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Compendium February 2006 (Vol 28, No 2)

Abstract Thoughts—Colon Volvulus in Dogs

by Joseph Harari, MS, DVM, DACVS

    Bentley AM, O'Toole TE, Kowaleski MP, et al: Volvulus of the colon in four dogs. JAVMA 227(2):253-256, 2005.

    Abstract: In this review of four dogs examined at a large private referral hospital and a university teaching hospital, the clinical features of canine colonic volvulus were described. The dogs were middle aged and large breeds (German shepherd, bullmastiff, Labrador retriever, Great Dane). Two dogs had a history of gastrointestinal tract disease. Physical examination findings were unremarkable except that abdominal palpation revealed discomfort and dilated intestinal segments. Clinical laboratory data revealed few abnormalities. Radiography was useful in revealing abnormally dilated portions of the intestinal tract in all dogs.

    Exploratory celiotomy was necessary to confirm the diagnosis and to permit definitive treatment. It was performed in three dogs within 4 hours after admission. Findings during surgery included gaseous distention of bowel loops, colonic discoloration, and rotation around the mesenteric root. Surgical treatments included colonic resection, colonic derotation, and gastrocolopexy. Three dogs recovered with minimal complications, whereas one dog was readmitted 1 month later for treatment of gastric dilatation-volvulus.

    Although the four dogs in this study recovered, the authors acknowledge the difficulty in quickly confirming the diagnosis of an obstructive condition requiring surgical intervention versus adynamic ileus, a medically managed condition. The decision to pursue exploratory surgery was correctly based on persistent, progressive, and severe distention of the intestines with gas.

    Commentary: Volvulus refers to rotation of an intestinal segment around its mesenteric axis, whereas torsion refers to twisting along the long axis of the bowel. Although uncommonly described in small animals, colonic volvulus is a life-threatening condition requiring prompt fluid resuscitation and surgical decompression. In these four cases, clinical history, signs, and physical and radiographic examination findings helped localize the lesion to the gastrointestinal tract, but prompt surgical exploration and treatment were necessary to confirm and manage the condition, respectively. Although abdominocentesis is not described in these cases, the authors note the value of it (in determining elevated cell counts as well as protein and bacteria levels) in identifying cases requiring surgical intervention. Furthermore, ultrasonographic examination of the abdomen would be useful to help confirm anatomic derangements of the intestines, mesentery, and adjacent viscera.

    Clinical Features Of Epistaxis In Dogs: A Retrospective Study

    Strasser JL, Hawkins EC: Clinical features of epistaxis in dogs: A retrospective study of 35 cases (1999-2002). JAAHA 41:179-184, 2005.

    Medical records were analyzed to evaluate dogs with epistaxis with regard to frequency of causes, presenting signs, and abnormalities in basic laboratory tests that aided the differential diagnosis. The following were reviewed: signalment, history, physical examination and diagnostic findings, duration of epistaxis and whether it was unilateral or bilateral, and facial or palate abnormalities. Specific criteria were used to confirm and classify systemic and intranasal diseases.

    Systemic diseases were diagnosed in seven dogs and intranasal diseases in 29 dogs, with 19 of these 29 having neoplasia. No significant differences were found between systemic and intranasal groups in sex, breed, body weight, or whether epistaxis was unilateral, bilateral, or progressing to bilateral. Chronic epistaxis (i.e., >1 month) occurred more with intranasal than systemic diseases. Only one laboratory value, packed cell volume (PCV), was associated with a specific disease group.

    Key Findings:

    • Acute epistaxis and lower PCV were associated with systemic rather than intranasal diseases.
    • Unilateral epistaxis did not distinguish systemic from intranasal groups.
    • Dogs with neoplasia were older than dogs with nonneoplastic intranasal diseases.
    • Intranasal neoplasia was associated with facial or palate deformities; intranasal disease was associated with decreased nasal airflow.
    • Screening for pathogens Ehrlichia canis and Bartonella vinsonii should be considered until additional data are available.

    Development Of Hypothyroidism After 131I Treatment Of Hyperthyroid Cats

    Nykamp SG, Dykes NL, Zarfoss MK, Scarlett JM: Association of the risk of development of hypothyroidism after iodine 131 treatment with the pretreatment pattern of sodium pertechnetate Tc 99m uptake in the thyroid gland in cats with hyperthyroidism: 165 cases (1990-2002). JAVMA 226:1671-1675, 2005.

    To correlate development of hypothyroidism, a complication of iodine 131 (131I) treatment, with the pretreatment pertechnetate uptake pattern of the thyroid in hyperthyroid cats, medical records and veterinarian questionnaires were evaluated in a retrospective study. Data reviewed included signalment; serum total thyroxine (T4) concentrations; pretreatment scintigraphic findings classified as unilateral (50 cats), bilateral"asymmetric (100), bilateral"symmetric (nine), or multifocal (six); and 131I treatment (significantly higher doses for the multifocal group). Questionnaires obtained information on the development of hypothyroidism (i.e., serum total T4 level less than the lower reference value >3 months after treatment), clinical signs of hypothyroidism or other diseases causing low T4 values, medications, treatment, and re­sponse to treatment.

    Hypothyroidism developed in 50 cats: 36 with bilateral"asymmetric, three with bilateral"symmetric, 10 with unilateral, and one with multifocal patterns. The probability of developing hypothyroidism was significantly higher for the bilateral than the unilateral pattern: Cats with either bilateral pattern were about twice as likely to develop hypothyroidism.

    Key Findings:

    • Despite limitations of the retrospective study design, the hypothesis—cats with bilateral"symmetric scintigraphic pattern lesions would have the greatest risk of developing hypothyroidism—was confirmed.
    • Scintigraphy can help predict the risk for hypothyroidism after 131I treatment, which may have implications in managing posttreatment renal malfunction.
    NEXT: Causes of Canine and Feline Pancytopenia

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