Evaluation of doramectin for the treatment of experimental canine spirocercosis

The nematode Spirocerca lupi is primarily a parasite of dogs, which causes typical lesions of esophageal nodular granulomas, aortic aneurysms and spondylitis. In order to evaluate the therapeutic effect of doramectin on experimental canine spirocercosis, seven beagle dogs experimentally infected with 40 infectious S. lupi larvae (L(3)) were treated with doramectin. Treatment was commenced following endoscopic visualization of esophageal granulomas, and typical S. lupi eggs were detected in the feces. The treatment protocol included six treatments of doramectin (400 microg/kg subcutaneously) at 2 weeks intervals, followed by monthly injections until the disappearance of the esophageal granulomas or the end of the study (768 days post-inoculation). Eggs could not be found on fecal examinations 3-10 days after the first or second doramectin treatment. In addition, a gradual decrease in size of granulomas was noticed in all seven dogs during the course of the study. Esophageal granulomas had completely resolved in six of the seven dogs between day 35 and day 544 post-initial doramectin treatment, by day 35 in one dog (after three treatments), by day 43 in two dogs (after four treatments), by day 98 in one dog (after seven treatments), by day 460 in one dog (after 18 treatments) and by day 544 in another dog (after 21 treatments). In one dog, remnants of S. lupi granulomas could still be seen 544 days post-initiation of treatment with doramectin. Multiple subcutaneous injections of doramectin (400 microg/kg) were shown to be effective and safe in the treatment of canine spirocercosis.

Canine spirocercosis: clinical, diagnostic, pathologic, and epidemiologic characteristics

The nematode Spirocerca lupi is a parasite of dogs with beetles of several species serving as intermediate hosts. The medical records of 50 dogs diagnosed with spirocercosis at the Hebrew University Veterinary Teaching Hospital (HUVTH) in Israel during 1991-1999 were retrospectively reviewed and compared to a control group (n=100). There was a seven-fold increase in the annual number of dogs diagnosed with spirocercosis during these years while the hospital caseload increased by 80%, indicating an emerging outbreak of this infection. Dogs from the greater Tel Aviv area were at the highest risk of being diagnosed with spirocercosis with 74% of the cases originating from this region compared to only 17% of the controls. The disease appeared to have a primarily urban pattern of distribution with a significantly higher percentage (P=0.025) of dogs from cities versus rural areas, as compared to the control group. Sixty-two percent of the cases were diagnosed during the colder months of December through April. The median age of infected dogs was 5 years, with dogs 1 year old or younger at the lowest risk of being diagnosed with spirocercosis. Large breeds were at a higher risk of infection in comparison to small breeds and the Labrador Retriever was significantly over represented (P=0.027) in the study group compared to the control population. The most common signs were vomiting or regurgitation (60%), pyrexia (24%), weakness (22%), respiratory abnormalities (20%), anorexia (18%), melena (18%) and paraparesis (14%). A caudal esophageal mass was identified by radiography in 53% of the dogs and spondylitis of the thoracic vertebrae in 33%. Fecal flotation was positive for S. lupi eggs in 80% of the dogs, and endoscopy was found to be the most sensitive diagnostic procedure and allowed diagnosis in 100% of the examined dogs. Fifty-three percent of the dogs were anemic and creatine kinase (CK) activities were elevated in 54%. Necropsy of 14 dogs revealed esophageal or gastric granulomas in 13 dogs, and an esophageal osteosarcoma in a single animal. Aortic aneurysms were found in six (43%) dogs. Out of 24, 15 dogs (63%) for which follow-up information was available died or were euthanized within 1 month of admission. The case-fatality rate decreased toward the end of the study period when improved therapy with avermectins became available.

Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse

Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse A 4-year-old Quarter Horse mare was evaluated because of recurrent esophageal obstruction. Endoscopic examination revealed a proliferative mass in the esophagus approximately 55 cm aborad to the nares. Histologic examination of biopsy specimens revealed diffuse suppurative esophagitis and granulation tissue with no evidence of neoplasia. The mass was excisedand ablated transendoscopically with a neodymium:yttrium-aluminum-garnet laser. During a follow-up examination 2 weeks after the final laser procedure, the mass was no longer apparent, and the esophagus appeared healed. Six months after the final examination, there had been no recurrence of the mass. In this horse, transendoscopic laser excision was efficacious and avoided problems associated with an esophagotomy.

Gastrinaemia, tissue gastrin concentration and G cell density in the antral mucosa of swine with and without gastric ulcer of the pars oesophagea

Gastric ulcer of the pars oesophagea (GUPO) of the stomach, which occurs spontaneously in swine, is of unknown aetiology. Because gastrin is a potent secretagogue linked to acid secretion, this study was designed to investigate, in pigs with or without GUPO, (1) basal and food-stimulated serum gastrin concentrations, (2) the concentration of tissue gastrin, and (3) gastrin-producing (G) cell density in the antral mucosa. Sixty-four pigs (32 with, and 32 without ulceration) were studied. Antral mucosa was obtained immediately after slaughter for assessment of G-cell number and tissue gastrin concentration. The presence or absence of GUPO was not significantly associated with either of the parameters measured.

Occurrences of candidiasis in a Fisher's lovebird and a budgerigar

Two cage birds, a two-month-old Fisher's lovebird (Agapornis fischeri) and a one-year-old budgerigar (Melopsittacus undulatus), manifested clinical symptoms with general weakness, loss of appetite and ruffled feathers, then died. Pathological findings revealed a large quantity of yellowish-white pseudomembrane on the mucosal membrane of the esophagus and crop in these two birds. Histopathologically, blastospores (5.5 microm long x 3.4 microm wide) and pseudohyphae were detected in the lesions of conspicuous parakeratosis and moderate acanthosis in the stratified squamous epithelium. These two birds were diagnosed as having had candidiasis.

Esophagoscopy

Esophageal pathology is one of the areas that had the major benefits from the advent of endoscopy. Esophagoscopy is a highly reliable diagnostic method for evaluating esophageal disorders that affect the mucosa or alter the lumen of the organ, such as foreign bodies, esophagitis, reflux disease, strictures, ulcers, fistula, and neoplasia. With endoscopy, the treatment of esophageal disorders has greatly improved as well, with the retrieval of foreign bodies and the dilation of esophageal strictures under direct visualization the main therapeutic indications.

Radiographic and computed tomographic changes and clinical presentation of spirocercosis in the dog

A retrospective study of 39 dogs with spirocercosis is described, emphasizing radiographic and computed tomographic aspects and clinical presentation. Dogs were classified as complicated or uncomplicated, both clinically and radiographically. Besides the expected upper gastrointestinal signs, a high incidence of respiratory (77%) and locomotor (23%) complications were present. All dogs had thoracic radiographs. Esophageal masses were radiographically classified as typical or atypical according to their location. Twenty-seven dogs had a typical caudal esophageal mass. Six dogs had a mass atypically located in the hilar region. These masses were smaller and more difficult to visualize radiographically. The remaining 6 dogs did not have a radiographically detectable esophageal mass. Radiology as an initial diagnostic tool was effective in detecting and localizing the mass and to detect early respiratory abnormalities such as pleuritis, mediastinitis, pneumonia, and bronchial displacement. Endoscopy was the modality of choice to confirm antemortem esophageal masses. In dogs where the mass filled the whole esophageal lumen, endoscopy failed to give essential information necessary for surgical excision of neoplastic masses, such as the extent of esophageal wall attachment. Caudal esophageal sphincter involvement was difficult to determine endoscopically with large caudal esophageal masses. Computed tomography was performed on 3 dogs and did not address the latter problems completely, but was found to be a sensitive tool to detect focal aortic mineralization and early spondylitis, both typical for the disease, and essential in the diagnosis of non- or extramural esophageal abnormalities.

