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Gondolfe M, Hans EC. Histologic findings of gastrointestinal biopsies and clinical outcome in dogs undergoing cholecystectomy for gallbladder mucoceles: 71 cases (2014-2021). J Small Anim Pract 2024. [PMID: 39223993 DOI: 10.1111/jsap.13781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 06/03/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES To determine the presence and categorise the severity of enteritis in dogs with gallbladder mucoceles, and evaluate for any associations with enteritis. This study also aimed to report clinical outcome following cholecystectomy and evaluate for associations with survival. MATERIALS AND METHODS Medical records were retrospectively reviewed (2014 to 2021) for dogs undergoing cholecystectomy and duodenal biopsy procedures for gallbladder mucocele. Signalment, bloodwork, abdominal ultrasound findings, surgical details, histology results and outcomes were reported. Surgeries were considered elective or emergent based on each dog's clinical presentation. Enteritis was categorised based on cell type and severity. Inflammation and clinical outcome were statistically evaluated. RESULTS Seventy-one dogs met the study criteria. Enteritis was present in 85.9% (61/71) of cases with the majority being lymphoplasmacytic (53.5%). Twelve dogs (16.9%) underwent gastrointestinal biopsies from multiple sites, which revealed the same enteritis type at each location. A total of 87.3% (n = 62) dogs survived, including 90.4% elective and 86% emergent cases. No significant differences in enteritis severity or patient survival were found between elective and emergent cases. Septic peritonitis was diagnosed in two dogs (2.82%). Mortality was significantly associated with leukocytosis, with nonsurviving dogs having a mean WBC count of 27.6 G/L (95% confidence interval: 10.6 to 21.5). CLINICAL SIGNIFICANCE Enteritis is present in a majority of dogs with gallbladder mucocele, especially mild to moderate with lymphoplasmacytic cell type. Obtaining a duodenal biopsy had minimal impact on patient outcome. Compared to previous studies, improved survival in emergent cases was noted. Further studies with long-term follow-up are needed to determine if enteropathy-related signs persist after cholecystectomy.
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Affiliation(s)
- M Gondolfe
- BluePearl Veterinary Partners, Southfield, Michigan, USA
| | - E C Hans
- BluePearl Veterinary Partners, Southfield, Michigan, USA
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2
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Holmberg J, Ljungvall I, Pelander L, Defarges A, Stiller J, Ingman J, Harlos C, Spillmann T, Häggström J. Video capsule endoscopy findings in dogs with chronic enteropathy and in healthy dogs. J Vet Intern Med 2024. [PMID: 39180366 DOI: 10.1111/jvim.17168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/31/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Video capsule endoscopy is a noninvasive technique for evaluation of the gastrointestinal tract. OBJECTIVE To investigate the safety of using the video capsule ALICAM in dogs with chronic enteropathy (CE) >10 kg, and to compare macroscopic gastrointestinal morphology between CE dogs and healthy controls (HC). ANIMALS Fifteen CE dogs and 15 similarly breed, age and body weight matched HC. METHODS All dogs underwent a clinical work up including blood analyses, fecal samples, abdominal ultrasonographic examination, and blood pressure measurement. The dogs were withheld from food for 16 hours before and 8 hours after they PO received an ALICAM. All recordings were quality assessed, and blindly evaluated by 2 trained observers. RESULTS The median age of CE dogs and HC was 3.3 (interquartile range [IQR] 2.5-5.9) years and 4.7 (IQR 3.3-5.6) years, respectively. The median body weight in the CE dogs and HC was 25.9 (IQR 20.6-30.9) kg, and 29 (IQR 16.2-30.5) kg, respectively. Complete recordings of the gastrointestinal tract were obtained from all dogs without complications. No significant differences were found between groups regarding number of abnormalities such as irregular mucosa, erythema, nonbleeding erosions, bleeding erosions, and dilated lacteals, as well as severity and extent of the abnormalities. CONCLUSIONS AND CLINICAL IMPORTANCE The use of ALICAM for evaluation of the gastrointestinal tract in CE dogs and HC seems safe and feasible regarding gastrointestinal transit and macroscopic morphology assessment in dogs >10 kg. Abnormalities were found in similar proportions in CE dogs and HC.
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Affiliation(s)
| | | | - Lena Pelander
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Jenny Stiller
- Lakeshore Animal Health Partners, Mississauga, Canada
| | - Jessica Ingman
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | | | - Jens Häggström
- Swedish University of Agricultural Sciences, Uppsala, Sweden
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3
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Fietz SA, Kalusa M, Jergens AE, Sahoo DK, Stewart T, Heilmann RM. Ultrastructural changes in chronic inflammatory enteropathies-a comparison between dogs and humans. Front Cell Dev Biol 2024; 12:1379714. [PMID: 38872928 PMCID: PMC11173093 DOI: 10.3389/fcell.2024.1379714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/24/2024] [Indexed: 06/15/2024] Open
Abstract
Chronic inflammatory enteropathies (CIEs) are an important group of diseases in dogs and involve complex pathogenetic aspects. Endoscopy and histopathology are vital for documenting the disease but are less useful for subclassifying CIEs and predicting the response to treatment. However, healing of the mucosal disease process (deep remission) and ultrastructural evaluation of the mucosa have received little attention in canine CIE. Given that canine CIE shares many similarities with inflammatory bowel diseases (IBDs) in human patients-and presents a good spontaneous disease model for human IBD-this perspective article evaluates the literature on ultrastructural lesions in canine CIE and human IBD and offers future directions for the study of ultrastructural mucosal lesions in canine CIE. Such lesions might have a higher sensitivity of detection than structural changes revealed upon light microscopy and may even precede or remain after the resolution of the clinical signs and histologic lesions.
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Affiliation(s)
- Simone A. Fietz
- Institute of Anatomy, Histology and Embryology, College of Veterinary Medicine, Leipzig University, Leipzig, Saxony, Germany
| | - Mirjam Kalusa
- Institute of Anatomy, Histology and Embryology, College of Veterinary Medicine, Leipzig University, Leipzig, Saxony, Germany
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Tracey Stewart
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Romy M. Heilmann
- Department for Small Animals, College of Veterinary Medicine, Leipzig University, Leipzig, Saxony, Germany
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4
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Jergens AE, Heilmann RM. Canine chronic enteropathy—Current state-of-the-art and emerging concepts. Front Vet Sci 2022; 9:923013. [PMID: 36213409 PMCID: PMC9534534 DOI: 10.3389/fvets.2022.923013] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Over the last decade, chronic inflammatory enteropathies (CIE) in dogs have received great attention in the basic and clinical research arena. The 2010 ACVIM Consensus Statement, including guidelines for the diagnostic criteria for canine and feline CIE, was an important milestone to a more standardized approach to patients suspected of a CIE diagnosis. Great strides have been made since understanding the pathogenesis and classification of CIE in dogs, and novel diagnostic and treatment options have evolved. New concepts in the microbiome-host-interaction, metabolic pathways, crosstalk within the mucosal immune system, and extension to the gut-brain axis have emerged. Novel diagnostics have been developed, the clinical utility of which remains to be critically evaluated in the next coming years. New directions are also expected to lead to a larger spectrum of treatment options tailored to the individual patient. This review offers insights into emerging concepts and future directions proposed for further CIE research in dogs for the next decade to come.
