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J Vet Intern Med. 2016 Jan-Feb;30(1):132-40. doi: 10.1111/jvim.13652. Epub 2015 Nov 26.

Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo-Obstruction in 6 Dogs.

Author information

1
William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA.
2
Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, Davis, CA.
3
Veterinary Specialty Hospital, San Diego, CA.
4
PETS Referral Center, Berkeley, CA.
5
Westside Veterinary Center, New York, NY.
6
Atascadero Pet Hospital & Emergency Center, Atascadero, CA.
7
Department of Medicine & Epidemiology, School of Veterinary Medicine, Davis, CA.

Abstract

BACKGROUND:

Intestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo-obstruction in humans and animals.

OBJECTIVE:

To characterize the clinical presentation, histopathologic features, and outcome of dogs with intestinal leiomyositis in an effort to optimize treatment and prognosis.

ANIMALS:

Six client-owned dogs.

METHODS:

Retrospective case series. Medical records were reviewed to describe signalment, clinicopathologic and imaging findings, histopathologic diagnoses, treatment, and outcome. All biopsy specimens were reviewed by a board-certified pathologist.

RESULTS:

Median age of dogs was 5.4 years (range, 15 months-9 years). Consistent clinical signs included vomiting (6/6), regurgitation (2/6), and small bowel diarrhea (3/6). Median duration of clinical signs before presentation was 13 days (range, 5-150 days). Diagnostic imaging showed marked gastric distension with dilated small intestines in 4/6 dogs. Full-thickness intestinal biopsies were obtained in all dogs by laparotomy. Histopathology of the stomach and intestines disclosed mononuclear inflammation, myofiber degeneration and necrosis, and fibrosis centered within the region of myofiber loss in the intestinal muscularis propria. All dogs received various combinations of immunomodulatory and prokinetic treatment, antimicrobial agents, antiemetics, and IV fluids, but none of the dogs showed a clinically relevant improvement with treatment. Median survival was 19 days after diagnosis (range, 3-270 days).

CONCLUSIONS AND CLINICAL IMPORTANCE:

Intestinal leiomyositis is a cause of intestinal pseudo-obstruction and must be diagnosed by full-thickness intestinal biopsy. This disease should be considered in dogs with acute and chronic vomiting, regurgitation, and small bowel diarrhea.

KEYWORDS:

Ileus; Intestine; Muscularis; Obstruction; Stomach

PMID:
26608226
PMCID:
PMC4913632
DOI:
10.1111/jvim.13652
[Indexed for MEDLINE]
Free PMC Article

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