Gastric emphysema and pneumatosis intestinalis in two common marmosets with duodenal dilation syndrome

BACKGROUND

Common marmosets (Callithrix jacchus) are widely used as primate experimental models in biomedical research. Duodenal dilation with chronic vomiting in captive common marmosets is a recently described life-threatening syndrome that is problematic for health control. However, the pathogenesis and cause of death are not fully understood.

CASE PRESENTATION

We report two novel necropsy cases in which captive common marmosets were histopathologically diagnosed with gastric emphysema (GE) and pneumatosis intestinalis (PI). Marmoset duodenal dilation syndrome was confirmed in each case by clinical observation of chronic vomiting and by gross necropsy findings showing a dilated, gas-filled and fluid-filled descending duodenum that adhered to the ascending colon. A diagnosis of GE and PI was made on the basis of the bubble-like morphology of the gastric and intestinal mucosa, with histological examination revealing numerous vacuoles diffused throughout the lamina propria mucosae and submucosa. Immunostaining for prospero homeobox 1 and CD31 distinguished gas cysts from blood and lymph vessels. The presence of hepatic portal venous gas in case 1 and possible secondary bacteremia-related septic shock in case 2 were suggested to be acute life-threatening abdominal processes resulting from gastric emphysema and pneumatosis intestinalis.

CONCLUSIONS

In both cases, the gross and histopathological findings of gas cysts in the GI tract walls matched the features of human GE and PI. These findings contribute to clarifying the cause of death in captive marmosets that have died of gastrointestinal diseases.

Expression of P-glycoprotein in the intestinal epithelium of dogs with lymphoplasmacytic enteritis

Inflammatory bowel disease (IBD) is an idiopathic chronic inflammatory disease of the stomach, the small intestine and/or the large intestine. Loss of integrity of the intestinal barrier may be an important factor in the pathogenesis of IBD. In dogs, lymphoplasmacytic enteritis (LPE) is one of the recognized forms of IBD. P-glycoprotein (P-gp) is a membrane-bound efflux pump constituting an important component of the intestinal barrier. Changes in P-gp expression at the level of the intestinal barrier may be important in the pathogenesis of canine LPE, as this may lead to variable protection against xenobiotics and bacterial products in the intestine. The aim of the present study was to evaluate the expression of epithelial P-gp in the intestine in dogs with LPE compared with disease-free animals. Formalin-fixed intestinal biopsy samples from 57 dogs with histopathological evidence of LPE were immunolabelled with anti-P-gp antibodies (C494 and C219). Endoscopic biopsy samples of the duodenum and colon from 16 healthy beagles were used as controls. None of the control dogs had P-gp expression in the apical membrane of duodenal enterocytes, but all had P-gp labelling at the colonic epithelial surface. Twenty out of 57 dogs with LPE had P-gp expression at the apical surface membrane of villus epithelial cells in the duodenum, jejunum and/or ileum. Six out of 16 colonic samples from dogs with LPE had decreased P-gp expression at the epithelial surface compared with controls. It is unclear whether these changes in P-gp expression in dogs with LPE are a cause or a consequence of the inflammation. The observed changes could affect bioavailability of therapeutic drugs used in LPE.

Collapse following gastrointestinal bleeding secondary to a congenital duodenal diverticulum in two littermate boxer pups

Two littermates, a young male and female boxer, were admitted to the Utrecht University's Department of Clinical Sciences of Companion Animals within a three month period. Both dogs suffered from anaemia caused by chronic intestinal blood loss, vomiting and weight loss. In both cases, there was no response to conservative medical management. Eventually, the dogs suffered significant gastrointestinal haemorrhage that resulted in collapse. Gastroduodenoscopy and exploratory surgery showed a duodenal diverticulum in both dogs. This is the first report that describes this congenital anomaly in two siblings.