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Affiliation(s)
- Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
- *Correspondence: Albert E. Jergens
| | - Romy M. Heilmann
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, Leipzig, SN, Germany
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5
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Febo E, Crisi PE, Oddi S, Pietra M, Galiazzo G, Piscitelli F, Gramenzi A, Prinzio RD, Di Tommaso M, Bernabò N, Bisogno T, Maccarrone M, Boari A. Circulating Endocannabinoids as Diagnostic Markers of Canine Chronic Enteropathies: A Pilot Study. Front Vet Sci 2021; 8:655311. [PMID: 34124221 PMCID: PMC8187750 DOI: 10.3389/fvets.2021.655311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic enteropathies (CEs) in dogs, according to the treatment response to consecutive trials, are classified as food-responsive (FRE), antibiotic-responsive (ARE), and immunosuppressive-responsive (IRE) enteropathy. In addition to this classification, dogs with loss of protein across the gut are grouped as protein-losing enteropathy (PLE). At present, the diagnosis of CEs is time-consuming, costly and sometimes invasive, also because non-invasive biomarkers with high sensitivity and specificity are not yet available. Therefore, this study aimed at assessing the levels of circulating endocannabinoids in plasma as potential diagnostic markers of canine CEs. Thirty-three dogs with primary chronic gastrointestinal signs presented to Veterinary Teaching Hospitals of Teramo and Bologna (Italy) were prospectively enrolled in the study, and 30 healthy dogs were included as a control group. Plasma levels of N-arachidonoylethanolamine (AEA), 2-arachidonoylglycerol (2-AG), N-palmitoylethanolamine (PEA), and N-oleoylethanolamine (OEA) were measured at the time of the first visit in dogs with different CEs, as well as in healthy subjects. Plasma levels of 2-AG (p = 0.001) and PEA (p = 0.008) were increased in canine CEs compared to healthy dogs. In particular, PEA levels were increased in the FRE group compared to healthy dogs (p = 0.04), while 2-AG was higher in IRE than in healthy dogs (p = 0.0001). Dogs affected by FRE also showed decreased 2-AG (p = 0.0001) and increased OEA levels (p = 0.0018) compared to IRE dogs. Moreover, dogs with PLE showed increased 2-AG (p = 0.033) and decreased AEA (p = 0.035), OEA (p = 0.016) and PEA (p = 0.023) levels, when compared to dogs affected by CEs without loss of proteins. The areas under ROC curves for circulating 2-AG (0.91; 95% confidence interval [CI], 0.79–1.03) and OEA (0.81; 95% CI, 0.65–0.97) showed a good accuracy in distinguishing the different forms of CEs under study (FRE, ARE and IRE), at the time of the first visit. The present study demonstrated that endocannabinoid signaling is altered in canine CEs, and that CE subtypes showed distinct profiles of 2-AG, PEA and OEA plasma levels, suggesting that these circulating bioactive lipids might have the potential to become candidate biomarkers for canine CEs.
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Affiliation(s)
- Elettra Febo
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | | | - Sergio Oddi
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy.,European Center for Brain Research/Santa Lucia Foundation Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Marco Pietra
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Giorgia Galiazzo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Fabiana Piscitelli
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy
| | | | | | | | - Nicola Bernabò
- Faculty of Bioscience, and Technology for Food Agriculture and Environment, University of Teramo, Teramo, Italy.,Institute of Biochemistry and Cell Biology, National Research Council, Rome, Italy
| | - Tiziana Bisogno
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Mauro Maccarrone
- European Center for Brain Research/Santa Lucia Foundation Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Boari
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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6
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Marsilio S. Differentiating Inflammatory Bowel Disease from Alimentary Lymphoma in Cats: Does It Matter? Vet Clin North Am Small Anim Pract 2021; 51:93-109. [PMID: 33187624 DOI: 10.1016/j.cvsm.2020.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging, and some clinicians argue that it is unnecessary because prognosis and treatment are similar. Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging and some clinicians argue that it is unnecessary since prognosis and treatment are similar. Altough the body of research on this topic has increased over time, we still know little about etiopathogenesis, progression, alternative treatment modalities and prognosis of the different forms of FCE. While differentiating IBD from SCL might not alter a single patients' disease course, further research efforts are required to alter the disease course for our feline patient population as a whole.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Tupper Hall, 1275 Med Science Drive, Davis, CA 95616, USA.
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7
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Chow B, Hill SL, Richter KP, Marsilio S, Ackermann MR, Lidbury JA, Suchodolski JS, Cocker S, Steiner JM. Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy. J Vet Intern Med 2020; 35:190-198. [PMID: 33345405 PMCID: PMC7848359 DOI: 10.1111/jvim.16000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Integrating immunohistochemistry (IHC) and clonality testing with histopathology may improve the ability to differentiate inflammatory bowel disease (IBD) and alimentary small cell lymphoma (LSA) in cats. Hypothesis/Objectives To evaluate the utility of histopathology, IHC, and clonality testing to differentiate between IBD and LSA and agreement of diagnostic results for endoscopic biopsy (EB) samples from the upper (USI) and lower small intestine (LSI). Animals Fifty‐seven cats with IBD or LSA. Methods All cases were categorized as definitive IBD (DefIBD), possible LSA (PossLSA), probable LSA (ProbLSA), or definitive LSA (DefLSA) based on histopathology alone. Results from IHC and clonality testing were integrated. Results Based on histopathology alone, 24/57 (42.1%), 15/57 (26.3%), and 18/57 (31.6%) cats were diagnosed with DefIBD, PossLSA or ProbLSA, and DefLSA, respectively. After integrating IHC and clonality testing, 11/24 cases (45.8%) and 15/15 cases (100%) previously categorized as DefIBD and PossLSA or ProbLSA, respectively, were reclassified as LSA. A final diagnosis of IBD and LSA was reported in 13/57 (22.8%) and 44/57 (77.2%) cats, respectively. Agreement between USI and LSI samples was moderate based on histopathology alone (κ = 0.66) and after integrating IHC and clonality testing (κ = 0.70). However, only 1/44 (2.3%) of the LSA cases was diagnosed based on LSI biopsy alone. Conclusions and Clinical Importance Integrating IHC and clonality testing increased the number of cases diagnosed with LSA, but the consequence for patient outcome is unclear. There was moderate agreement between USI and LSI samples. Samples from the LSI rarely changed the diagnosis.
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Affiliation(s)
- Betty Chow
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,VCA Animal Specialty & Emergency Center, Los Angeles, California, USA
| | - Steve L Hill
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | - Keith P Richter
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, School of Veterinary Medicine, Davis, California, USA.,Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Mark R Ackermann
- Department of Biomedical Sciences and Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Sarah Cocker
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
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8
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Endoscopic Biopsies and Histopathological Findings in Diagnosing Chronic Gastrointestinal Disorders in Dogs and Cats. Vet Med Int 2020; 2020:8827538. [PMID: 33133490 PMCID: PMC7568807 DOI: 10.1155/2020/8827538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023] Open
Abstract
Nowadays, endoscopic examination is a diagnostic tool gaining popularity in the management of gastrointestinal disorders in dogs and cats. Direct accessibility of the lumen of gastrointestinal tract combined with the mucosal biopsy provides a great diagnostic potential. Using endoscopy and endoscopically guided biopsy, one can conduct both macro- and microscopic assessment of lesions and perform many specialist adjunct examinations. Histopathological examination of mucosal biopsy specimens collected from the stomach and intestines allows us to distinguish between types of inflammations and to diagnose ulcerative, polypoid, and cancerous lesions.
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9
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Abstract
Clinical findings with triaditis and individual disease components overlap and may include hyporexia, weight loss, lethargy, vomiting, diarrhea, dehydration, icterus, abdominal pain, thickened bowel loops, pyrexia, dyspnea, and shock. A definitive diagnosis of triaditis requires histologic confirmation of inflammation in each organ, but this may not be possible because of financial or patient-related constraints. Evidence-based data indicate that histologic lesions of triaditis are present in 30% to 50% of cats diagnosed with pancreatitis and cholangitis/inflammatory liver disease. Treatment of triaditis is based on the overall health status of the patient and the type and severity of disease in component organs.
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10
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Study of Correlations between Clinical Signs and Morphological Features Identified in Dogs Affected with Inflammatory Bowel Disease. MACEDONIAN VETERINARY REVIEW 2020. [DOI: 10.2478/macvetrev-2019-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
This paper evaluates possible relations between the clinical activity and the histopathological findings of the entire intestine in dogs with inflammatory bowel disease (IBD). To perform this study, hospital records of 64 dogs of different sex and breed diagnosed with IBD were evaluated. The results of this study did not show a statistically significant correlation between clinical activity and the histopathological assessment of dogs with IBD. Certain connections were found between diarrhea and lacteal dilation in duodenum, and hematochezia and villous epithelial injury in colon but no other associations were found between the rest of the lesions and symptoms.
