Uterine horn intussusception in immediate post-partum in a Pomeranian Spitz dog.

A 2-year-old Pomeranian-Spitz dog (5.8 kg) was admitted with symptoms of uterine prolapse and lethargy 1 day after whelping three puppies. The prolapsed uterus was corrected, but the next day, prolapse reoccurred. To fix the cervix to the abdominal wall, the dog underwent a surgery operation where intussusception in the left horn of the uterus was found. Ovariohysterectomy was performed as the treatment of choice. The diagnosis of intussusception is challenging, and exploratory laparotomy is the reliable diagnostic approach. Although uterine intussusception is rare, it should be one of the important considerations in dogs within the post-partum period.

Colonic gastrointestinal stromal tumor (GIST) presenting with colocolonic intussusception: A rare case report.

An 8-year-old spayed female British bulldog was presented with vomiting, hyporexia, and large-bowel diarrhea. Abdominal ultrasound revealed a focal colonic mass with an intussusception located immediately oral to the mass. The intussusception encompassed the ascending and transverse colon and was non-reducible. Colonic resection and anastomosis were completed to include the intussusception and colonic mass. Histopathological examination of the mass demonstrated a spindle cell neoplasm arising within the muscular wall of the intussuscepted segment that obliterated normal architecture. Mild-to-moderate cytoplasmic immunoreactivity of the tumor cell population for CD117 and smooth muscle actin was consistent with a diagnosis of a gastrointestinal stromal tumor. The dog described herein remains alive and free of progressive disease at the time of writing. Key clinical message: The entire gastrointestinal tract should be evaluated in any animal with gastrointestinal symptoms. A gastrointestinal stromal tumor remains a plausible differential diagnosis, regardless of the intestinal segment affected, and tumorassociated intussusception is a rare but urgent clinical finding.

Tumeur stromale gastro-intestinale du côlon (GIST) présentant une invagination colocolique : un rapport de cas rare. Une femelle bouledogue anglais stérilisée de 8 ans a présenté des vomissements, une hyporexie et une diarrhée d'origine du gros intestin. L'échographie abdominale a révélé une masse colique focale avec une invagination située immédiatement oralement à la masse. L'intussusception englobait le côlon ascendant et transverse et était non réductible. La résection colique et l'anastomose ont été réalisées pour inclure l'intussusception et la masse colique. L'examen histopathologique de la masse a révélé un néoplasme à cellules fusiformes apparaissant dans la paroi musculaire du segment invaginé qui a oblitéré l'architecture normale. L'immunoréactivité cytoplasmique légère à modérée de la population de cellules tumorales pour le CD117 et l'actine des muscles lisses étaient compatibles avec un diagnostic de tumeur stromale gastro-intestinale. Le chien décrit ici est toujours vivant et exempt de maladie évolutive au moment de la rédaction.Message clinique clé :L'ensemble du tractus gastro-intestinal doit être évalué chez tout animal présentant des symptômes gastrointestinaux. Une tumeur stromale gastro-intestinale reste un diagnostic différentiel plausible, quel que soit le segment intestinal atteint, et l'intussusception associée à la tumeur est une constatation clinique rare mais urgente.(Traduit par Dr Serge Messier).

Colonic Hamartomatous Ganglioneuromatosis in a 4 Mo Old Puppy.

A 4 mo old male goldendoodle puppy was evaluated for chronic hematochezia with a history of recurrent rectal prolapse and tenesmus. A colo-colonic intussusception was diagnosed via abdominal imaging. Surgery was elected to reduce the intussusception, wherein a colonic mass was discovered. Colonic resection and anastomosis was performed, and the tissue were submitted for histopathological examination. The puppy was diagnosed with colonic hamartomatous ganglioneuromatosis based on the presence of markedly hyperplastic submucosal and myenteric plexi with infiltration and expansion of the mucosa and submucosa by Schwann cells and neuronal cell bodies. Ganglioneuromatosis is a rarely reported entity in the veterinary literature, and limited clinical follow up data is available for described cases. In humans, ganglioneuromatosis is associated with a PTEN genetic mutation, which confers increased susceptibility to the development of neoplasia of endocrine organs. Approximately 1 yr after the operation, this puppy appeared clinically normal with no abnormalities on repeated imaging. This case report describes the clinical presentation, surgical treatment, and histologic features of colonic hamartomatous ganglioneuromatosis with 1 yr postoperative clinical follow up data in a dog. Although uncommon, ganglioneuromatosis should be considered as a differential diagnosis list as a cause of gastrointestinal masses in puppies and young dogs.