IMAGING DIAGNOSIS?EXTRAHEPATIC BILIARY TRACT OBSTRUCTION SECONDARY TO A DUODENAL FOREIGN BODY IN A CAT

A 13-month-old, neutered female domestic shorthaired cat was evaluated for vomiting, anorexia, and lethargy. The cat was icteric and hyperbilirubinemic. Radiographically a partially radiolucent proximal duodenal foreign body was suspected. Ultrasonographically, there was a foreign body at the level of the duodenal papilla and dilation of the common bile duct and cystic duct; a diagnosis of extrahepatic biliary tract obstruction secondary to a duodenal foreign body was made. Sonographic findings were confirmed at surgery and a duodenal foreign body was removed. This information defines duodenal foreign body as a cause of extrahepatic biliary obstruction in cats.

Effect of short-term sequential administration of nonsteroidal anti-inflammatory drugs on the stomach and proximal portion of the duodenum in healthy dogs

OBJECTIVE

To evaluate effects of injection with a nonsteroidal anti-inflammatory drug (NSAID) followed by oral administration of an NSAID on the gastrointestinal tract (GIT) of healthy dogs.

ANIMALS

6 healthy Walker Hounds.

PROCEDURES

In a randomized, crossover design, dogs were administered 4 treatments consisting of an SC injection of an NSAID or control solution (day 0), followed by oral administration of an NSAID or inert substance for 4 days (days 1 through 4). Treatment regimens included carprofen (4 mg/kg) followed by inert substance; saline (0.9% NaCl) solution followed by deracoxib (4 mg/kg); carprofen (4 mg/kg) followed by carprofen (4 mg/kg); and carprofen (4 mg/kg) followed by deracoxib (4 mg/kg). Hematologic, serum biochemical, and fecal evaluations were conducted weekly, and clinical scores were obtained daily. Endoscopy of the GIT was performed before and on days 1, 2, and 5 for each treatment. Lesions were scored by use of a 6-point scale.

RESULTS

No significant differences existed for clinical data, clinicopathologic data, or lesion scores in the esophagus, cardia, or duodenum. For the gastric fundus, antrum, and lesser curvature, an effect of time was observed for all treatments, with lesions worsening from before to day 2 of treatments but improving by day 5.

CONCLUSIONS AND CLINICAL RELEVANCE

Sequential administration of NSAIDs in this experiment did not result in clinically important gastroduodenal ulcers. A larger study to investigate the effect of sequential administration of NSAIDs for longer durations and in dogs with signs of acute and chronic pain is essential to substantiate these findings.

Influence of nifedypine on the hyperalgesic action of duodenal distention in sheep

The aim of this study was to determine the influence of nifedypine--competitive antagonist of voltage-gated dependent L-type Ca2+ channels (VGCCs)--on inhibition of reticulo-ruminal motility, heart beats, respiratory rates and other nociceptive behavior symptoms caused by duodenal distention (DD). The animals, which were under general anesthesia, had duodenal and ruminal fistulas and intracerebroventriculary (i.c.v.) cannulas inserted into the lateral ventricle. Reticulo-ruminal contractions were recorded mechanographically using an electronic tensometer. The frequency of reticulo-ruminal contractions was determined by the number of mechanograms with 5 min intervals prior to and after DD (for 180 min). The duodenal distention was performed using a rubber balloon (10 cm length), which was inserted via the duodenal fistula and filled with 40 ml water. Five min DD caused immediate and almost complete inhibition of reticulo-ruminal contractions, nociceptive behavior symptoms, tachycardia and hyperventilation. Nifedypine per se did not change the reticulo-ruminal motility, general behavior or clinical symptoms; however, doses of 1 and 2 mg of nifedypine in toto infused i.c.v 10 minutes before DD prevented all signs of reticulo-ruminal disorders, as well as the general nociceptive behavior. Nifedypine inhibited particularly clinical symptoms such as tachycardia and hyperventilation. The observed antinociceptive action of VGCCs type-L blockers suggests that these channels play a crucial role in the modulation of acute visceral hyperalgesia. Nifedipine can be useful in controlling acute visceral pain associated, for example, with different kinds of colic.