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11
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Cazzini P, Watson MK, Gottdenker N, Mayer J, Reavill D, Fox JG, Parry N, Sakamoto K. Proposed grading scheme for inflammatory bowel disease in ferrets and correlation with clinical signs. J Vet Diagn Invest 2019; 32:17-24. [PMID: 31884894 PMCID: PMC7003233 DOI: 10.1177/1040638719896555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammatory bowel disease (IBD) is an idiopathic, chronic, inflammatory disease of the gastrointestinal tract of companion animals, including ferrets (Mustela putorius furo). Clinical signs of IBD are nonspecific, and intestinal biopsies are necessary for a definitive diagnosis. A grading scheme has not been established for ferrets. Additionally, the association between histologic severity and clinical signs in ferrets is unknown. We evaluated enteric samples from ferrets diagnosed with IBD, compared histologic grading schemes, and correlated the results with the severity of clinical signs. Enteric sections from 23 ferrets with IBD were analyzed using grading schemes for intestinal inflammation in cats and dogs, and a correlation with clinical signs was evaluated. After dividing the histologic samples into groups based on the severity of clinical signs, main histologic differences were identified. Age and sex were also assessed for correlation with clinical signs. No significant correlation was found between the 2 grading schemes and clinical signs (rho = 0.02, p = 0.89; rho = 0.26, p = 0.18, respectively). Degree of villus fusion, hemorrhage and/or fibrin, epithelial damage, inflammation density, and crypt abscess formation were used retrospectively to create a ferret IBD grading scheme, which was significantly correlated with the severity of clinical signs (rho = 0.48, p = 0.01). A positive correlation was observed between age (p = 0.04) and females (p = 0.007) with severity of clinical signs. Our ferret grading scheme may have clinical utility in providing a more objective, consistent evaluation of IBD in ferrets.
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Affiliation(s)
- Paola Cazzini
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Megan K Watson
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Nicole Gottdenker
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Joerg Mayer
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Drury Reavill
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - James G Fox
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Nicola Parry
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Kaori Sakamoto
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
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12
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Marsilio S, Ackermann MR, Lidbury JA, Suchodolski JS, Steiner JM. Results of histopathology, immunohistochemistry, and molecular clonality testing of small intestinal biopsy specimens from clinically healthy client-owned cats. J Vet Intern Med 2019; 33:551-558. [PMID: 30820999 PMCID: PMC6430868 DOI: 10.1111/jvim.15455] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/05/2019] [Indexed: 01/25/2023] Open
Abstract
Background Histopathology, immunohistochemistry, and molecular clonality testing are metrics frequently used to diagnose chronic enteropathy (CE) in cats. However, normal values for these metrics have been based mainly on samples from cats that were relatively young, specific pathogen‐free, or both. Objectives To describe results of histopathology, immunohistochemistry, and clonality testing of endoscopically‐derived biopsy specimens of the upper small intestinal tract from a cohort of clinically healthy client‐owned cats. Animals Twenty clinically healthy client‐owned cats ≥3 years of age. Methods Tissue specimens were collected from the stomach and duodenum and evaluated single blinded by a board‐certified pathologist. In addition, samples were evaluated by routine immunohistochemistry and clonality testing. Cats were followed after the procedure for signs of CE. Results Integrated results from histopathology, immunohistochemistry, and clonality testing were interpreted as consistent with small cell lymphoma (SCL; n = 12), emerging SCL (n = 1), lymphocytic enteritis (n = 6), and pseudoclonality (n = 1). On follow‐up, 3 cats eventually developed clinical signs of CE, of which 2 were euthanized 295 and 654 days post‐endoscopy. The remaining 17 cats did not show clinical signs of CE after a median of 709 days (range, 219‐869 days). Conclusions and Clinical Importance Intestinal biopsy specimens from clinically healthy client‐owned cats commonly had abnormal findings on histopathology, immunohistochemistry, clonality testing, or some combination of these without apparent clinical relevance. Current diagnostic metrics for diagnosing CE in cats may need modification to be applicable to the general population of cats.
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Affiliation(s)
- Sina Marsilio
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas
| | - Mark R Ackermann
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas.,Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas
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Bottero E, Mussi E, Pieramati C, De Lorenzi D, Silvestri S, Lepri E. Comparison of 2 differently sized endoscopic biopsy forceps in the evaluation of intestinal disease in cats. J Vet Intern Med 2018; 33:523-530. [PMID: 30556184 PMCID: PMC6430887 DOI: 10.1111/jvim.15356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/05/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In clinical practice, histopathological diagnosis of chronic intestinal disease is challenging because of difficulty in obtaining adequate duodenal samples. At present, no studies have investigated the influence of biopsy forceps size on sample quality in cats. OBJECTIVES Duodenal biopsy using larger biopsy forceps (2.4 mm) will provide higher quality samples. ANIMALS Fifty client-owned cats underwent endoscopy of the upper gastrointestinal tract for evaluation of chronic gastrointestinal signs, with inflammatory bowel disease (IBD) or intestinal lymphoma as differential diagnoses. METHODS For each cat, duodenal biopsy specimens were obtained using both small (1.8 mm) and large (2.4 mm) forceps and evaluated for adequacy, orientation, the presence of artifacts, villi morphology, the presence of inflammation, and neoplastic infiltration. RESULTS The percentage of adequate and evaluable biopsy specimens obtained using the larger forceps was significantly higher than that collected using the smaller forceps. Agreement between the forceps was variable for histological features and substantial in the case of lymphoma. However, in case of disagreement, the proper diagnosis usually was achieved only with the larger biopsy forceps. CONCLUSIONS AND CLINICAL IMPORTANCE Use of a larger biopsy forceps allows collection of a higher percentage of adequate and evaluable biopsy specimens compared to the commonly used smaller forceps and indirectly decreases the percentage of artifacts and increases the percentage of samples with evaluable villi. The use of a larger forceps could be helpful to obtain high-quality samples and improve diagnostic accuracy.
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Affiliation(s)
- Enrico Bottero
- Poliambulatorio Argentina, Freelance Gruppo Endovet, Arma di Taggia, Italy
| | - Emanuele Mussi
- Clinica Veterinaria Croce Azzurra, Freelance Gruppo Endovet, Empoli, Italy
| | - Camillo Pieramati
- Dipartimento di Medicina Veterinaria, University of Perugia, Perugia, Italy
| | | | | | - Elvio Lepri
- Dipartimento di Medicina Veterinaria, University of Perugia, Perugia, Italy
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Allenspach KA, Mochel JP, Du Y, Priestnall SL, Moore F, Slayter M, Rodrigues A, Ackermann M, Krockenberger M, Mansell J, Luckschander N, Wang C, Suchodolski J, Berghoff N, Jergens AE. Correlating Gastrointestinal Histopathologic Changes to Clinical Disease Activity in Dogs With Idiopathic Inflammatory Bowel Disease. Vet Pathol 2018; 56:435-443. [DOI: 10.1177/0300985818813090] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prior studies have failed to detect a convincing association between histologic lesions of inflammation and clinical activity in dogs with inflammatory bowel disease (IBD). We hypothesized that use of a simplified histopathologic scoring system would improve the consistency of interpretation among pathologists when describing histologic lesions of gastrointestinal inflammation. Our aim was to evaluate the correlation of histopathologic changes to clinical activity in dogs with IBD using this new system. Forty-two dogs with IBD and 19 healthy control dogs were enrolled in this retrospective study. Endoscopic biopsies from the stomach, duodenum, ileum, and colon were independently scored by 8 pathologists. Clinical disease activity was scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), depending on the individual study center. Summative histopathological scores and clinical activity were calculated for each tissue (stomach, duodenum, ileum, and colon) and each tissue histologic score (inflammatory/morphologic feature). The correlation between CCECAI/CIBDAI and summative histopathologic score was significant ( P < .05) for duodenum ( r = 0.42) and colon ( r = 0.33). In evaluating the relationship between histopathologic scores and clinical activity, significant ( P < .05) correlations were observed for crypt dilation ( r = 0.42), lamina propria (LP) lymphocytes ( r = 0.40), LP neutrophils ( r = 0.45), mucosal fibrosis ( r = 0.47), lacteal dilation ( r = 0.39), and villus stunting ( r = 0.43). Compared to earlier grading schemes, the simplified scoring system shows improved utility in correlating histopathologic features (both summative histology scores and select histologic scores) to IBD clinical activity.
