected lesions revealed granulomatous inflammation involving the muscularis and serosa. Fluorescence in situ hybridization demonstrated invasive bacteria in 2/10 dogs. Post-resection, all dogs received metronidazole and tapering immunosuppressive doses of prednisolone. Remission (median 17 months) was achieved in 8/10 dogs.

CLINICAL SIGNIFICANCE

Focal lipogranulomatous lymphangitis is a rare and severe form of canine inflammatory bowel disease with preferential localisation to the ileum and the ileocolic junction. An underlying infectious aetiology was not identified.

Fecal calprotectin concentrations in adult dogs with chronic diarrhea

OBJECTIVE

To evaluate fecal calprotectin concentrations in healthy dogs and dogs with chronic diarrhea, to identify cutoff values for fecal calprotectin concentrations for use in differentiating dogs with chronic diarrhea and a canine chronic enteropathy clinical activity index (CCECAI) < 12 from dogs with chronic diarrhea and a CCECAI ≥ 12, and to evaluate the association between histologic evidence of intestinal mucosal changes and fecal calprotectin concentrations in dogs with chronic diarrhea.

SAMPLE

Fecal samples from 96 adult dogs (27 dogs with chronic diarrhea and 69 healthy control dogs).

PROCEDURES

Severity of clinical signs was evaluated on the basis of the CCECAI scoring system. Endoscopy was performed in all dogs with chronic diarrhea, and mucosal biopsy specimens were evaluated histologically. Fecal calprotectin concentration was quantified via radioimmunoassay.

RESULTS

Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea than in healthy control dogs. Fecal calprotectin concentrations were also significantly higher in dogs with a CCECAI ≥ 12, compared with concentrations for dogs with a CCECAI between 4 and 11. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea associated with histologic lesions, compared with concentrations in control dogs, and were significantly correlated with the severity of histologic intestinal lesions. Among dogs with chronic diarrhea, the best cutoff fecal calprotectin concentration for predicting a CCECAI ≥ 12 was 48.9 μg/g (sensitivity, 53.3%; specificity, 91.7%).

CONCLUSIONS AND CLINICAL RELEVANCE

Fecal calprotectin may be a useful biomarker in dogs with chronic diarrhea, especially dogs with histologic lesions.

Chronic idiopathic large bowel diarrhea in the dog

Chronic idiopathic large bowel diarrhea (CILBD) is a descriptive diagnosis reached by exclusion of the most common diseases associated with chronic large bowel diarrhea. The most important features of irritable bowel syndrome in people are reviewed. The authors report 19 new cases of CILBD that they compare with 37 cases from the literature. The disease appears to be common among dogs referred for colonoscopy. Many dogs with CILBD experience behavioral problems or are exposed to a stressful environment. Most dogs respond to diet change and fiber supplementation. Some benefit from behavior-modifying therapy.

Gastric helicobacters in cats

The types of helicobacter which are found in the stomachs of carnivorous pets, especially cats, have been traditionally referred to as 'gastric helicobacter-like organisms' (GHLOs). These are microaerophilic, Gram-negative, spiral bacteria with multiple terminal flagellae and are endowed with high-level urease activity which allows them to survive in an acidic environment. Certain species have one or more periplasmic fibrils. The two GHLOs most commonly found in cats are Helicobacter felis and a species related to H heilmannii which was recently cultured from dogs. All phenotypic and genotypic (16S RNA gene sequences) evidence suggests that both of these bacteria belong in the genus Helicobacter. Whether or not helicobacters can be transmitted to humans from carnivorous pets is controversial but the recent discovery of H pylori -infected cats may be evidence of an animal reservoir for this pathogen. Although the role of H pylori in inducing antral gastritis and perpetuating pyloric ulcers in humans is well established, whether or not Helicobacter spp are causally involved in any feline gastric inflammatory conditions is unknown.

Differential pathogenic effect of two Helicobacter-like organisms in dog gastric mucosa

Two forms of Helicobacter were detected in the gastric mucosa of twelve healthy beagle dogs. According to ultrastructural criteria they could be classified as Helicobacter bizzozeronii-like and Helicobacter felis-like species. In five animals, the light fundic load of Helicobacter bizzozeronii-like did not affect the integrity of the glandular epithelium. In three animals, the heavy bacterial load extended in the lumens of antral glands and coincided with increased intraepithelial lymphoid infiltrate. The heavy bacterial load observed in 4 animals was mixed (Helicobacter bizzozeronii-like and Helicobacter felis-like), fundic and antral, luminal and intracellular. Adherence of Helicobacter felis-like to epithelial cells and intracellular penetration were responsible for focal necrosis, and glandular atrophy might be observed. Helicobacter bizzozeronii-like thus appeared non pathogenic in beagle dogs, even when the heavy bacterial load extended to the antrum. By contrast, Helicobacter felis-like showed a constant pathogenic effect linked to its properties of adhesion and penetration into epithelial cells. A wider comparative study in humans and domestic carnivorous will determine if the latter may play a role of reservoir-host for pathogenic bacteria.

Pathogenic role of gastric Helicobacter sp in domestic carnivores

As a result of phylogenic studies using new molecular biology techniques and fundamental experimental studies, we now know more about helicobacteria in domestic carnivores, their morphologic characteristics, their taxonomia and more important we know more about their ecological niche. Few clinical studies have been carried out, but the ones that have been undertaken are interesting in that they confirm the extensive prevalence of Helicobacter infections in domestic carnivores and underline their role in the genesis of the inflammatory gastropathies observed in these species. Finally, recent observations have demonstrated the ubiquitous character of these helicobacteria by showing their presence in the stomach of man, dog and cat. This ubiquitous character has led some scientists to consider the potential zoonotic risk of the human infection by Helicobacter heilmannii, felis or pylori.

[Helicobacter infections of man and of domestic carnivores: comparative data]

The role of Helicobacter pylori in generating of the chronic gastritis and in the maintaining of the gastroduodenal ulcerous disease, has been a major medical discovery of these past years in human gastroenterology. More recently in Man, studies have showed that the gastric tumours (adenocarcinoma, lymphoma) are epidemiologically associated with the H. pylori infection. Although the H. pylori infection is the one of the most frequent in the word, the epidemiologic and ecologic aspects of this infections are still not very well known. Thanks to phylogenic studies using the new molecular biology techniques and to fundamental experimental studies, we know more about helicobacteria in domestic carnivores as well as their morphologic characteristic, their taxonomia and more importantly details concerning their ecological niche. Few clinical studies have been made to this day, but the ones that have been undertaken are interesting in confirming the extensive prevalence of Helicobacter infections in domestic carnivores and in underlining their role in the genesis of the inflammatory gastropathies observed in these species. Recent observations have demonstrated the ubiquitous character of these helicobacteria by showing their presence in the stomach of man, dogs and cats. This ubiquitous character has led some scientists to consider the potential zoonotic risk of the human infection by Helicobacter heilmannii, felis or pylori. Finally, the Helicobacter infection of animals seems to be an interesting model not only in the study of the affections caused by these bacteria, but also in the elaboration of a future vaccine against the H. pylori infection in man.