Intestinal motility after massive small bowel resection in conscious canines: comparison of acute and chronic phases

Extensive small bowel resection in dogs and cats: 20 cases (1998–2004)

OBJECTIVE

To determine outcome in dogs and cats that underwent extensive (ie, > 50%) resection of the small intestine and identify factors associated with outcome.

DESIGN

Retrospective case series.

ANIMALS

13 dogs and 7 cats.

PROCEDURE

Medical records were reviewed, and follow-up information was obtained.

RESULTS

In all 7 cats and in 8 of the 13 dogs, extensive intestinal resection was performed because of a foreign body. Mean+/-SD estimated percentage of intestine that was removed was 68+/-14% (range, 50% to 90%). Two dogs were euthanized 3 days after surgery because of dehiscence of the surgical site and development of septic peritonitis; 1 dog died of acute respiratory distress syndrome 5 days after surgery. The remaining 10 dogs and 7 cats were discharged from the hospital, and follow-up information was available for 15 of the 17. Median survival time was 828 days, and 12 of the 15 animals for which long-term follow-up information was available had good outcomes. However, none of the factors examined, including percentage of intestine resected, were significantly associated with outcome.

CONCLUSIONS AND CLINICAL RELEVANCE

Most dogs and cats that underwent extensive resection of the small intestine had a good outcome. The amount of intestine resected was not associated with outcome. These data may be useful in providing prognostic information in cases of extensive small intestinal resection.

Isopower mapping of electrogastrograms in short-bowel syndrome

Methods for making topographic or isopower electrogastrographic (EGG) maps and for obtaining maximum power foci (MPFs) by means of 27-channel EGG recordings are briefly described. The methods are applied to short-bowel syndrome (SBS). The gastro-intestinal tract is traced by videofluorograms after X-ray-opaque barium has been ingested. The MPFs are generally located on the trace of the gastro-intestinal tract. The gastric area is occupied by 3 cycles x min(-1) (up to 28% of total MPFs) and 6 cycles x min(-1) MPFs (26%). The trace of the small intestine is occupied mainly by 8 cycles x min(-1) (39%) and 10 cycles x min(-1) (43%) MPFs. The trace of the colon is occupied almost evenly by all five spectral frequency groups, that is, by 1 (58%), 3 (53%), 6 (48%), 8 (57%) and 10 cycles x min(-1) (42%). Most interestingly, the numbers of 8-10 cycles x min(-1) power foci found on EGG maps (including MPFs and relatively higher power foci) are proportional to the remaining length at operation and to the length of the remaining small intestine in the long-term, over 6 years postoperatively. It is therefore possible to follow approximately the trace of the gastero-intestinal tract.

Effects of trimebutine on intestinal motility after massive small bowel resection

Effects of trimebutine maleate (TM) on intestinal motility in short bowel syndrome (SBS) were studied in conscious canines in both acute and chronic phases following 80% massive distal small bowel resection (MSBR). TM was administered orally to beagles with MSBR or as controls in the postprandial and fasting states, and given simultaneously with meals. Intestinal motility was measured using bipolar electrodes for approximately 1 month after the electrodes were implanted in each beagle and the data compared between treatment groups. When TM was given with meals, the postprandial period without duodenal migrating myoelectric (or motor) complexes (MMCs) was shorter than in those given meals only. When TM was given in the postprandial state in short bowel beagles, the initial duodenal MMCs occurred earlier, i.e. the postprandial period was shorter. Diarrhea did not occur in these beagles. When TM was given in the fasting state, duodenal MMCs occurred and propagated to the distal intestine. In conclusion, oral TM administration can produce a more appropriate intestinal condition for the next food intake and make enteral nutrition possible even in the acute phase after MSBR. Such feeding can be carried out without overloading gut function as a result of the modulation of gastrointestinal motility by TM.

Effects of intestinal muscular wrapping on remnant intestinal motility after massive small bowel resection in conscious canines

We searched the effect of the muscular valve on the management of short bowel syndrome. The motility of the remnant intestine with a special muscular valve after 80% massive distal small bowel resection (MSBR) was evaluated in conscious dogs. The valve (muscular ring) was made by the autointestinal muscle layer holding vascular pedicle. Interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gauge force transducers 2-4 weeks after the surgery, and data of this group (Group I) were compared to the motility in dogs after MSBR without valve construction (Group II) and in controls (Control). Results; Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) in Group I occurred at longer intervals than in Control and almost similarly to those in Group II. MMCs arising from the duodenum were often interrupted before the jejunum above the valve and the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment including that from the duodenum to the proximal jejunum, and to the jejunum above the anastomosis. Transit time in MSBR group (I and II) from the duodenum to the terminal ileum was extremely shorter than in Control, but there were no differences between in Groups I and II. The duration of the postprandial period without duodenal MMCs in Group I was significantly prolonged than in Control, but was shorter than that in Group II. The muscular valve was frequently activated, and the jejunum covered with the valve was contracted frequently which synchronized with the valve activity. It seemed the valve worked as sphincter. However, intestinal obstruction was not occurred through the jejunum covered by the valve. In conclusion, changes in gut motility after MSBR with the valve construction compensate for the shortened intestine and maintain the bowel content earlier postoperatively in comparison with the MSBR alone, and also contribute to the adaptive increase in the remnant intestinal absorption.