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Jaffey JA. Canine hepatobiliary anatomy, physiology and congenital disorders. J Small Anim Pract 2021; 63:95-103. [PMID: 34409602 DOI: 10.1111/jsap.13410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/21/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
The biliary system is an integral component of normal physiologic homeostasis and essential for survival. It acts as a conduit for the removal of detoxified and catabolised compounds as well as aids in fat digestion and absorption. Derangements in this system can have dangerous sequela that are associated with varying degrees of morbidity and mortality. Moreover, abnormalities in development of the biliary system can have varied and unpredictable changes on function and long-term outcome. The aims of this article were to review canine hepatobiliary anatomy, physiology and cholestasis as well as summarise congenital biliary disorders including human corollaries.
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Affiliation(s)
- J A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
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2
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Struthers JD, Robl N, Wong VM, Kiupel M. Gastrinoma and Zollinger-Ellison syndrome in canids: a literature review and a case in a Mexican gray wolf. J Vet Diagn Invest 2018; 30:584-588. [PMID: 29860931 DOI: 10.1177/1040638718779638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gastrinoma, an infrequent diagnosis in middle-aged dogs, occurs with nonspecific gastrointestinal morbidity. Laboratory tests can yield a presumptive diagnosis, but definitive diagnosis depends on histopathology and immunohistochemistry. We describe a malignant pancreatic gastrinoma with lymph node metastases and corresponding Zollinger-Ellison syndrome in a Mexican gray wolf ( Canis lupus baileyi) and review this endocrine neoplasm in domestic dogs. A 12-y-old, captive, male Mexican gray wolf developed inappetence and weight loss. Abdominal ultrasonography revealed a thickened duodenum and peritoneal effusion. Two duodenal perforations were noted on exploratory celiotomy and were repaired. Persisting clinical signs led to a second celiotomy that revealed a mesenteric mass, which was diagnosed histologically as a neuroendocrine carcinoma. During the following 16 mo, the wolf received a combination of H2-receptor antagonists, proton-pump inhibitors, gastroprotectants, and anti-emetics, but had recurrent episodes of anorexia, nausea, acid reflux, and remained underweight. Worsening clinical signs and weakness prompted euthanasia. The antemortem serum gastrin concentration of 414 ng/L (reference interval: 10-40 ng/L) corroborated hypergastrinemia. Autopsy revealed a mass expanding the right pancreatic limb; 3 parapancreatic mesenteric masses; duodenal ulcers; focal duodenal perforation with septic fibrinosuppurative peritonitis; chronic-active ulcerative esophagitis; and poor body condition. The pancreatic mass was diagnosed histologically as a neuroendocrine carcinoma and the parapancreatic masses as lymph node metastases. Immunohistochemistry of the pancreatic mass was positive for gastrin and negative for glucagon, insulin, pancreatic polypeptide, serotonin, somatostatin, and vasoactive intestinal peptide.
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Affiliation(s)
- Jason D Struthers
- Animal Health Institute, Department of Pathology and Population Medicine, Midwestern University, Glendale, AZ (Struthers, Wong).,Veterinary Diagnostics and Infectious Diseases, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT (Robl).,Veterinary Diagnostic Laboratory, Department of Pathobiology and Diagnostic Investigation, Michigan State University, Lansing, MI (Kiupel)
| | - Nick Robl
- Animal Health Institute, Department of Pathology and Population Medicine, Midwestern University, Glendale, AZ (Struthers, Wong).,Veterinary Diagnostics and Infectious Diseases, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT (Robl).,Veterinary Diagnostic Laboratory, Department of Pathobiology and Diagnostic Investigation, Michigan State University, Lansing, MI (Kiupel)
| | - Valerie M Wong
- Animal Health Institute, Department of Pathology and Population Medicine, Midwestern University, Glendale, AZ (Struthers, Wong).,Veterinary Diagnostics and Infectious Diseases, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT (Robl).,Veterinary Diagnostic Laboratory, Department of Pathobiology and Diagnostic Investigation, Michigan State University, Lansing, MI (Kiupel)
| | - Matti Kiupel
- Animal Health Institute, Department of Pathology and Population Medicine, Midwestern University, Glendale, AZ (Struthers, Wong).,Veterinary Diagnostics and Infectious Diseases, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT (Robl).,Veterinary Diagnostic Laboratory, Department of Pathobiology and Diagnostic Investigation, Michigan State University, Lansing, MI (Kiupel)
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3
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Carvalho T, Frois D, Tinoco H, Pessanha A, Paixão T, Santos R. Malignant pancreatic gastrinoma in a maned wolf (Chrysocyon brachyurus): case report. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT A captive 12-year-old female maned wolf (Chrysocyon brachyurus), previously diagnosed with visceral leishmaniasis, developed severe myiasis in the right ear, followed by prostration and death. A firm solid nodule, measuring 1 x 3cm, was grossly observed in the pancreas. Histologically, there was neoplastic proliferation in the pancreas and pancreatic lymph node. Neoplastic cells had a neuroendocrine pattern, and were positive for gastrin and pancreatic polypeptide by immunohistochemistry. The wolf had also ulcerative gastritis. To the best of our knowledge is the first reported case gastrinoma in this species.