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Affiliation(s)
- Karin A. Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jonathan P. Mochel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Yingzhou Du
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Simon L. Priestnall
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK
| | | | | | - Aline Rodrigues
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Mark Ackermann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | | | - Joanne Mansell
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | | | - Chong Wang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jan Suchodolski
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Nora Berghoff
- College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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Edery EG, Scase T, Kisielewicz C, Dhumeaux MP. Comparison of standard single-bite with multiple-bite biopsy forceps for collection of gastrointestinal biopsies in dogs: a prospective study. Vet Rec 2018; 183:624. [PMID: 30115670 DOI: 10.1136/vr.104742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 07/15/2018] [Accepted: 07/25/2018] [Indexed: 11/04/2022]
Abstract
Various types of endoscopic biopsy forceps have been investigated in dogs. The Multibite (MB) are multiple-bite forceps that collect up to four tissue specimens in a single pass through the endoscope, reducing procedure time. The authors prospectively investigated its clinical utility by comparing procedure times and diagnostic quality of samples obtained with the MB to that of biopsies performed with a single-bite forceps (SB), in 21 dogs with gastrointestinal disorders. When comparing the depth, crush artefacts and diagnostic adequacy of the gastric and duodenal biopsies, there was no significant difference between the MB and SB forceps. The procedure time was significantly longer with the MB. There was no learning curve effect, and there were no reported adverse events. This study failed to demonstrate any significant clinical advantage associated with the use of the Multibite forceps over that of conventional disposable SB forceps.
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Candido MV, Syrjä P, Kilpinen S, Spillmann T. Canine breeds associated with gastric carcinoma, metaplasia and dysplasia diagnosed by histopathology of endoscopic biopsy samples. Acta Vet Scand 2018; 60:37. [PMID: 29914568 PMCID: PMC6004666 DOI: 10.1186/s13028-018-0392-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 06/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background Gastric carcinoma (GC) is a rather rare pathological finding in dogs, with the exception of some breeds which seem predisposed. The etiopathogenesis is largely unknown in dogs, whereas in humans GC often develops from gastric mucosal metaplasia and dysplasia. This study investigates whether dogs of certain breeds are more often subject to gastroduodenoscopy (GDS), and diagnosed with GC, mucosal metaplasia or dysplasia. A retrospective clinical database search was performed at the Veterinary Teaching Hospital at the University of Helsinki, Finland. The following inclusion criteria were applied to estimate relative risk for metaplasia/dysplasia and GC: dogs from pure breeds with at least five individuals subject to GDS with histopathology of gastric biopsies. Results Between 2006 and 2016, from a total of 54945 canine patients presented, 423 dogs underwent GDS. Inclusion criteria were met in 180 dogs of 20 different pure breeds. Eight dogs had GCs (mean age = 9.8 ± 1.7 years): Belgian Tervuren (n = 4), Collie (n = 2), Golden Retriever (n = 1) and Jack Russel Terrier (n = 1). Fourteen dogs of eight breeds had gastric mucosal metaplasia or dysplasia. A log-binomial statistical model revealed that dogs in the following breeds had a significantly higher probability to undergo GDS than the others in the study population: Australian Terrier, Belgian Tervuren, Cairn Terrier, Collie and Siberian Husky. Belgian Tervuren was found at higher risk to be diagnosed with GC [RR = 19 (5.7–63.9; P < 0.0001)], as well as mucosal metaplasia/dysplasia [RR (7.6; 2.95–19.58; P < 0.0001)], as compared to the other breeds included. Shetland Sheepdog had an increased RR (5.83; 1.75–19.45; P = 0.0041) for metaplasia. Conclusions The results indicate a very low incidence of GC in dogs. The Belgian Tervuren, however, appears as predisposed. The histopathologic descriptions of mucosal changes such as metaplasia and dysplasia were also rare, but were more frequent in the Belgian Tervuren. Previous reports of these changes in dogs are very scarce, but they might be presumably related to GC in dogs, as they are in humans. Future research should investigate the possible role of metaplasia and dysplasia in the development of GC in dogs, especially those of predisposed breeds.
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Heilmann RM, Berghoff N, Mansell J, Grützner N, Parnell NK, Gurtner C, Suchodolski JS, Steiner JM. Association of fecal calprotectin concentrations with disease severity, response to treatment, and other biomarkers in dogs with chronic inflammatory enteropathies. J Vet Intern Med 2018; 32:679-692. [PMID: 29460444 PMCID: PMC5866976 DOI: 10.1111/jvim.15065] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/01/2018] [Accepted: 01/16/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Calprotectin is a marker of inflammation, but its clinical utility in dogs with chronic inflammatory enteropathies (CIE) is unknown. OBJECTIVE Evaluation of fecal calprotectin in dogs with biopsy-confirmed CIE. ANIMALS 127 dogs. METHODS Prospective case-control study. Dogs were assigned a canine chronic enteropathy clinical activity index (CCECAI) score, and histologic lesions severity was assessed. Fecal calprotectin, fecal S100A12, and serum C-reactive protein (CRP) were measured. Food- or antibiotic-responsive cases (FRE/ARE, n = 13) were distinguished from steroid-/immunosuppressant-responsive or -refractory cases (SRE/IRE, n = 20). Clinical response to treatment in SRE/IRE dogs was classified as complete remission (CR), partial response (PR), or no response (NR). RESULTS Fecal calprotectin correlated with CCECAI (ρ = 0.27, P = .0065) and fecal S100A12 (ρ = 0.90, P < .0001), some inflammatory criteria, and cumulative inflammation scores, but not serum CRP (ρ = 0.16, P = .12). Dogs with SRE/IRE had higher fecal calprotectin concentrations (median: 2.0 μg/g) than FRE/ARE dogs (median: 1.4 μg/g), and within the SRE/IRE group, dogs with PR/NR had higher fecal calprotectin (median: 37.0 μg/g) than dogs with CR (median: 1.6 μg/g). However, both differences did not reach statistical significance (both P = .10). A fecal calprotectin ≥15.2 μg/g separated both groups with 80% sensitivity (95% confidence interval [95%CI]: 28%-100%) and 75% specificity (95%CI: 43%-95%). CONCLUSIONS AND CLINICAL IMPORTANCE Fecal calprotectin could be a useful surrogate marker of disease severity in dogs with CIE, but larger longitudinal studies are needed to evaluate its utility in predicting the response to treatment.
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Affiliation(s)
- Romy M. Heilmann
- Small Animal ClinicCollege of Veterinary Medicine, University of LeipzigLeipzigSaxonyGermany
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexas
| | - Nora Berghoff
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexas
- Department of Pathobiology & Diagnostic InvestigationCollege of Veterinary Medicine, Michigan State UniversityEast LansingMichigan
| | - Joanne Mansell
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexas
| | - Niels Grützner
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexas
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle‐WittenbergHalle (Saale)Saxony‐AnhaltGermany
| | - Nolie K. Parnell
- Small Animal Veterinary Teaching Hospital, College of Veterinary Medicine, Purdue UniversityWest LafayetteIndiana
| | - Corinne Gurtner
- Institute of Animal Pathology, Department of Infectious Diseases and PathobiologyVetsuisse Faculty Bern, University of BernBernSwitzerland
- Institute of Veterinary Pathology, College of Veterinary Medicine, Freie Universität BerlinBerlinGermany
| | - Jan S. Suchodolski
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexas
| | - Jörg M. Steiner
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexas
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18
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Sattasathuchana P, Allenspach K, Lopes R, Suchodolski JS, Steiner JM. Evaluation of Serum 3-Bromotyrosine Concentrations in Dogs with Steroid-Responsive Diarrhea and Food-Responsive Diarrhea. J Vet Intern Med 2017. [PMID: 28626891 PMCID: PMC5508308 DOI: 10.1111/jvim.14742] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background The clinical usefulness of serum 3‐BrY concentrations for subclassifying dogs with food‐responsive diarrhea (FRD) and steroid‐responsive diarrhea (SRD) has not been studied. Hypothesis/Objectives To compare serum 3‐BrY concentrations in dogs with FRD, dogs with SRD, and healthy control dogs. Animals 38 dogs with FRD, 14 dogs with SRD, and 46 healthy dogs. Methods Prospective study. Measurement of 3‐BrY concentration in serum samples was performed by gas chromatography/mass spectrometry. Results There was no association of peripheral eosinophilia in dogs with FRD, SRD, and healthy control dogs (P = 0.069). There was no significant correlation between peripheral eosinophil counts and serum 3‐BrY concentrations (ρ = −0.15, P = 0.13). Serum 3‐BrY concentrations in dogs with SRD (median [range] = 3.27, 0.9–26.23 μmol/L) were significantly higher than in dogs with FRD (median [range] = 0.99, 0.62–8.82 μmol/L; P = 0.007) or in healthy dogs (median [range] = 0.62, 0.62–1.79 μmol/L; P < 0.001). Also, serum 3‐BrY concentrations in dogs with FRD were significantly higher than in healthy dogs (P = 0.025). There was no significant correlation between the canine chronic enteropathy clinical activity index and serum 3‐BrY concentrations (ρ = 0.17, P = 0.23). Conclusions and Clinical Importance Measurement of serum 3‐BrY concentrations, but not the peripheral eosinophil count, is helpful for detecting dogs with SRD and FRD.
