Regional eosinophilic coloproctitis, typhlitis and ileitis in a dog

Influence of closure technique on leakage pressures in an ex vivo canine typhlectomy model

OBJECTIVE

To determine the influence of three closure techniques on leakage pressures of canine typhlectomies.

STUDY DESIGN

Experimental, ex vivo.

SAMPLE POPULATION

Grossly normal cecal segments from 24 adult canine cadavers.

METHODS

Typhlectomies were assigned to one of three closure techniques: simple continuous closure with a Parker-Kerr pattern with 4-0 polydioxanone (group 1), closure with a 60-mm gastrointestinal stapler loaded with a 3.8-mm staple cartridge (group 2), and placement of a Cushing suture to augment the stapled closure (group 3). The median (range) of initial leakage pressure (ILP) and maximum leakage pressure (MLP) was compared between groups along with leakage location.

RESULTS

Typhlectomies in group 3 leaked at higher ILP (310 mm Hg; 188-310) than those in groups 1 (43 mm Hg; 31-80) and 2 (109.5 mm Hg; 68-173; P < .0001). Maximum leakage pressure were greater in group 3 than in other groups (P < .0001). Leakage was detected in 20 of 24 (83%) typhlectomies, located at the incisional line in 13 of 24 (54%) specimens and from suture holes in seven of 24 (29%) specimens.

CONCLUSION

Placement of a Cushing suture pattern to augment stapled incisions improved the ability of typhlectomies to sustain pressure compared with sutured or stapled cadaveric specimens alone.

CLINICAL SIGNIFICANCE

These results provide evidence to support placement of a Cushing suture pattern to augment the staple line for typhlectomies in dogs, although in vivo studies are required to determine the clinical significance of these findings.

Canine eosinophilic gastrointestinal disorders

Eosinophils play a crucial role in the inflammatory response in conjunction with both innate and adaptive immunity. Eosinophils have long been recognized as inflammatory leukocytes that are particularly important in patients with parasitic infestations. However, recent studies in veterinary medicine demonstrate a number of canine eosinophilic gastrointestinal (GI) disorders unrelated to a parasitic infestation. Although the underlying pathophysiology behind eosinophilic infiltration of the canine GI tract remains uncertain, medical intervention aiming to decrease the activation of eosinophils seems effective in reducing symptoms and preventing organ damage. This review focuses on the biology of eosinophils and their products. It describes, the composition of eosinophil granules, mechanisms of eosinophil activation, and eosinophil-related disease processes leading to organ damage. Even though the main clinical signs of canine eosinophilic gastroenteritis, vomiting and diarrhea, are similar to those of other types of gastroenteritis, the clinical response and prognosis are worse for this condition. The clinical signs and diagnostic approach for eosinophilic GI disorders are described and compared between canine and human patients for each region of GI tract, from the esophagus to the colon. Moreover, the current treatments for this syndrome in canine and human patients are summarized and paralleled. The comparative study of canine and human patients with eosinophilic gastroenteritis will advance the understanding of this syndrome in both species and may lead to the development of novel treatment strategies.

Eosinophilic gastroenteritis syndrome in a dog

We performed a clinical and pathological study of a 5 year old female mongrel dog (Drahthaar) with eosinophilic gastroenteritis. The animal was presented with vomiting and was reported to have had bloody diarrhoea for 4 months. The lesions were in atypical locations: in the fundus of the stomach, the ileocaecal valve and the rectum, near the anal sphincter. The lesions in the stomach wall were particularly severe and included severe fibroplasia, especially in the muscle layer and submucosa. Fibroplasia was less visible in the other locations. The presence of eosinophilic granulomatous masses led us to suspect a possible parasitic infection, although some authors note that this pathological condition may have an allergic aetiology.