Spirocerca lupi esophageal granulomas in 7 dogs: resolution after treatment with doramectin

Seven dogs with Spirocerca lupi esophageal granulomas were identified based on the site of involvement (ie, distal esophagus) and characteristic endoscopic appearance. Six dogs presented with signs of esophageal disease and 1 dog was asymptomatic. Ova were only identified in the feces of 2 dogs. On thoracic radiographs, 4 dogs had evidence of a caudodorsal mediastinal mass, and 2 of these dogs had spondylitis of midthoracic vertebrae. On endoscopy, single esophageal nodules were observed in 5 dogs, 1 dog had 3 nodules, and 1 dog had 6 nodules. All 7 dogs were treated with doramectin at a dosage of 200 microg/kg SC at 14-day intervals for 3 treatments. Dogs had physical and endoscopic examinations at 2, 4, and 6 weeks after treatment. By 6 weeks, clinical signs had resolved in 6 dogs (1 dog was asymptomatic), and the esophageal nodules had completely resolved in 4 dogs, and incompletely resolved in 3 dogs. Two dogs with incomplete resolution were treated again with doramectin at 500 microg/kg PO daily for an additional 6 weeks. Complete resolution of the esophageal nodules was confirmed by endoscopy in all dogs. Nodules had resolved in 4 dogs by 6 weeks, in 2 dogs by 12 weeks (after 6 weeks additional daily oral therapy), and in 1 dog 22 months after the initial 200 microg/kg treatment regimen. No dog experienced adverse effects to the drug, and all symptomatic dogs have been free of disease for periods ranging from 3 to 4 years.

Cell proliferation and apoptosis in the pathogenesis of oesophagogastric lesions in pigs

Recent studies have stressed the importance of epithelial hyperproliferation in the pathogenesis of early lesions (parakeratotic hyperkeratosis) of the porcine gastric pars oesophagea (PO). In this study, immunohistochemical staining with Ki67 (clone MIB1) and AgNOR proteins silver staining were used to evaluate, by means of image analysis, cell proliferation in normal and parakeratotic (parakeratotic hyperkeratosis) epithelia of the PO. Apoptotic activity was also assessed with the TUNEL assay and compared with cell proliferative parameters. Early lesions of the PO were characterised by a significant increase in epithelial proliferative activity while there was no difference in the apoptotic activity between normal and parakeratotic epithelia. Our data confirm the hyperproliferative nature of epithelial changes preceding degeneration and erosion/ulcer of the PO and suggest that an underlying feature of gastric ulcers in pigs is an imbalance between cell proliferation and programmed cell death.

Esophageal obstruction in horses: a retrospective study of 34 cases

The major purpose of this investigation was to describe the causes, possible complications, and prognoses of horses with esophageal obstruction. Of 34 cases presenting with esophageal obstruction, 28 cases were due to impaction of ingesta. Obstruction due to pre-existing esophageal disease occurred in 4 horses with megaesophagus, in 1 horse with stricture in the upper third of the esophagus, and in 1 horse with esophageal diverticulum. There was no significant difference in the contamination of the trachea between horses that subsequently developed aspiration pneumonia and those that did not. The duration of esophageal obstruction prior to admission was significantly longer in horses that developed aspiration pneumonia (median 18, range 2-48 h) than in those horses that did not (median 4, range 0.5-48 h). Although the obstruction was relieved in all 34 horses, 4 were euthanized because of recurring obstruction due to megaesophagus (n = 2), esophageal diverticulum (n = 1), and esophageal stricture (n = 1).