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Affiliation(s)
- P Sattasathuchana
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.,Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - K Allenspach
- Department of Veterinary Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - R Lopes
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J S Suchodolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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19
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Lidbury JA, Rodrigues Hoffmann A, Ivanek R, Cullen JM, Porter BF, Oliveira F, Van Winkle TJ, Grinwis GC, Sucholdolski JS, Steiner JM. Interobserver Agreement Using Histological Scoring of the Canine Liver. J Vet Intern Med 2017; 31:778-783. [PMID: 28295598 PMCID: PMC5435077 DOI: 10.1111/jvim.14684] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/16/2017] [Accepted: 01/30/2017] [Indexed: 11/29/2022] Open
Abstract
Background Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme. Hypothesis/Objectives To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red. Animals Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives. Methods Six board‐certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed‐rank test. Results Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E‐stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248). Conclusions and Clinical Importance There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.
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Affiliation(s)
- J A Lidbury
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - A Rodrigues Hoffmann
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - R Ivanek
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Cullen
- North Carolina College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - B F Porter
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | | | - T J Van Winkle
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - G C Grinwis
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Utrecht, Utrecht, The Netherlands
| | - J S Sucholdolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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20
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Dahan J, Semin MO, Monton C, Amiriantz S, Concordet D, Raymond-Letron I, Dossin O. Comparison of routinely used intestinal biopsy forceps in dogs: an ex vivo histopathological approach. J Small Anim Pract 2017; 58:162-167. [PMID: 28267217 DOI: 10.1111/jsap.12643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 11/18/2016] [Accepted: 12/05/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To compare the quality of duodenal and ileal samples obtained with different biopsy forceps. METHODS Fifteen dogs were included in a prospective ex vivo study. After euthanasia, the duodenum and the ileum were sampled with four different forceps and evaluated according to a standardised scoring system. The biopsy forceps evaluated had alligator jaws or cups with smooth edge with or without a needle. RESULTS The global quality of the biopsies was better in the ileum that in the duodenum regardless of the biopsy forceps. Biopsy forceps with smooth edge including a needle resulted in fewer artefacts than biopsy forceps with smooth edge but no needle in both sites and those with alligator jaws without a needle provided deeper biopsies than those with smooth edge without a needle only in the duodenum. There was no effect of the biopsy forceps type on the size of the biopsies. CLINICAL SIGNIFICANCE Our findings may aid in choosing the appropriate type of forceps for intestinal biopsy.
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Affiliation(s)
- J Dahan
- Department of Clinical Sciences and Clinical Research Unit, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - M O Semin
- Department of Biological Sciences, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - C Monton
- Department of Clinical Sciences and Clinical Research Unit, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - S Amiriantz
- Department of Clinical Sciences and Clinical Research Unit, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - D Concordet
- Department of Biological Sciences, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - I Raymond-Letron
- Department of Biological Sciences, National Veterinary School - INP, University of Toulouse, Toulouse, France
| | - O Dossin
- Department of Clinical Sciences and Clinical Research Unit, National Veterinary School - INP, University of Toulouse, Toulouse, France.,IRSD, INSERM 1220, INSERM, INRA, ENVT, UPS, University of Toulouse, 31024 Toulouse, France
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21
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Hoehne SN, McDonough SP, Rishniw M, Simpson KW. Identification of Mucosa-Invading and Intravascular Bacteria in Feline Small Intestinal Lymphoma. Vet Pathol 2016; 54:234-241. [PMID: 27627983 DOI: 10.1177/0300985816664792] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Persistent bacterial infections of the gastrointestinal mucosa are causally linked to gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in people and laboratory animals. We examined the relationship of mucosa-associated bacteria to alimentary lymphoma in cats. Intestinal biopsies from 50 cats with alimentary lymphoma (small cell, n = 33; large cell, n = 17) and 38 controls without lymphoma (normal to minimal change on histopathology, n = 18; lymphocytic-plasmacytic enteritis, n = 20) were evaluated. The number and spatial distribution of bacteria (ie, in luminal cellular debris, villus-associated mucus, adherent to epithelium, mucosal invasion, intravascular, or serosal) were determined by fluorescence in situ hybridization with the eubacterial probe EUB-338. Mucosa-invasive bacteria were more frequently observed in cats with large cell lymphoma (82%, P ≤ .001) than in cats with small cell lymphoma (18%), normal to minimal change on histopathology, and lymphocytic-plasmacytic enteritis (3%). Intravascular bacteria were observed solely in large cell lymphoma (29%), and serosal colonization was more common in cats with large cell lymphoma (57%) than with small cell lymphoma (11%, P ≤ .01), normal to minimal change (8%, P ≤ .01), and lymphocytic-plasmacytic enteritis (6%, P ≤ .001). The high frequency of invasive bacteria within blood vessels and serosa of cats with large cell lymphoma may account for the sepsis-related complications associated with large cell lymphoma and inform clinical management. Further studies are required to determine the role of intramucosal bacteria in the etiopathogenesis of feline alimentary lymphoma.
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Affiliation(s)
- S N Hoehne
- 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.,2 William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA, USA
| | - S P McDonough
- 3 Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - M Rishniw
- 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - K W Simpson
- 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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22
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Fragkou FC, Adamama-Moraitou KK, Poutahidis T, Prassinos NN, Kritsepi-Konstantinou M, Xenoulis PG, Steiner JM, Lidbury JA, Suchodolski JS, Rallis TS. Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats. J Vet Intern Med 2016; 30:1031-45. [PMID: 27296565 PMCID: PMC5089651 DOI: 10.1111/jvim.14356] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 04/26/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022] Open
Abstract
Background The term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats. Hypothesis/Objectives The histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings. Animals Domestic cats (27 symptomatic, 20 asymptomatic, and 8 normal). Methods Prospective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin‐like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL®], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy. Results Inflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022). Conclusions and Clinical Importance Histopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.
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Affiliation(s)
- F C Fragkou
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K K Adamama-Moraitou
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Poutahidis
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N N Prassinos
- Surgery and Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Kritsepi-Konstantinou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P G Xenoulis
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - T S Rallis
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Scudamore CL, Soilleux EJ, Karp NA, Smith K, Poulsom R, Herrington CS, Day MJ, Brayton CF, Bolon B, Whitelaw B, White ES, Everitt JI, Arends MJ. Recommendations for minimum information for publication of experimental pathology data: MINPEPA guidelines. J Pathol 2015; 238:359-67. [PMID: 26387837 DOI: 10.1002/path.4642] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/01/2015] [Accepted: 09/13/2015] [Indexed: 12/27/2022]
Abstract
Animal models are essential research tools in modern biomedical research, but there are concerns about their lack of reproducibility and the failure of animal data to translate into advances in human medical therapy. A major factor in improving experimental reproducibility is thorough communication of research methodologies. The recently published ARRIVE guidelines outline basic information that should be provided when reporting animal studies. This paper builds on ARRIVE by providing the minimum information needed in reports to allow proper assessment of pathology data gathered from animal tissues. This guidance covers aspects of experimental design, technical procedures, data gathering, analysis, and presentation that are potential sources of variation when creating morphological, immunohistochemical (IHC) or in situ hybridization (ISH) datasets. This reporting framework will maximize the likelihood that pathology data derived from animal experiments can be reproduced by ensuring that sufficient information is available to allow for replication of the methods and facilitate inter-study comparison by identifying potential interpretative confounders.