Cytokine mRNA quantification in duodenal mucosa from dogs with chronic enteropathies by real-time reverse transcriptase polymerase chain reaction

The pathogenesis of inflammatory bowel disease (IBD) and antibiotic-responsive diarrhea (ARD) in dogs likely involves an interaction between the intestinal immune system and luminal bacterial or food antigens. German Shepherd Dogs (GSD) are particularly predisposed to both IBD and ARD. CD4+ T cells are important for the regulation of immune responses in the mucosa, and they exert their effects through the secretion of cytokines. The present study examined the role of cytokines in the pathogenesis of canine chronic enteropathies by quantification of mRNA encoding interleukin-2 (IL-2), IL-4, IL-5, IL-6, IL-10, IL-12, IL-18, interferon gamma, tumor necrosis factor-alpha, transforming growth factor-beta, and glyceraldehyde-3-phosphate dehydrogenase by real-time reverse transcriptase polymerase chain reaction in duodenal mucosal biopsies obtained from 39 dogs with chronic diarrhea and 18 control dogs. Contemporaneously collected biopsies were assessed for histologic changes with a 4-point grading system. No significant difference in the expression of cytokine mRNA (P > .01) was detected between dogs with and those without chronic diarrhea. Similarly, no significant differences in cytokine mRNA expression were observed between GSD and other breeds with chronic diarrhea, or between histologically normal duodenal mucosa and that with evidence of inflammatory change. Failure to detect a difference in mRNA expression does not rule out the possibility of a defect downstream at the level of translation or protein function. No conclusion can be drawn from these data as to the predominant CD4+ cell type in the pathogenesis of these canine chronic enteropathies.

Protein-losing enteropathy associated with cystic mucoid changes in the intestinal crypts of two dogs

Two dogs were emaciated and hypoalbuminemic due to protein-losing enteropathy associated with a severe, focal, mucoid, cryptal ectasia of the duodenum and marked villus atrophy. In one case, diseased portions of the duodenum were obvious endoscopically and were limited to discrete, focal areas in the small intestine, with apparently more undiseased tissue than diseased tissue being present. The signs and lesions in one dog resolved after initiating combination dietary and pharmacological therapy.

Duodenal obstruction caused by infection with Pythium insidiosum in a 12-week-old puppy

Pythium insidiosum is an aquatic fungus-like organism that causes a serious chronic granulomatous disease called pythiosis in animals and humans in tropical and subtropical regions of the world. In North America, pythiosis is most often diagnosed in the Gulf Coast states. Early recognition of the disease is crucial to successful treatment, which includes surgical resection of granulomatous lesions and administration of antifungal agents. Despite increasing availability of diagnostic tests, intestinal pythiosis is insidious and is often not detected until lesions are extensive. Intestinal pythiosis was diagnosed in a 12-week-old puppy from South Carolina examined because of vomiting, diarrhea, and anorexia. Pythiosis was not initially suspected because of the young age of the patient and because pythiosis is uncommon in this area.

Strangulation of the duodenum by the uterus during late pregnancy in two cows

Two Swiss Braunvieh cows in late pregnancy underwent surgery because of a rare form of ileus due to strangulation of the duodenum at its caudal flexure by the gravid uterus. The whole uterus had passed through a gap between the mesoduodenum and duodenum and with increasing weight had led to strangulation of the duodenum. This was possible since the mesoduodenum and both walls of the greater omentum adjacent to its caudal edge were not connected with the duodenum, probably due to a congenital inhibitory malformation. A transsection and an end-to-end anastomosis of the duodenum were necessary in both cases since it was impossible to retract the gravid uterus through the defect. Postoperative recovering was uneventful in both cows, which were discharged after seven and five days respectively and calved normally about two months later.

Gastroduodenoscopy in the dog and cat

Endoscopic examination of the upper gastrointestinal (GI) tract in dogs and cats is a relatively recent development. It was just over 20 years ago, in 1978, that the first series report of GI endoscopy in dogs and cats was presented. In those initial days, endoscopy was truly a novelty, and the primary uses for endoscopes were to retrieve foreign objects or visualize the esophagus and stomach. It was not until the mid-1980s that technology and training made gastroduodenoscopy standard practice. The evolution in endoscopic technology has also mirrored the evolution in computers and imaging modalities. The original fiberoptic endoscopes, although still available, are giving way to video endoscopy and digital imaging capabilities that provide spectacular images and an ability to generate hard copy images for medical records, teaching purposes, and research data that was previously not possible.

