Pneumatosis coli in a dog

Clinical features and outcome of dogs and cats with gastrointestinal pneumatosis: 30 cases (2010-2021)

OBJECTIVES

To describe the presentation, etiology, and outcome of dogs and cats diagnosed with gastrointestinal pneumatosis (GP).

DESIGN

Retrospective study.

SETTING

Three referral institutions.

ANIMALS

Twenty-six dogs and 4 cats.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The most common sites of GP were the stomach (n = 19), followed by the colon (n = 8) and small intestine (n = 2). One case had pneumatosis of both the stomach and the colon. GP was most commonly associated with gastrointestinal disease in dogs (18/26 [69%]) and cats (3/4 [75%]), with common diagnoses including gastric dilatation and volvulus (n = 5), acute hemorrhagic diarrhea syndrome (n = 4), and gastrointestinal ulceration (n = 4). Of the 4 cases of gastrointestinal ulceration, 3 were dogs with a history of glucocorticosteroid or nonsteroidal anti-inflammatory drug administration and vomiting and diarrhea. Six of 30 cases (20%), all of which were dogs, were determined to have a surgical indication for exploratory celiotomy, although not solely on the basis of diagnosis of GP. Five cases underwent exploratory celiotomy, of which 1 (20%) survived to hospital discharge. Of the medically managed cases, 13 of 24 (54%) survived to hospital discharge. Overall, 14 of 30 cases (47%) survived to hospital discharge.

CONCLUSIONS

GP is an uncommon diagnostic imaging finding that is associated with a variety of disease processes. Its development is often related to primary gastrointestinal diseases. In the absence of other surgical disease, exploratory celiotomy based solely on the diagnosis of GP is unlikely to be indicated.

Pneumatosis Coli in a Dog

The objective of this report is to document a case of pneumatosis coli in an immunosuppressed dog successfully treated with supportive care that included hyperbaric oxygen. A 9 yr old, neutered male Maltese was presented for hematochezia of ∼36 h duration. The dog had a history of immune-mediated thrombocytopenia that was well managed with prednisone and azathioprine. Initial evaluation was unremarkable except for increased rectal temperature and hematochezia on digital rectal examination. Abdominal radiographs revealed diffuse gas within the colonic wall consistent with pneumatosis coli. Scant-free air was also appreciated in the peritoneal and retroperitoneal cavities. The dog was managed for 4 days in hospital with broad spectrum antibiotic, anthelminthic, and gastroprotectant therapy. He received one session of hyperbaric oxygen therapy while in hospital. Repeat abdominal radiographs after 72 hr of medical management showed improvement of the pneumatosis coli. After 4 days of hospitalization, he was discharged with resolution of clinical signs. Pneumatosis coli is rarely diagnosed in dogs but should be considered in cases with clinical signs of colorectal disease.

Pneumatosis coli after partial ligation of congenital portosystemic shunt in a dog

Pneumatosis coli is a rare intestinal disorder in dogs that is characterized by submucosal or subserosal emphysema of the colon. An 8-year-old castrated male Shih Tzu developed anorexia and hematochezia after undergoing surgery for a congenital splenophrenic shunt. Abdominal radiographic examination revealed linear radiolucency throughout the wall of the large intestine. Results of abdominal computed tomography revealed intramural gas tracking along the colon and rectum. Based on these findings, a diagnosis of pneumatosis coli was made. The dog was treated with antibiotics, but the general condition gradually deteriorated, and the dog died 6 days after the day of diagnosis. It was suspected that portal hypertension following partial ligation of congenital portosystemic shunt may have been associated with pneumatosis coli in this case.

Feline gastric pneumatosis

CASE SUMMARY

A 9-year-old male neutered domestic shorthair cat was presented with a 2 day history of anorexia and vomiting. A minimum database, including a complete blood count, serum biochemistry profile and urinalysis were unremarkable apart from a toxic neutrophilic left shift and borderline proteinuria. Abdominal ultrasound revealed intramural gas entrapment with thinning of the gastric wall, a hypoechoic pancreas, peritoneal fluid and a small volume of peritoneal gas along with a hyperechoic mesentery. CT was performed and demonstrated gas within the gastric submucosa and gas in the peritoneal cavity. Generalised gastric erythema was present at surgery and histopathology of excised abnormal areas reported gastric erosion with no obvious causative agents; however, pretreatment with dexamethasone may have been a contributing factor. Culture from biopsied gastric tissue was sterile. Clinical signs resolved after partial gastrectomy and medical management.

RELEVANCE AND NOVEL INFORMATION

Feline gastric pneumatosis is a rare clinical finding. Imaging is essential for diagnosis and to decide on the appropriate treatment; this is often medical but in cases where there is suspicion or evidence of gastric perforation, surgery is indicated. To our knowledge, this is the first case of feline gastric pneumatosis secondary to gastric ulceration, diagnosed via CT and where dexamethasone may have been a contributing factor.