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Affiliation(s)
| | - D.N. Frois
- Universidade Federal de Minas Gerais, Brazil
| | - H.P. Tinoco
- Fundação Zoobotânica de Belo Horizonte, Brazil
| | | | - T.A. Paixão
- Universidade Federal de Minas Gerais, Brazil
| | - R.L. Santos
- Universidade Federal de Minas Gerais, Brazil
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Heilmann RM, Berghoff N, Grützner N, Parnell NK, Suchodolski JS, Steiner JM. Effect of gastric acid-suppressive therapy and biological variation of serum gastrin concentrations in dogs with chronic enteropathies. BMC Vet Res 2017; 13:321. [PMID: 29115998 PMCID: PMC5688819 DOI: 10.1186/s12917-017-1233-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 10/30/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Serum gastrin concentration can help diagnose gastrinomas in dogs if >3-10× the upper reference limit (URL), but antisecretory therapy and other conditions can also cause hypergastrinemia. Effects of antisecretory therapy (famotidine or ranitidine, omeprazole) on serum gastrin concentration in dogs with chronic enteropathy (CE) and its biological variation (BV) are unknown. Aim of the study was to evaluate serum gastrin in acid-suppressant-treated or -naïve CE dogs; test the association between serum gastrin and histopathologic findings in acid-suppressant-naïve CE dogs; and evaluate the BV of serum gastrin in dogs not receiving any gastric acid suppressive therapy. Samples from 231 dogs were used and serum gastrin was measured by chemiluminescence assay. Gastric and duodenal histologic lesions were evaluated and graded. BV of serum gastrin was evaluated in serial samples. RESULTS Serum gastrin concentrations were significantly higher in acid-suppressant-treated than acid-suppressant-naïve dogs (P = 0.0245), with significantly higher concentrations in proton pump inhibitor (PPI)- than H2-antihistamine-treated patients (P = 0.0053). More PPI- than H2-antihistamine-treated dogs had gastrin concentrations above URL (P = 0.0205), but not >3× nor >10× the URL. Serum gastrin concentrations correlated with the severity of gastric antral epithelial injury (P = 0.0069) but not with any other lesions or the presence/numbers of spiral bacteria in gastric biopsies. Intra- and inter-individual BV were 43.4 and 21.6%, respectively, in acid-suppressant-naïve dogs, with a reciprocal individuality index of 0.49 and a critical difference of ≥29.5 ng/L. CONCLUSIONS Antisecretory (particularly PPI) treatment leads to hypergastrinemia in CE dogs, but the concentrations seen in this study are unlikely to compromise a diagnosis of gastrinoma. Use of a population-based URL for canine serum gastrin and a URL of ≤27.8 ng/L are appropriate.
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Affiliation(s)
- Romy M. Heilmann
- College of Veterinary Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, DE Germany
- Gastrointestinal Laboratory, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
| | - Nora Berghoff
- Gastrointestinal Laboratory, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
- Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, 784 Wilson Rd, East Lansing, MI 48824 USA
| | - Niels Grützner
- Gastrointestinal Laboratory, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
- Farm Animal Clinic, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109a, CH, 3012 Bern, BE Switzerland
| | - Nolie K. Parnell
- College of Veterinary Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, DE Germany
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
| | - Jörg M. Steiner
- Gastrointestinal Laboratory, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
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Daure E, Ross L, Webster CRL. Gastroduodenal Ulceration in Small Animals: Part 1. Pathophysiology and Epidemiology. J Am Anim Hosp Assoc 2017; 53:1-10. [DOI: 10.5326/jaaha-ms-6635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Gastroduodenal ulceration in small animals is a complex and important comorbidity that occurs when the physiological homeostasis of the gastrointestinal tract is disrupted secondary to administration of medications or the presence of local or systemic diseases. The aim of this article is to provide a comprehensive review of the veterinary literature regarding the pathophysiology, epidemiology, and risk factors associated with gastroduodenal ulceration in small animals. Pertinent concepts from the human literature will be integrated into the discussion. This article serves as an introduction to the second part of this series, which will review current evidence regarding the use of H2-receptor antagonists and proton pump inhibitors in small animals.