Relative deficiency in IgA production by duodenal explants from German shepherd dogs with small intestinal disease

Matched samples of serum, saliva and tears were collected from four groups of dogs; two of the groups were German shepherd dogs (GSDs) either with (Group 1) or without (Group 4) a variety of small intestinal disorders; the remaining two groups were dogs of other breeds, again with (Group 2) or without (Group 3) small intestinal disease. Capture ELISAs were used to measure IgG, IgM, IgA and albumin concentrations within these samples; intestinal humoral immune status of clinical cases was assessed by quantifying immunoglobulin production from duodenal explant cultures.There were no significant differences in IgG, IgM or IgA concentrations in serum, saliva or tears between the different groups of dog. Moreover, no significant differences were noted between groups for IgG, IgM and IgA salivary and tear secretory indices. IgA production by 24-h explant cultures was significantly lower in GSDs compared with non-GSDs with small intestinal disease (groups 1 and 2, respectively), but the numbers of lamina propria IgA(+) plasma cells in duodenal biopsies were not different between groups. These results suggest that there may be a relative deficiency in local IgA secretion in GSDs with small intestinal enteropathies, which is not reflected in either serum IgA concentrations, or in secretion at unaffected mucosal sites. It remains to be determined whether such a deficiency is a breed-related primary defect, or whether it arises secondary to the pathological processes within the intestinal mucosa.

Cytokine mRNA expression in mucosal biopsies from German shepherd dogs with small intestinal enteropathies

German shepherd dogs (GSD) are predisposed to enteropathies such as inflammatory bowel disease (IBD) and small intestinal bacterial overgrowth (SIBO). The present study examined the role of cytokines in the immunopathogenesis of both conditions. Duodenal mucosal biopsies were taken from GSDs with small intestinal enteropathies (group 1; N = 16) or control dogs (group 2, N = 12). IL-2, IL-4, IL-5, IL-10, IL-12p40, IFN-gamma, TNF-alpha, and TGF-beta1 mRNA expression was determined by semiquantitative reverse transcriptase polymerase chain reaction. IL-2, IL-5, IL-12p40, TNF-alpha, and TGF-beta1 mRNA expression in group 1 dogs was significantly greater than in group 2 dogs (all P<0.01), but there were no significant differences between dogs with IBD or SIBO. Further, antibiotic treatment in five dogs with SIBO, resulted in reduced TNF-alpha and TGF-beta1 mRNA expression (P<0.05). Such alterations in cytokine mRNA expression suggest heightened immune responses within the duodenal mucosa in GSDs with either SIBO or IBD.

Duodenal perforation in a cat following the administration of nonsteroidal anti-inflammatory medication

A one-year-old, female domestic shorthair was presented for septic peritonitis 10 days following a routine ovariohysterectomy and subsequent oral administration of carprofen. Exploratory laparotomy revealed a perforated duodenum which was treated with a gastroduodenostomy (Billroth I) and open abdomen management. Etiology of the duodenal perforation was most likely due to the administration of carprofen, a nonsteroidal anti-inflammatory drug approved for oral use in dogs only.

Duodenal volvulus in free-living green turtles from coastal United Arab Emirates

Post-mortem examinations performed during May and August of 1997 on three free-living green turtles (Chelonia mydas) in the United Arab Emirates revealed that all had stomachs full of fresh seagrass (approximately 99% of the total ingesta) and presented with a duodenal volvulus involving a length of approximately 100 cm. Duodeni appeared empty and necrotic with diffuse purple-black mucosa. No apparent signs of obstruction by foreign objects, acute endoparasitism, or other disorders were observed. In all cases, duodenal volvulus was diagnosed, the cause of which may have been dietary in origin. The rise in water temperature, with an associated rise in the temperature of seagrass, thus enhancing the over-fermentation of ingesta with the subsequent liberation of excessive amounts of gas was the probable cause of volvulus formation. Ingestion of foreign bodies and physical movement also are discussed as causes of digestive disorders. It is recommended that handlers should avoid 360 degrees rotation when overturning turtles onto their carapaces.