Idiopathic distal esophageal dilation in a southern black rhinoceros (Diceros bicornis minor)

An adult female southern black rhinoceros (Diceros bicornis minor) experienced intermittent periods of regurgitation while eating, suggesting an esophageal disorder. Endoscopy for evaluation of the trachea, esophagus, and stomach revealed a 30-mm nasopharyngeal orifice with associated recess located in the caudodorsal pharynx and a 10-cm dilated segment of the distal esophagus that was presumably the cause of regurgitation. Dietary management of esophageal dilation through short-term utilization of a "soft feed" program successfully eliminated the regurgitation. This is the first report of esophageal dysfunction in a rhinoceros.

Gastroesophageal intussusception in a Labrador retriever

A 14-month-old, intact male Labrador retriever was referred for evaluation of vomiting and regurgitation. A diagnosis of gastroesophageal intussusception with aspiration pneumonia was made. The patient responded favorably to aggressive surgical and medical management. The guarded to poor prognosis for gastroesophageal intussusception makes the successful outcome of this case unique.

Oesophageal impaction in a Canada goose (Branta canadensis)

An oesophageal impaction, consisting of plant material and nylon fishing line, and alimentary parasitism were diagnosed and treated in a Canada goose. At presentation the bird was non-ambulatory with flaccid neck muscles, lethargic, emaciated, dehydrated and had watery brown to green faeces. Palpation of the neck revealed a solid tubular mass ventrally in the mid-cervical region with gritty material cranial to it. Radiographs disclosed an oesophageal mass containing seed or grit-like radio-opaque material, and dilated cranial oesophagus containing radio-opaque material. Laboratory investigations revealed non-regenerative anaemia, heterophilia, lymphopenia, hypoproteinaemia, and many strongyle eggs in faeces. Treatment included supportive therapy, oesophageal gavage, oesophagotomy and drug therapy. The bird recovered and was released 27 days after initial presentation.

Esophageal electrochemical burns due to button type lithium batteries in dogs

Incidences of swallowing lithium batteries have been increasing. More severe tissue damage may be produced by the flow of electric current through tissue due to a lithium battery than a button alkali battery, because the former has the higher voltage of 3V. In this study, model CR2032 lithium batteries were fixed in the esophagus of 5 adult mongrel dogs for 15 or 30 min or 1, 2 or 5 h. On microscopical examination of the esophagus 15 min after fixation of the battery, necrosis was demonstrated from the lamina propria mucosa to the inner muscular layer. Thirty min after fixation of the battery, the esophageal epithelium had completely disappeared to form a blackish-brown area and the outer muscular layer was partially necrosed. Histological findings after 1, 2 or 5 h were similar to those after 30 min, and the blackish-brown area became larger with time. The necrosis extended to the trachea after 1 h. The necrosis developed sooner in tissue in contact with the lithium battery. An ingested lithium battery appears to be more dangerous than a button alkali battery unless it is removed quickly.

Production of gastroesophageal erosions and ulcers (GEU) in gnotobiotic swine monoinfected with fermentative commensal bacteria and fed high-carbohydrate diet

Erosions and gastroesophageal ulcers (GEU) were produced in the pars esophagea of young gnotobiotic swine fed a carbohydrate-enriched liquid diet and monoinfected with two different fermentative commensal bacteria, Lactobacillus and Bacillus sp. In contrast, piglets, fed a similar diet and inoculated with Gastrospirillum sp. (Helicobacter heilmannii), a helicobacter species that colonizes the gastric mucosa, did not develop GEU. Experimental GEU likely develops secondary to epithelial damage mediated by microbial-origin acids whose production is potentiated by high dietary carbohydrate and parietal cell-origin hydrochloric acid.

Gastrointestinal disease and its management

Gastrointestinal (GI) diseases involving the alimentary tract and hepatobiliary system are common in geriatric dogs and cats. Inflammatory disorders predominate, but motility disturbances and degenerative lesions may also cause GI signs in affected animals. Treatment is directed at correction of the underlying cause and often requires tissue biopsy. The prognosis is good in many diseases with appropriate drug nutritional, and/or surgical therapy.