Noninvasive hydrostatic reduction of an ileocecocolic intussusception in a puppy.

A 5-week-old male intact Golden Retriever puppy was presented for a history of vomiting and diarrhea with hematochezia. Ultrasound findings confirmed the presence of an ileocecocolic intussusception. Surgical correction was declined because of financial concerns. Based on a pediatric procedure used in humans, an ultrasound-guided hydrostatic reduction (USGHR) was performed. This procedure consisted in injecting saline rectally under controlled pressure to mechanically reduce the intussusception. Reduction of the intussusception and evaluation of potential complications were concurrently evaluated by ultrasound during the procedure. No recurrence was observed the next day and the puppy was discharged. Follow-up indicated that the dog was still doing well 6 months later. This case report describes a new technique in veterinary medicine allowing successful nonsurgical reduction of an ileocecocolic intussusception in a dog. This procedure is innovative, simple, and substantially decreases the cost and minimizes morbidity potentially associated with surgical management.

A case of colonic-colonic intussusception in a dog secondary to lymphoma treated with colonic resection and anastomosis.

A 2-year-old castrated male Great Dane crossbreed dog was presented with a history of diarrhea and suspected intussusception. Abdominal ultrasound revealed a colonic-colonic intussusception. The gastrointestinal tract was explored, and an approximately 5-cm intussusception was discovered mid-colon. All other gastrointestinal structures were normal in appearance. The intussusception could not be reduced manually. A colonic resection and anastomosis were performed together with a left-sided incisional colopexy. The dog recovered from surgery and histopathology revealed the intussusception to be secondary to large cell transmural lymphoma. Sections from the surgical margins revealed proliferation of fibrovascular tissue along the serosal surface segmentally, but no neoplastic cells were identified. The dog was subsequently treated with chemotherapy consisting of doxorubicin and prednisone. No evidence of disease recurrence was noted on ultrasound 9 months after surgery. Approximately 2 years after surgery, the dog is noted to be clinically normal at home with no abnormal findings on physical examination. A complete blood (cell) count and chemistry obtained at this time revealed no significant abnormalities besides mild azotemia. Additional restaging was declined by the owner.

Un cas d'intussusception colon-colon chez un chien secondaire à un lymphome traité par résection c olonique et anastomose. Un grand danois croisé mâle castré âgé de 2 ans a été présenté avec des antécédents de diarrhée et une suspicion d'intussusception. L'échographie abdominale a révélé une intussusception colon-colon. Le tractus gastro-intestinal a été exploré et une intussusception d'environ 5 cm a été découverte au milieu du côlon. Toutes les autres structures gastro-intestinales avaient un aspect normal. L'intussusception n'a pas pu être réduite manuellement. Une résection colonique et une anastomose ont été réalisées avec une colopexie incisionnelle du côté gauche. Le chien a récupéré de la chirurgie et de l'histopathologie a révélé que l'intussusception était secondaire à un lymphome transmural à grandes cellules. Des sections des marges chirurgicales ont révélé une prolifération de tissu fibrovasculaire le long de la surface séreuse de manière segmentaire, mais aucune cellule néoplasique n'a été identifiée. Le chien a ensuite été traité par une chimiothérapie composée de doxorubicine et de prednisone. Aucun signe de récidive de la maladie n'a été noté à l'échographie 9 mois après la chirurgie. Environ 2 ans après la chirurgie, le chien est cliniquement normal à la maison sans résultats anormaux à l'examen physique. Une numération sanguine (cellule) complète et l'analyse chimique obtenues à ce moment n'ont révélé aucune anomalie significative outre une légère azotémie. Une nouvelle restadification a été refusée par le propriétaire.(Traduit par Dr Serge Messier).

Gastroesophageal intussusception in a 4-week-old German shepherd puppy.

The surgical treatment of a gastroesophageal intussusception (GEI) in a 4-week-old male intact German shepherd puppy is described in this report. Bilateral gastropexies were performed; an incisional gastropexy on the right and a gastrostomy tube gastropexy on the left. The dog recovered well and is thriving long-term with no clinical signs of persistent megaesophagus. With the combination of early detection and surgical correction of GEI, mortality rates may be lower than the 95% mortality rate that has been reported in previous literature and supports new studies that have reported a 65% survival rate long-term. Key clinical message: Young animals presenting with vague clinical signs require thorough evaluation to identify uncommon, yet life-threatening diseases such as GEI. Early detection and interventions can subsequently lead to successful outcomes.