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Affiliation(s)
- Evence Daure
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Linda Ross
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Cynthia R. L. Webster
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
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Vander Hart D, Berry CR. INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN. Vet Radiol Ultrasound 2014; 56:12-7. [DOI: 10.1111/vru.12193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/04/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Daniel Vander Hart
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610
| | - Clifford R. Berry
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610
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Mordecai A, Sellon RK, Mealey KL. Normal dogs treated with famotidine for 14 days have only transient increases in serum gastrin concentrations. J Vet Intern Med 2011; 25:1248-52. [PMID: 22092612 DOI: 10.1111/j.1939-1676.2011.00826.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 08/08/2011] [Accepted: 09/19/2011] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In people, serum gastrin concentrations increase in response to administration of H(2) receptor antagonists, but the effect of famotidine administration on serum gastrin concentrations has not been evaluated in dogs. OBJECTIVES To determine if serum gastrin concentrations increase in response to 14 days of famotidine treatment and the time needed to return to baseline after discontinuation of famotidine; define stability of gastrin in samples held at room temperature. ANIMALS Eleven healthy dogs were included in part A (famotidine treatment) and 7 healthy dogs in Part B (serum gastrin stability). In part A, famotidine (0.5 mg/kg p.o. q12h) was administered for 14 days. Fasting blood samples were collected on days 0, 3, 7, 11, 14, 16, 18, 20, and 22. In part B, blood was collected after a 12-hour fast. Gastrin concentrations in serum samples held at room temperature for ≤30 minutes after sampling were compared to concentrations in samples held at room temperature for 150 minutes after sampling. RESULTS Serum gastrin concentrations increased by day 3 of famotidine administration and returned to baseline concentrations in all dogs by day 14 despite continued famotidine administration. Serum gastrin concentrations were lower (20% mean decrease; P = .0005) in samples held at room temperature for 150 minutes. CONCLUSIONS AND CLINICAL IMPORTANCE After 14 days of famotidine administration, clinically healthy dogs have normal serum gastrin concentrations. In a dog with clinical features consistent with gastrinoma, chronic famotidine administration is unlikely to contribute to increases in serum gastrin concentrations.
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Affiliation(s)
- A Mordecai
- Small Animal Internal Medicine, Veterinary Specialty Center, Buffalo Grove, IL, USA
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Elwood C, Devauchelle P, Elliott J, Freiche V, German AJ, Gualtieri M, Hall E, den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K. Emesis in dogs: a review. J Small Anim Pract 2010; 51:4-22. [PMID: 20137004 PMCID: PMC7167204 DOI: 10.1111/j.1748-5827.2009.00820.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2009] [Indexed: 11/26/2022]
Abstract
Emesis is a common presenting sign in small animal practice. It requires a rational approach to management that is based upon a sound understanding of pathophysiology combined with logical decision making. This review, which assesses the weight of available evidence, outlines the physiology of the vomiting reflex, causes of emesis, the consequences of emesis and the approach to clinical management of the vomiting dog. The applicability of diagnostic testing modalities and the merit of traditional approaches to management, such as dietary changes, are discussed. The role and usefulness of both traditional and novel anti-emetic drugs is examined, including in specific circumstances such as following cytotoxic drug treatment. The review also examines areas in which common clinical practice is not necessarily supported by objective evidence and, as such, highlights questions worthy of further clinical research.