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Affiliation(s)
| | - Elizabeth J Soilleux
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Natasha A Karp
- Mouse Informatics Group, Wellcome Trust Sanger Institute, Cambridge, UK
| | - Ken Smith
- Pathology and Pathogen Biology, Royal Veterinary College, Hertfordshire, UK
| | - Richard Poulsom
- Blizard Institute, Queen Mary University of London, UK and Scientific Editor, The Journal of Pathology
| | - C Simon Herrington
- Edinburgh Cancer Research Centre, Institute of Genetics & Molecular Medicine, Edinburgh, UK and Editor in Chief, The Journal of Pathology
| | - Michael J Day
- School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Cory F Brayton
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Bruce Whitelaw
- The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Eric S White
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, USA
| | | | - Mark J Arends
- Centre for Comparative Pathology, University of Edinburgh, Edinburgh, UK
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24
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Hanifeh M, Heilmann RM, Sankari S, Rajamäki MM, Mäkitalo L, Syrjä P, Kilpinen S, Suchodolski JS, Steiner JM, Spillmann T. S100A12 concentrations and myeloperoxidase activity in the intestinal mucosa of healthy dogs. BMC Vet Res 2015; 11:234. [PMID: 26370713 PMCID: PMC4570263 DOI: 10.1186/s12917-015-0551-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 09/01/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Relatively few laboratory markers have been evaluated for the detection or monitoring of intestinal inflammation in canine chronic enteropathies, including inflammatory bowel disease (IBD). Previous research found that the intestinal mucosal levels of S100A12 and myeloperoxidase (MPO), as biomarkers of gut inflammation, were elevated in human patients with IBD. To date, the S100A12 and MPO levels in intestinal mucosal samples from either healthy dogs or from dogs suffering from IBD remain unreported. Therefore, this study aimed to evaluate the mucosal S100A12 and MPO levels in four different parts of the intestine (duodenum, jejunum, ileum and colon) in 12 healthy laboratory Beagle dogs using the ELISA and spectrophotometric methods, respectively. RESULTS Based on histological examinations, the recorded findings for all the samples were considered normal. The mucosal concentration of S100A12 in the ileum was significantly higher than in all other segments of the intestine (p < 0.05). MPO activity was significantly higher in the ileal, jejunal and duodenal than in colonic mucosal samples (p < 0.05). Moreover, its concentration was higher in the jejunum than in the duodenum. CONCLUSIONS This study showed that S100A12 and MPO are reliably detectable in canine intestinal mucosa. The assays used appeared to be sufficient to further evaluate the role of S100A12 and MPO in the pathogenesis of canine chronic enteropathies, including IBD. These biomarkers may play a role in the initial detection of gut inflammation suggesting the need for further investigations to confirm IBD or to differentiate between IBD subtypes. Understanding the role of S100A12 and MPO in the pathogenesis of chronic intestinal inflammation in future may result in an improved understanding of canine chronic intestinal inflammation.
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Affiliation(s)
- Mohsen Hanifeh
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, PO Box 57, Viikintie 49, 00014, Helsinki, Finland.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Postal code 5166616471, Tabriz, Iran.
| | - Romy M Heilmann
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA.
| | - Satu Sankari
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, PO Box 57, Viikintie 49, 00014, Helsinki, Finland.
| | - Minna M Rajamäki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, PO Box 57, Viikintie 49, 00014, Helsinki, Finland.
| | - Laura Mäkitalo
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, PO Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland.
| | - Pernilla Syrjä
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, PO Box 66, Agnes Sjöberginkatu 2, 00014, Helsinki, Finland.
| | - Susanne Kilpinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, PO Box 57, Viikintie 49, 00014, Helsinki, Finland.
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA.
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4474, USA.
| | - Thomas Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, PO Box 57, Viikintie 49, 00014, Helsinki, Finland.
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25
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Pignon C, Huynh M, Husnik R, Jekl V. Flexible Gastrointestinal Endoscopy in Ferrets (Mustela putorius furo). Vet Clin North Am Exot Anim Pract 2015; 18:369-400. [PMID: 26335999 DOI: 10.1016/j.cvex.2015.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Gastrointestinal disease is a common complaint in ferrets (Mustela putorius furo). Their relatively simple and short gastrointestinal tract makes them good candidates for flexible endoscopy. However, apart from a few references in biomedical research articles, there is little information on the use of flexible endoscopy in ferrets. This review describes patient preparation, equipment, and select gastrointestinal endoscopy techniques in ferrets, including esophagoscopy, gastroscopy, duodenoscopy, percutaneous endoscopic gastrostomy, jejunoileoscopy, colonoscopy, and biopsy.
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Affiliation(s)
- Charly Pignon
- Exotics Medicine Service, Alfort National Veterinary School, 7 Avenue du Général de Gaulle, Maisons-Alfort 94700, France.
| | - Minh Huynh
- Exotics Medicine Service, Centre Hospitalier Vétérinaire Frégis, Rue Aristide Briand, Arcueil 94110, France
| | - Roman Husnik
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA; International Clinical Research Center (ICRC), St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic
| | - Vladimir Jekl
- Avian and Exotic Animal Clinic, University of Veterinary and Pharmaceutical Sciences Brno, Brno 65691, Czech Republic
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26
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Simpson KW. Pancreatitis and triaditis in cats: causes and treatment. J Small Anim Pract 2015; 56:40-9. [DOI: 10.1111/jsap.12313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/12/2014] [Accepted: 10/28/2014] [Indexed: 01/16/2023]
Affiliation(s)
- K. W. Simpson
- College of Veterinary Medicine; Cornell University; Ithaca NY 14850 USA
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27
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Distinguishing Intestinal Lymphoma From Inflammatory Bowel Disease in Canine Duodenal Endoscopic Biopsy Samples. Vet Pathol 2014; 52:668-75. [DOI: 10.1177/0300985814559398] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inflammatory bowel disease (IBD) and intestinal lymphoma are intestinal disorders in dogs, both causing similar chronic digestive signs, although with a different prognosis and different treatment requirements. Differentiation between these 2 conditions is based on histopathologic evaluation of intestinal biopsies. However, an accurate diagnosis is often difficult based on histology alone, especially when only endoscopic biopsies are available to differentiate IBD from enteropathy-associated T-cell lymphoma (EATL) type 2, a small cell lymphoma. The purpose of this study was to evaluate the utility of histopathology; immunohistochemistry (IHC) for CD3, CD20, and Ki-67; and polymerase chain reaction (PCR) for antigen receptor rearrangement (T-cell clonality) in the differential diagnosis of severe IBD vs intestinal lymphoma. Endoscopic biopsies from 32 dogs with severe IBD or intestinal lymphoma were evaluated. The original diagnosis was based on microscopic examination of hematoxylin and eosin (HE)–stained sections alone followed by a second evaluation using morphology in association with IHC for CD3 and CD20 and a third evaluation using PCR for clonality. Our results show that, in contrast to feline intestinal lymphomas, 6 of 8 canine small intestinal lymphomas were EATL type 1 (large cell) lymphomas. EATL type 2 was uncommon. Regardless, in dogs, intraepithelial lymphocytes were not an important diagnostic feature to differentiate IBD from EATL as confirmed by PCR. EATL type 1 had a significantly higher Ki-67 index than did EATL type 2 or IBD cases. Based on the results of this study, a stepwise diagnostic approach using histology as the first step, followed by immunophenotyping and determining the Ki67 index and finally PCR for clonality, improves the accuracy of distinguishing intestinal lymphoma from IBD in dogs.