Intussusception gastro-oesophagienne chez un chiot berger allemand de 4 semaines. Le traitement chirurgical d'une intussusception gastro-oesophagienne (GEI) chez un chiot berger allemand mâle intact âgé de 4 semaines est décrit dans ce rapport. Des gastropexies bilatérales ont été réalisées; une gastropexie incisionnelle à droite et une gastropexie par tube de gastrostomie à gauche.Le chien a bien récupéré et se porte bien à long terme sans aucun signe clinique de mégaoesophage persistant.Avec la combinaison de la détection précoce et de la correction chirurgicale de la GEI, les taux de mortalité peuvent être inférieurs au taux de mortalité de 95 % qui a été rapporté dans la littérature antérieure et soutient de nouvelles études qui ont rapporté un taux de survie à long terme de 65 %.Message clinique clé :Les jeunes animaux présentant des signes cliniques vagues nécessitent une évaluation approfondie pour identifier des maladies rares, mais potentiellement mortelles, telles que la GEI. Une détection et des interventions précoces peuvent ensuite conduire à des résultats positifs.(Traduit par Dr Serge Messier).

Ultrasonographic and radiographic features of a true gastrogastric intussusception with spontaneous resolution in a cat.

An 11-year-old, female spayed, domestic shorthair cat with a 1-week history of vomiting was diagnosed with a gastrogastric intussusception using ultrasound. Distinguishing ultrasonographic findings included invagination of the gastric fundus into the body and were correlated to radiographs acquired at the time of the evaluation. Spontaneous resolution of the gastrogastric intussusception was observed on a positive-contrast upper gastrointestinal fluoroscopic study done the following day. Due to worsening comorbidities, which most significantly included chronic renal disease and pancreatitis, and declining quality of life, the patient was humanely euthanized 10 months later. Necropsy revealed no gross and histopathologic abnormalities associated with the stomach. A definitive cause for the intussusception remains unknown.

Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog.

A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions. Key clinical message: This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.

Caractéristiques échographiques et tomodensitométriques d'une véritable intussusception gastrogastrique avec corps étrangers concomitants chez un chien. Un chien Cane Corso mâle intact de 2 ans a été présenté pour faiblesse aiguë, vomissements et diarrhée. L'échographie abdominale a révélé que l'estomac présentait un ædème sévère de la paroi et une apparence de cible. La tomodensitométrie était compatible avec une intussusception gastro-gastrique et des corps étrangers gastriques de type minéral concomitants. Après réduction de l'intussusception, une gastropexie incisionnelle bilatérale a été réalisée pour prévenir les récidives. L'intussusception gastro-gastrique vraie est une affection rare et doit être envisagée si l'estomac présente un ædème sévère de la paroi avec un signe de cible à l'échographie abdominale. La tomodensitométrie a été utile pour confirmer ce diagnostic rare et d'examiner tout l'abdomen à la recherche de lésions concomitantes.Message clinique clé :Ce cas met en évidence l'utilité d'un examen CT pour confirmer ce diagnostic rare, pour déterminer la position des compartiments gastriques et pour détecter d'éventuelles lésions concomitantes avant la chirurgie.(Traduit par Dr Serge Messier).

Gastroesophageal intussusception secondary to induction of emesis with subsequent development of septic pericardial effusion after corrective surgery.

A juvenile boxer dog was diagnosed with gastroesophageal intussusception that occurred after the induction of emesis with apomorphine. A ventral midline coeliotomy and diaphragmotomy were performed and the intussusception was manually reduced. Despite initial satisfactory recovery, the dog was diagnosed with cardiac tamponade 1 week post-operatively. Escherichia coli was cultured from pericardial and pleural effusion samples. During subtotal pericardiectomy surgery the pericardium was found to be markedly thickened with adhesions to the epicardium, thoracic wall and diaphragm. Substantial haemorrhage and refractory hypotension necessitated the administration of a blood transfusion during surgery. The dog entered cardiac arrest in the immediate post-operative period and cardiopulmonary resuscitation was unfortunately unsuccessful. Gastroesophageal intussusception should be considered a possible severe adverse effect of administering apomorhine to induce emesis in dogs. Additionally, septic pericardial and pleural effusions may occur post-reduction of gastroesophageal intussusception.