Pancreatic exocrine studies in intact animals: historic and current methods

This report presents a review of the historic and current methods for performing pancreatic exocrine studies in intact animals. Special emphasis is given to the various surgical procedures--pancreatic fistulas, duodenal pouches, and duodenal fistulas--and practice of collecting pancreatic secretion in dogs. Procedures in other animal species--rat, cat, pig, rabbit, cattle, sheep, and horse--also are specified. The advantages and disadvantages, as well as the indications and limitations of the distinct methods, are discussed.

Evaluation of plasma chemistry and haematological studies on chickens infected with Eimeria tenella and E acervulina

Plasma chemistry and haematological studies were conducted on chickens with coccidiosis. Male White Leghorn chickens, of two weeks old, were inoculated with 5 x 10(4) Eimeria tenella sporulated oocysts or with 1 x 10(6) E acervulina sporulated oocysts. Blood samples were taken four, seven and 11 days after inoculation. A wet chemistry system was applied to measure the plasma activities of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma glutamyltransferase, creatine kinase, amylase and lactate dehydrogenase and the concentrations of creatine, total bilirubin, urate, total cholesterol, total protein, albumin, glucose and triglycerides. A dry chemistry system was applied to measure sodium, potassium, chloride and calcium. The number of red blood cells and packed cell volume were determined by a micro cell counter and blood pH was measured with a blood gas analyser. The erythrocyte count, packed cell volume, sodium and chloride levels in the chickens infected with E tenella were significantly (P < 0.05) lower than those of the uninfected controls. The significant decrease in blood pH of the chickens infected with E acervulina suggests malabsorption associated with duodenal lesions induced by the infection.

Gastroduodenal intussusception in a young dog

A 21-month-old German shepherd crossbreed presented with a nine-month history of intermittent vomiting, anorexia and melaena interspersed with periods of clinical normality. Investigations suggested recurrent pancreatitis and the vomiting resolved with supportive therapy but recurred two weeks later. Abdominal radiographs revealed evidence of an intermittent abdominal mass which, on ultrasonography, had the typical appearance of an intussusception. At laparotomy, a gastroduodenal intussusception was found obstructing the pancreatic and bile duct outflows with perforation of the duodenal wall. The dog was euthanased. Postmortem examination and histology showed no obvious cause for the intussusception but confirmed pancreatic involvement. This is believed to be the first case of gastroduodenal intussusception reported in an animal.

Multiple intussusceptions in a juvenile rhea (Rhea americana) with proventricular impaction

Multiple intussusceptions of the small intestine were identified in a 4-mo-old rhea (Rhea americana) that died acutely after chronically poor growth. The chick was one of a group of 12 chicks that exhibited musculoskeletal deformities, poor growth, and subsequent death. Gross necropsy findings of this chick revealed proventricular impaction by sticks and stones accompanied by multiple intussusceptions of the small intestine. This finding identifies a disease process that may afflict ratites when raised for production and that may complicate treatment of proventricular impaction.

Idiopathic, duodenogastric intussusception in an adult dog

An adult Basset Hound was examined because of acute vomiting, signs of depression, dehydration, and signs of abdominal pain. Radiography revealed a soft tissue dense mass in the stomach. At exploratory laparotomy, 75% of the stomach was black, and the pylorus, proximal portion of the duodenum, and pancreas were found inverted into the stomach. The dog was euthanatized.

Duodenal perforation and abdominal abscess in a cow

A mature Jersey cow developed duodenal perforation and localized abscessation. After failure of a right flank marsupialization procedure, a side-to-side duodenojejunal anastomosis was created. The duodenum distal to the anastomosis was ligated and the original duodenal fistula was closed with chromic gut sutures. The abscess cavity was sutured to the right lateral body wall for drainage, and the cow recovered slowly.

Alaria nasuae (Trematoda: Diplostomidae) from domestic dogs

Two stray dogs were found naturally infected with adult Alaria nasuae in Tamaulipas, Mexico. This is the first report of this species from a domestic dog, the first report of it from Mexico, and the first time the species has been recorded since its original description.

Fiberoptic gastroduodenoscopy in the horse

A method of fiberoptic gastroduodenoscopy and biopsy was developed for use in large horses. A 275 cm X 13.5 mm fiberendoscope was used to examine the stomach and proximal portion of the duodenum. Food was withheld for 24 to 48 hours before examination. In more than 50 horses, gastric and duodenal structures were easily visualized. A variety of lesions was detected, including parasitic lesions, gastric ulcers, gastric neoplasia, and pyloric stenosis. Mucosal biopsy specimens were obtained in selected cases.