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28
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Okanishi H, Kagawa Y, Watari T. Expression of selectins and P-selectin glycoprotein ligand-1 in dogs with lymphocytic–plasmacytic enteritis. Vet Immunol Immunopathol 2014; 161:42-8. [DOI: 10.1016/j.vetimm.2014.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/20/2014] [Accepted: 06/26/2014] [Indexed: 12/22/2022]
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29
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Jergens AE, Evans RB, Ackermann M, Hostetter J, Willard M, Mansell J, Bilzer T, Wilcock B, Washabau R, Hall EJ, Minami T, Wang C, Day MJ. Design of a simplified histopathologic model for gastrointestinal inflammation in dogs. Vet Pathol 2013; 51:946-50. [PMID: 24280943 DOI: 10.1177/0300985813511123] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Significant interobserver variability in the diagnostic interpretation of endoscopic gastrointestinal (GI) specimens exists even with the use of World Small Animal Veterinary Association (WSAVA) standardization criteria. Chi-square analyses compared the extent of pathologists' agreement for microarchitectural features of inflammation in endoscopic specimens obtained from 253 animals of the original WSAVA study. Patterns of agreement between pathologists were classified as broad (3/4 pathologists agreed), dichotomous (2/4 pathologists agreed), or divergent (no agreement between pathologists). The simplified model for GI inflammation was based on those parameters for which the pathologists had either broad or minimally divergent opinions of histopathologic significance. In this model, the parameters chosen were as follows: gastric parameters (intraepithelial lymphocytes [IELs], lamina propria [LP] infiltrates, and mucosal fibrosis), duodenal parameters (villus atrophy, epithelial injury, IELs, crypt changes, and LP infiltrates), and colonic parameters (epithelial injury, crypt dilation, fibrosis, LP infiltrates, and goblet cell depletion). Preliminary data using this simplified model showed excellent correlation between pathologists in defining the presence and extent of GI inflammation in dogs.
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Affiliation(s)
- A E Jergens
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - R B Evans
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - M Ackermann
- Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - J Hostetter
- Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - M Willard
- Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - J Mansell
- Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - T Bilzer
- Institut fur Neuropathologie, Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Germany
| | - B Wilcock
- Histovet Surgical Pathology, Guelph, Ontario, Canada
| | - R Washabau
- Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
| | - E J Hall
- School of Veterinary Sciences, University of Bristol, Langford, UK
| | - T Minami
- HistoVet Inc., Kanagawa-ku, Yokohama, Japan
| | - C Wang
- Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - M J Day
- School of Veterinary Sciences, University of Bristol, Langford, UK
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30
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Sharman MJ, Bacci B, Whittem T, Mansfield CS. In vivo confocal endomicroscopy of small intestinal mucosal morphology in dogs. J Vet Intern Med 2013; 27:1372-8. [PMID: 24128334 DOI: 10.1111/jvim.12214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/03/2013] [Accepted: 09/03/2013] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Confocal endomicroscopy (CEM) is an endoscopic technology that permits in vivo cellular and subcellular imaging of the gastrointestinal mucosa. OBJECTIVE To determine the feasibility of CEM to evaluate small intestinal mucosal topologic morphology in dogs and to characterize the appearance in healthy dogs. ANIMALS Fourteen clinically healthy research colony dogs. METHODS Experimental study. Dogs were anesthetized for standard endoscopic evaluation of the small intestine followed by CEM. Two fluorophores were used to provide contrast: fluorescein (10% solution, 15 mg/kg IV) before administration of topical acriflavine (0.05% solution) via an endoscopy spray catheter. A minimum of 5 sites within the small intestine were assessed and at each location, sequential adjustment of imaging depth allowed collection of a three-dimensional volume equivalent to an 'optical biopsy'. CEM-guided pinch biopsies were obtained for histologic examination. RESULTS CEM provided high-quality in vivo cellular and subcellular images. Intravenous administration of fluorescein provided sufficient contrast to allow assessment of the vasculature, cellular cytoplasmic features and goblet cell numbers, and distribution. Topical application of acriflavine preferentially stained cellular nucleic acids, allowing evaluation of nuclear morphology. Quality of captured images was occasionally affected by motion artifact, but improved with operator experience. CONCLUSION AND CLINICAL IMPORTANCE CEM provides in vivo images that allow for cellular and subcellular assessment of intestinal mucosal morphology during endoscopy. This has implications for aiding in vivo diagnosis of gastrointestinal disease.
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Affiliation(s)
- M J Sharman
- Faculty of Veterinary Science, The University of Melbourne, Melbourne, Vic, Australia
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31
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Okanishi H, Kabeya H, Maruyama S, Kagawa Y, Watari T. Activation of nuclear factor-kappa B and cell adhesion molecule mRNA expression in duodenal mucosa of dogs with lymphocytic-plasmacytic enteritis. Vet Immunol Immunopathol 2013; 154:145-52. [DOI: 10.1016/j.vetimm.2013.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/07/2013] [Accepted: 05/19/2013] [Indexed: 01/26/2023]
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32
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Walker D, Knuchel-Takano A, McCutchan A, Chang YM, Downes C, Miller S, Stevens K, Verheyen K, Phillips A, Miah S, Turmaine M, Hibbert A, Steiner J, Suchodolski J, Mohan K, Eastwood J, Allenspach K, Smith K, Garden O. A Comprehensive Pathological Survey of Duodenal Biopsies from Dogs with Diet-Responsive Chronic Enteropathy. J Vet Intern Med 2013; 27:862-74. [DOI: 10.1111/jvim.12093] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/15/2013] [Accepted: 03/13/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- D. Walker
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A. Knuchel-Takano
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A. McCutchan
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - Y-M. Chang
- Research Office; The Royal Veterinary College; London UK
| | - C. Downes
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - S. Miller
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Stevens
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Verheyen
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - A.D. Phillips
- Institute of Child Health; University College London; Royal Free Hospital; London UK
| | - S. Miah
- Institute of Orthopaedics and Musculoskeletal Science; University College London; Royal National Orthopaedic Hospital; Stanmore UK
| | - M. Turmaine
- Division of Biosciences; Medical Sciences Building; University College London; London UK
| | - A. Hibbert
- Department of Comparative Biomedical Sciences; The Royal Veterinary College; Royal College Street; London UK
| | - J.M. Steiner
- Gastrointestinal Laboratory; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX
| | - J.S. Suchodolski
- Gastrointestinal Laboratory; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX
| | - K. Mohan
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - J. Eastwood
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Allenspach
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
| | - K. Smith
- Department of Pathology and Infectious Diseases; The Royal Veterinary Col-lege; Hatfield UK
| | - O.A. Garden
- Department of Clinical Sciences and Services; The Royal Veterinary College; Hatfield UK
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33
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Goutal-Landry C, Mansell J, Ryan K, Gaschen F. Effect of Endoscopic Forceps on Quality of Duodenal Mucosal Biopsy in Healthy Dogs. J Vet Intern Med 2013; 27:456-61. [DOI: 10.1111/jvim.12085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 12/12/2012] [Accepted: 03/07/2013] [Indexed: 12/25/2022] Open
Affiliation(s)
- C.M. Goutal-Landry
- Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge LA
| | - J. Mansell
- College of Veterinary Medicine; University of Texas A&M; College Station TX
| | - K.A. Ryan
- Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge LA
| | - F.P. Gaschen
- Department of Veterinary Clinical Sciences; School of Veterinary Medicine; Louisiana State University; Baton Rouge LA
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Procoli F, Mõtsküla P, Keyte S, Priestnall S, Allenspach K. Comparison of Histopathologic Findings in Duodenal and Ileal Endoscopic Biopsies in Dogs with Chronic Small Intestinal Enteropathies. J Vet Intern Med 2013; 27:268-74. [DOI: 10.1111/jvim.12041] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/03/2012] [Accepted: 12/10/2012] [Indexed: 01/02/2023] Open
Affiliation(s)
- F. Procoli
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; University of London; North Mymms UK
| | - P.F. Mõtsküla
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; University of London; North Mymms UK
| | - S.V. Keyte
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; University of London; North Mymms UK
| | - S. Priestnall
- Department of Pathology and Infectious Diseases; The Royal Veterinary College; University of London; North Mymms UK
| | - K. Allenspach
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; University of London; North Mymms UK
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Jergens AE. Feline idiopathic inflammatory bowel disease: what we know and what remains to be unraveled. J Feline Med Surg 2012; 14:445-58. [PMID: 22736679 PMCID: PMC10822384 DOI: 10.1177/1098612x12451548] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Feline idiopathic inflammatory bowel disease (IBD) denotes one form of chronic enteropathy that is immunologically mediated and characterized by persistent or recurrent gastrointestinal (GI) signs and histologic inflammation. Signs of vomiting, diarrhea and weight loss generally predominate, and mucosal inflammation may occur in any portion of the GI tract (especially the small intestine). Affected cats may also have concurrent inflammation in other organs, such as the pancreas and liver, which may impact clinical disease severity. CLINICAL CHALLENGES The exact etiologies of this heterogeneous group of disorders have yet to be determined, though results from basic science and clinical studies suggest that interplay between genetic factors and enteric bacteria is crucial for disease development. The diagnosis is one of exclusion and requires intestinal mucosal biopsy to characterize the type and severity of the inflammatory infiltrate, and to differentiate IBD from other disorders, including alimentary lymphoma. Controversy exists concerning the relative diagnostic accuracy of endoscopic versus full-thickness specimens for the diagnosis of IBD and its differentiation from alimentary lymphoma. AUDIENCE This article is intended to provide veterinary practitioners with a comprehensive clinical update on idiopathic IBD in cats. It reviews the current evidence-based data, the diagnostic approach, the evolving histologic criteria, and treatment options and outcome for feline patients with this syndrome.