Postoperative improvement of megaesophagus and esophageal motility in a 19-day-old puppy with gastroesophageal intussusception.

Canine gastroesophageal intussusception (GEI) is a rare and life-threatening condition that requires prompt diagnosis and treatment. A 19-day-old Siberian Husky with a 4-day history of regurgitation was diagnosed with GEI based on the findings of computed tomography (CT) performed without anesthesia. Endoscopic reduction of intussusception was impossible; thus, surgical reduction by traction of the duodenum was performed. CT revealed improvement of megaesophagus 82 days postoperatively. Eleven months postoperatively, fluoroscopy showed recovery to nearly normal esophageal motility. Two years postoperatively, no clinical signs were reported. CT is useful to diagnose GEI in neonate puppies with poor abdominal fat and to assess the gastric edema and the anatomical association of stomach with other organs. Fluoroscopy is helpful for evaluating postoperative esophageal motility.

Nonsurgical reduction of prolapsed colocolic intussusception in 2 puppies.

OBJECTIVE: To describe the nonsurgical management of prolapsed colocolic intussusception in 2 puppies. CASE SUMMARY: Two 3-month-old male intact puppies (Pug and Labrador Retriever) developed intussusceptions that had prolapsed from the anus after they had suffered from tenesmus with soft feces or diarrhea. Reduction of the prolapsed tissue was performed and colocolic intussusception was diagnosed ultrasonographically in 1 dog. Rectal manipulation and saline enema were performed in both dogs, and reduction of the intussusception was confirmed endoscopically or ultrasonographically. Bupivacaine and prednisolone foam enemas were administered to reduce tenesmus. Abdominal ultrasonography the following day in 1 dog confirmed a normal appearing colon. No further tenesmus was noted in 1 dog; the other had a brief rectal prolapse after an episode of tenesmus that was manually reduced. Intussusception had not recurred 4 months and 1 year following manual reduction procedures. NEW OR UNIQUE INFORMATION PROVIDED: This is the first report of successful nonsurgical management of colocolic intussusception in a companion animal. Nonsurgical management is a first-line treatment of intussusception in children and could be considered in dogs with colocolic intussusception. Further investigation is required to define specific aspects, including rectal manipulation, saline enema, or anesthesia, that aid in resolution of this type of intussusception.

Intussusception caused by intestinal neoplasia in mature rainbow trout (Oncorhynchus mykiss, Walbaum 1792).

The aquaculture industry is growing and includes the farming and breeding of more than 580 aquatic species worldwide. The rainbow trout (Oncorhynchus mykiss, Walbaum 1792) is the most commonly bred trout species in Hungary. As broodfish form the basis of most fish farms, investigation into tumours occurring in trout, although under-researched, has proven to be a valuable and necessary field of study. During our investigation, we examined a broodstock of 3- to 6-year-old rainbow trouts (800) affected with idiopathic intestinal tumours (3%) which had consequentially led to ileus (40%). While performing necropsy, initial pathological observations showed intussusceptions. Tumours were discovered upon opening the body cavity, as well as metastasis forming in the livers and in the vessels of the gills. Histopathological and immunohistochemical tests allowed us to identify the neoplasms. The primary adenocarcinoma was found to have been developed within the intestines of the fish. The tumour tissue broke through the basal membrane and infiltrated the propria, protruding asymmetrically into the lumen of the mid-intestines, causing it to narrow significantly. This subsequently led to passage disorders, invagination of the intestinal segment and finally the emaciation of the fish. Histopathological and immunohistochemical inspection of the tumour cells displayed a high mitotic index, confirming malignancy.

Colocolic Intussusception Associated with Octangium sp. (Digenea: Microscaphidiidae) in a Green Sea Turtle Chelonia mydas.