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Affiliation(s)
- C Elwood
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire SG5 3HR
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de Brito Galvao JF, Pressler BM, Freeman LJ, Rohleder JJ, Burgess RCF, Ramos-Vara JA. Mucinous Gastric Carcinoma With Abdominal Carcinomatosis and Hypergastrinemia in a Dog. J Am Anim Hosp Assoc 2009; 45:197-202. [DOI: 10.5326/0450197] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 12-year-old, spayed female Australian cattle dog was evaluated for a 5-month history of progressive vomiting. Abdominal radiographs and ultrasound revealed significant gastric wall thickening and a peripancreatic mass, and serum gastrin concentration was increased (127 pg/mL, reference range 10 to 40 pg/mL). Surgical exploration of the abdomen revealed a thickened, firm, and irregular gastric fundus, pylorus, and antrum; nodules were present throughout the spleen and mesentery adjacent to the left limb of the pancreas. Mucinous gastric carcinoma with carcinomatosis was diagnosed by histopathological examination of surgically excised tissues. Unfortunately, severe postoperative complications resulted in euthanasia 10 days after surgery, and a necropsy was not performed. This case is significant, because it is the first report of a mucinous gastric carcinoma associated with hypergastrinemia in a dog.
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Affiliation(s)
- Joao F. de Brito Galvao
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
| | - Barrak M. Pressler
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
| | - Lynetta J. Freeman
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
| | - Jacob J. Rohleder
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
| | - Richard C. F. Burgess
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
| | - Jose A. Ramos-Vara
- Departments of Veterinary Clinical Sciences (de Brito Galvao, Pressler, Freeman, Rohleder, Burgess) and Comparative Pathobiology (Ramos-Vara), School of Veterinary Medicine, Purdue University, West Lafayette, Indiana 47907
- From the
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Abstract
CASE HISTORY A 6.2 kg, 8-year-old, spayed female Australian Terrier was presented with weight loss, inappetence, lethargy and a 2-day history of intermittent vomiting. CLINICAL FINDINGS The dog had cranial abdominal pain and there was melaena present on digital rectal examination. Haematology revealed a marked, acute leucogram. DIAGNOSIS AND TREATMENT Fasting serum gastrin levels were markedly elevated and gastrinoma was suspected. Treatment was initiated with omeprazole, ranitidine and sucralfate. The dog remained clinically normal for 26 months, at which time exploratory surgery was undertaken and the dog subsequently euthanised due to extensive metastases. Histopathology and immunocytochemistry confirmed the diagnosis of metastatic gastrinoma. CLINICAL RELEVANCE This is a rare condition infrequently reported. Although the number of cases treated with omeprazole are too few to draw firm conclusions, it would appear that proton pump inhibitors are useful and should be considered for cases of gastrinoma managed medically. Long-term prognosis is poor, and survival times range from 1 to 147 weeks. Many treatment options are discussed in the medical literature though not all are feasible in veterinary patients.
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Affiliation(s)
- S M Hughes
- Taranaki Veterinary Centre, PO Box 193, Stratford, New Zealand.
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Buote NJ, Mitchell SL, Penninck D, Freeman LM, Webster CRL. Cholecystoenterostomy for treatment of extrahepatic biliary tract obstruction in cats: 22 cases (1994–2003). J Am Vet Med Assoc 2006; 228:1376-82. [PMID: 16649942 DOI: 10.2460/javma.228.9.1376] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify factors associated with outcome in cats with extrahepatic biliary tract obstruction (EHBTO) that undergo biliary diversion surgery. DESIGN Retrospective case series. ANIMALS 22 cats. PROCEDURES Medical records of cats with surgically confirmed EHBTO that underwent cholecystoenterostomy were reviewed. RESULTS Clinical signs and physical examination findings included vomiting, anorexia, icterus, lethargy, weakness, and weight loss. Common clinicopathologic abnormalities included high serum hepatic enzyme activities and serum bilirubin concentration. Abdominal ultrasonography was performed in 21 cats, and all 21 had findings consistent with EHBTO. Eleven of 15 cats in which blood pressure was monitored had intraoperative hypotension. Eighteen cats had anemia following surgery, and 14 cats had persistent hypotension. Extrahepatic biliary tract obstruction was a result of neoplasia in 9 cats and chronic inflammatory disease in 13. Fourteen cats survived long enough to be discharged from the hospital, but only 6 survived > 6 months after surgery, all of which had chronic inflammatory disease. Median survival time for cats with neoplasia (14 days) was significantly shorter than that for cats with inflammatory disease (255 days). No other variable was associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that cats with EHBTO secondary to neoplasia have a poorer prognosis than cats with EHBTO secondary to chronic inflammatory disease. However, the overall prognosis for cats with EHBTO undergoing cholecystoenterostomy must be considered guarded to poor, and the incidence of perioperative complications is high.
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Affiliation(s)
- Nicole J Buote
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA
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