Bilateral incisional gastropexies for treatment of intermittent gastroesophageal intussusception in a puppy

Intermittent gastroesophageal intussusception was diagnosed in an 8-week-old puppy that had had recurrent regurgitation since it was acquired at 6 weeks old. Abnormalities were not detected on survey radiographs or positive-contrast esophagograms; the intussusception was evident only during endoscopic examination of the esophagus. Treatment consisted of bilateral incisional gastropexies attaching the gastric fundus and body to the left and right body walls, respectively. Clinical signs resolved completely after surgery. Gastroesophageal intussusception is rare in dogs, and most dogs with gastroesophageal intussuception have severe clinical abnormalities, including collapse, respiratory difficulties, and shock. However, for dogs with intermittent gastroesophageal intussusception, the only clinical sign may be recurrent regurgitation. Bilateral incisional gastropexies appear to be useful for preventing recurrence of gastroesophageal intussusception in dogs.

Development and evaluation of an endoscopic technique permitting rapid visualization of the cardiac region of the porcine stomach

Our study was designed to ascertain whether a flexible videoscope could be used to efficiently monitor ulcers of the pars esophagea in a large group of grower-finisher swine. Gastroscopy was performed on 2 separate occasions in 32 pigs following anesthesia with intravenous pentobarbital, and ulcers of the pars esophagea were subjectively graded. The pigs were then necropsied. Grades from the second endoscopic examination were compared for agreement with grades derived from gross inspection of the pars esophagea at necropsy, and with grades derived from histopathologic examination of sections of the same region. The pars esophagea was adequately visualized in all endoscopic examinations. The average duration of each examination, from anesthetic induction, was approximately 8 min. Gastroscopy permitted appreciation of a wide range of focal and diffuse superficial and deep ulcerative lesions of the pars esophagea, but failed to unequivocally identify parakeratosis of the pars esophagea. Agreement between endoscopic and subsequent necroscopic and histopathologic gradings of ulcerations was poor. We concluded that the use of a flexible videoscope permitted rapid inspection of the pars esophagea, and was therefore a practical method of experimentally monitoring the progression of spontaneous gastric ulcers in pigs. We also postulated that the poor agreement between endoscopic and postmortem findings occurred because endoscopy was possibly more sensitive at detecting small and superficial ulcerations. However, further studies are needed to verify the accuracy of endoscopic diagnosis of gastric ulcers in the live pig.

Keratin pattern in hyperkeratotic and ulcerated gastric pars oesophagea in pigs

Ulceration of the gastric pars oesophagea is a serious problem in the pig industry, and in spite of numerous studies the underlying mechanisms of the development of such ulcers remains largely unknown. The present study was designed first to test the hypothesis that the epithelium of the pars oesophagea of affected pigs would be more susceptible to the irritating action of acidic gastric content owing to a change in the pattern of expression of keratin, and second to look for a member of the keratin family that could be a suitable indicator of early lesions. Samples were collected from the gastric pars oesophagea of slaughter pigs with and without grossly visible mucosal changes, and the keratin patterns of normal and hyperkeratotic and ulcerated epithelium were compared immunohistochemically. The keratin pairs K 4/K 13, and K 5/K 14 were present in both normal and affected epithelia, and had a similar pattern of expression in both conditions. K 4 and K 13 were expressed in all the suprabasal layers, and K 5 and K 14 were expressed only in the basal and epibasal cells. Immunological reactivity with the monoclonal antibodies LL020 and LHK6-markers for hyperproliferative conditions-was present in the suprabasal layers of the epithelium of the hyperkeratotic and the ulcerated pars oesophagea but not in the normal epithelium. These results indicate that K 6 is expressed in association with the mucosal changes. The pattern of the intermediate filaments of keratin suggests that in basic to gastric ulcers in pigs there is an epithelial proliferation leading to visible hyperkeratosis.