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Affiliation(s)
- Albert E Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
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37
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Barrs VR, Beatty JA. Feline alimentary lymphoma: 2. Further diagnostics, therapy and prognosis. J Feline Med Surg 2012; 14:191-201. [PMID: 22370861 PMCID: PMC10822435 DOI: 10.1177/1098612x12439266] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Accurate diagnosis of the distinct subtypes of alimentary lymphoma (AL) that occur in cats is important as there are major differences between them in clinical presentation, treatment and prognosis. Unlike intermediate- and high-grade alimentary lymphoma (I/HGAL) and large granular lymphocyte lymphoma (LGLL), which can often be diagnosed by aspiration cytology, full-thickness intestinal biopsies are usually required for the diagnosis of low-grade alimentary lymphoma (LGAL). CLINICAL CHALLENGES LGAL is an increasingly recognised clinical problem and it can be challenging to differentiate from inflammatory disease. Where there is ambiguity on histology, further diagnostics (immunophenotyping and clonality analysis) may be required. The diagnosis of LGLL requires an index of suspicion as it may be missed with routine diagnostics. While cats with LGAL typically achieve durable remissions with oral prednisolone and chlorambucil, I/HGAL runs a more aggressive clinical course and requires multi-agent chemotherapeutic protocols. Information on the treatment of LGLL is limited and this form of AL has the poorest prognosis. Preliminary studies suggest that abdominal irradiation may potentially be of benefit in cats with AL and further investigations are warranted. EVIDENCE BASE The evidence supporting this review is derived from grade II, III and IV prospective studies, retrospective case series, reviews, extrapolation from other species, pathophysiological justification and the combined clinical experience of those working in the field.
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Affiliation(s)
- Vanessa R Barrs
- Valentine Charlton Cat Centre, University of Sydney, Sydney NSW 2006, Australia.
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38
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Simpson KW, Jergens AE. Pitfalls and progress in the diagnosis and management of canine inflammatory bowel disease. Vet Clin North Am Small Anim Pract 2011; 41:381-98. [PMID: 21486642 DOI: 10.1016/j.cvsm.2011.02.003] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Inflammatory bowel disease (IBD) is the collective term for a group of chronic enteropathies characterized by persistent or recurrent gastrointestinal (GI) signs and inflammation of the GI tract. The specific steps that lead to IBD and the basis for phenotypic variation and unpredictable responses to treatment are not known. This article examines IBD in dogs, focusing on the interaction between genetic susceptibility and the enteric microenvironment (bacteria, diet), the utility of recently developed histologic criteria, the prognostic indicators, and the standardized approaches to treatment.
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Affiliation(s)
- Kenneth W Simpson
- Veterinary Clinical Sciences, College of Veterinary Medicine, Cornell University, VMC2001, Ithaca, NY 14853, USA.
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39
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García-Sancho M, Sainz A, Villaescusa A, Rodríguez A, Rodríguez-Franco F. White spots on the mucosal surface of the duodenum in dogs with lymphocytic plasmacytic enteritis. J Vet Sci 2011; 12:165-9. [PMID: 21586876 PMCID: PMC3104171 DOI: 10.4142/jvs.2011.12.2.165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Distended lacteals, described as expanded white villi in duodenum, are strongly indicative of primary intestinal lymphangiectasia. In the present study, we evaluated the significance of white spots present in the duodenal mucosa of dogs with lymphocytic plasmacytic enteritis (LPE). Fifty dogs with LPE were included in this study, and white spots were detected in the duodenal mucosa in 22 dogs during endoscopy. Hypoproteinemia was more frequent in dogs with white spots than in dogs without spots (p = 0.02). Serum protein and albumin concentration were significantly lower in LPE dogs with white spots (p = 0.038) compared to LPE dogs without white spots (p = 0.039). There was a significant correlation between white spots density and lymphatic dilatation histological scores (p = 0.023; ρ = 0.481). These results suggest that the presence of white spots in the duodenal mucosa of dogs is not a finding exclusive for intestinal lymphangiectasia. Low serum protein and albumin concentrations together with lymphatic dilatation seem to be related to the presence of white spots in the duodenal mucosa of LPE dogs.
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Affiliation(s)
- Mercedes García-Sancho
- Department of Animal Medicine and Surgery, College of Veterinary Medicine, Complutense University of Madrid, Avenida Puerta de Hierro s/n, 28040 Madrid, Spain.
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Kathrani A, Schmitz S, Priestnall SL, Smith KC, Werling D, Garden OA, Allenspach K. CD11c+ cells are significantly decreased in the duodenum, ileum and colon of dogs with inflammatory bowel disease. J Comp Pathol 2011; 145:359-66. [PMID: 21592490 DOI: 10.1016/j.jcpa.2011.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 02/21/2011] [Accepted: 03/15/2011] [Indexed: 02/08/2023]
Abstract
CD11c serves as a marker for human and murine dendritic cells (DCs) and cells expressing this marker have been shown to have similar morphological and functional characteristics in the canine immune system. The aim of this study was to quantify CD11c(+) cells in the duodenum, ileum and colon of healthy dogs and dogs with inflammatory bowel disease (IBD). Endoscopic biopsies from the duodenum (n=12 cases), ileum (n=8 cases) and colon (n=12 cases) were obtained from dogs diagnosed with IBD. Intestinal tissue from 10 healthy beagle dogs was used as control. Immunofluorescence microscopy was carried out using an anti-canine CD11c monoclonal antibody. Labelled cells were recorded as cells per 120,000 μm(2). The canine chronic enteropathy clinical activity index (CCECAI) was calculated for all dogs with IBD. In addition, sections from all dogs with IBD were evaluated according to the guidelines of the World Small Animal Veterinary Association Gastrointestinal Standardization Group. The number of CD11c(+) cells in the duodenum, ileum and colon of dogs with IBD was significantly reduced compared with controls (P<0.01, P<0.01 and P<0.05, respectively). There was a significant negative correlation between the number of CD11c(+) cells in the colon of dogs with IBD and the CCECAI (P=0.044, r(2)=-0.558). Chronic inflammation in canine IBD appears to involve an imbalance in the intestinal DC population. Future studies will determine whether reduced expression of CD11c could be a useful marker for the diagnosis and monitoring of canine IBD.
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Affiliation(s)
- A Kathrani
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, London, UK
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Willard M, Mansell J. Correlating Clinical Activity and Histopathologic Assessment of Gastrointestinal Lesion Severity: Current Challenges. Vet Clin North Am Small Anim Pract 2011; 41:457-63. [DOI: 10.1016/j.cvsm.2011.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Washabau R, Day M, Willard M, Hall E, Jergens A, Mansell J, Minami T, Bilzer T. Endoscopic, Biopsy, and Histopathologic Guidelines for the Evaluation of Gastrointestinal Inflammation in Companion Animals. J Vet Intern Med 2010; 24:10-26. [DOI: 10.1111/j.1939-1676.2009.0443.x] [Citation(s) in RCA: 256] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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