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Bowel Necrosis

Patient Information

Age
13 Years
Gender
Male, Neutered
Species
Canine

Images

History

Spontaneous Bowel Necrosis In A Beagle

History (Bdzula VT): A 13- year old MN Beagle dog presented with vomiting, diarrhea, inappetance, and lethargy. The clinical exam revealed 5% dehydration and mildly tender mid cranial abdomen. CBC, Chemistry, and urinalysis were normal. Folate was mildly elevated. CPL was Negative. Empirical treatment with metronidazole, cerenia, and SQ fluids produced only minor positive clinical response.

Image Interpretation

(Lindquist DMV, DABVP)

Sonographic Differential Diagnosis

(Lindquist DMV, DABVP): Focal transmural small intestinal disease with emerging peritonitis, underlying inflammatory bowel disease, granulomatous enteritis, infectious enteritis, emerging lymphoma, mast cell disease or other neoplasia is suspected.

Sampling

Full-thickness surgical biopsy & resection of the affected bowel (Stockmal DVM). Images 4, 5, and 6 reveal reactive fat and hemorrhage (arrows) that corresponds to the reactive omentum in videos 2 & 3 noted in the sonogram. The smaller arrows in image 4 represent the transition from normal bowel thickness to that affected by the transmural pathology. Biopsy results revealed moderate, chronic, lymphoplasmacytic enteritis with severe granulomatous lymphangitis.

Outcome

(Stockmal DVM) The pet was started on prednisone and Imuran and bland diet. The pet had episodes of vomiting and bloody stool while on the prednisone. The patient was managed periodically with metronidazole, hypoallergenic diet and gastrointestinal protectants. One year later the owner reported that the pet is doing well. The pet is currently taking metronidazole 125mg SID, Dexamethazone 0.375mg EOD, tapering dose of imuran, colostrum 2 BID, and various neutrxceuticals.

Comments

Special thanks to Dr. Christine Stockmal & Staff at American Animal Hospital, Ledgewood, New Jersey, USA, for managing this case and referring for ultrasound consultation.

Videos