Eimeria acervulina infection and the zinc-cadmium interrelationship in the chick

The purpose of this study was to evaluate the effects of Eimeria acervulina infection (duodenal coccidiosis) on cadmium (Cd) toxicity and zinc (Zn) status in the young chick. Additions of Cd (45 mg/kg) were made to diets that contained either 0 or 52 mg/kg supplemental Zn (from ZnCO3). Duodenal coccidiosis was produced by multiple crop inoculations of 4 X 10(5) sporulated E. acervulina oocysts. Growth and efficiency of feed utilization were reduced by dietary Cd addition while concurrent coccidial infection reduced these parameters further. Addition of Cd also increased Cd content of liver and kidney and depressed hemoglobin, hematocrit, and plasma Zn content. Coccidial infection exacerbated tissue Cd deposition and depressed hematological parameters further. Although dietary Zn addition ameliorated some of the adverse effects of Cd toxicity, Cd administration tended to enhance tissue Zn deposition. Administration of Cd enhanced synthesis of metallothionein.

Intramural intestinal hematoma causing obstruction in three dogs

Intramural hematoma of the intestine caused intestinal obstruction in three dogs. Two dogs were examined because of vomiting and anorexia of several weeks' duration. In one of these, an intramural hematoma of the duodenum was associated with chronic pancreatitis. A cause was not found in the second dog. The third dog, which had clinical and radiographic evidence of gastric dilatation, was found at surgery to have hemoperitoneum associated with a ruptured intramural intestinal hematoma. In 1 dog, the hematoma was evacuated through a serosal incision. In the other 2 dogs, the problem was resolved by resection of the involved segment of intestine, followed by anastomosis. All 3 dogs recovered without complications.

Traumatic duodenitis in a dairy cow

The history, clinical signs, and clinical pathology in a mature Holstein cow were consistent with a diagnosis of intussusception, but the lesion found during exploratory laparotomy consisted of a penetrating wire in the anterior duodenum.

Chronic bile duct cannulation of rhesus macaques (Macaca mulatta) without causing biliary fistulas

Two surgical procedures were used for establishing chronic bile duct cannulations in rhesus macaques (Macaca mulatta) while maintaining an intact enterohepatic circulation for use in metabolism studies. One procedure resulted in the formation of biliary fistulas in all of the animals, whereas the other procedure allowed successful maintenance of the macaques without fistulation for up to 8 months after surgery. The possible importance of pressure against bile outflow in the development of the fistulas was discussed.

The prevalence of Gasterophilus intestinalis and G nasalis in horses in Ireland

During the months October-May inclusive 90-8% of horses slaughtered at an abattoir near Dublin and 66-9% of those at an abattoir near Belfast were infected with Gasterophilus intestinalis; 28-6% of horses at the former abattoir harboured G nasalis while none of the horses examined at the latter abattoir was found to be infected with this species.

Intestinal obstruction in the horse. Physical signs and blood chemistry

Physical signs and blood changes were studied in horses with artificially produced obstructions of the duodenum and the small colon and simulated volvulus of the ileum. Horses with obstruction of the duodenum had the most violent physical signs and the shortest survival time. Blood changes were an initial rise in pH followed by acidosis, hyperkalemia and a decrease in HCO3 minus, Na+ and C1 minus. Obstruction of the small colon resulted in mild physical signs. The blood parameters recorded were normal. Simulated volvulus resulted in continuous colic. Blood changes were acidosis and hyperkalemia with a continuous decrease in HCO3 minus and C1 minus levels.

Mucosal cysts in the gastrointestinal tract of beagle dogs

Mucosal cysts were observed microscopically in the duodenum, jejunum and, to a lesser extent, stomach and large intestine in 102 out of 236 beagle dogs examined. These dogs were used in toxicity studies or had died spontaneously in a breeding colony. The cysts were lined by intestinal epithelium and filled mainly with cellular debris and mucus. Pathogenesis and aetiology of the lesion are unknown.