Reports of intussusception in sea turtles are generally linked to marine debris ingestion; therefore, only a few cases of the disease are associated with parasitic infestations. The objective of this study was to describe the necropsy findings of the first reported case of colocolic intussusception in a green sea turtle Chelonia mydas, associated with the helminth Octangium sp. A juvenile female green sea turtle, which was registered and rescued by the team from the Cetaceans Project of Costa Branca, State University of Rio Grande do Norte, was examined. The animal died 1 d after being treated and was immediately submitted for necropsy. Our findings indicated that parasitic infestation by Octangium sp. in the green sea turtle caused intussusception and consequently led to the animal's death. Early diagnosis and surgical correction are fundamental for a good prognosis and, consequently, for successful rehabilitation of marine species.

Gastroesophageal intussusception and extreme esophageal dilatation secondary to bilateral laryngeal paralysis in a cat.

Gastroesophageal intussusception, extreme esophageal dilatation, and laryngeal paralysis are individually rare clinical entities in cats and the simultaneous occurrence in a single animal has not been described. We describe these 3 conditions occurring concurrently in a geriatric cat, and resolution of the cat's clinical signs after treatment with unilateral arytenoid lateralization. This finding supports the need for thorough history taking and examination in cats with extreme esophageal dilatation to determine if upper respiratory tract abnormalities are present, as appropriate treatment might resolve the esophageal dilatation.

Imaging and clinical features of a true gastrogastric intussusception in a dog.

An 18-month-old male mixed breed dog was evaluated for acute vomiting and hematemesis. Clinical signs and initial radiographic findings shared commonalities with reported cases of pylorogastric intussusception in dogs. However, unlike previously reported cases, additional imaging [including ultrasound and computed tomography (CT)] revealed invagination of the gastric fundus into the gastric body, consistent with true gastrogastric intussusception. These findings were confirmed with histopathology and on necropsy. Key clinical message: Although extremely rare, gastrogastric intussusception should be included as a differential diagnosis for any patient presenting with acute vomiting, abdominal pain, dehydration, or tachycardia in combination with the diagnostic imaging findings described in this report.

Caractéristiques cliniques et d'imagerie d'une intussusception gastro-gastrique vraie chez un chien. Un chien mâle de race croisée âgé de 18 mois fut évalué pour des vomissements aigus et de l'hématémèse. Les signes cliniques et les trouvailles radiographiques initiales partageaient des similarités avec des cas rapportés d'intussusception pyloro-gastrique chez des chiens. Toutefois, contrairement aux cas rapportés précédemment, des examens d'imagerie supplémentaires [incluant l'échographie et la tomodensitométrie (CT)] ont révélé une invagination du fundus gastrique dans le corps de l'estomac, compatible avec une intussusception gastro-gastrique vraie. Ces données furent confirmées lors de l'examen histopathologique et de la nécropsie.Message clinique clé :Bien qu'extrêmement rare, l'intussusception gastro-gastrique devrait être incluse dans le diagnostic différentiel pour tout patient présenté avec des vomissements aigus, de la douleur abdominale, de la déshydratation ou de la tachycardie en combinaison avec les trouvailles en imagerie diagnostique décrites dans le présent rapport.(Traduit par Dr Serge Messier).

Two-portal video-assisted colopexy in the treatment of intussusception and prolapse of the descending colon in a lamb.

A lamb presented with recurrent prolapse of the descending colon. On clinical examination, intussusception of the descending colon with the prolapse of a segment was verified. The external anal sphincter had a rupture, extending to the lacerated wound in the anus. The lamb underwent colopexy with the two-portal video-assisted incisional technique and was discharged 6 days after the surgical procedure with a satisfactory clinical outcome. There were no recurrences or complications for at least 9 months. Video-assisted colopexy is an alternative treatment for intussusception and recurrent colon prolapse in sheep, even in the presence of an external anal sphincter rupture.

Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions.

OBJECTIVE: To describe perioperative characteristics and outcomes of dogs surgically treated for intestinal intussusception. STUDY DESIGN: Multi-institutional, retrospective study. ANIMALS: One hundred fifty-three client-owned dogs with intestinal intussusception. METHODS: Dogs were included when they had undergone surgical treatment of a confirmed intestinal intussusception. Medical records were reviewed for demographics and clinical data, including surgical complications (graded 1-4). Follow-up was obtained via telephone interview with owners and referring veterinarians. RESULTS: Dogs had a median age of 10 months (range, 2-156), and the most common location for intussusception was ileocolic (66/153 [43%]). Most cases had no identifiable cause (104/155 [67%]). Intestinal resection and anastomosis (IRA) was performed in 129 of 153 (84%) dogs; enteroplication was performed in 28 of 153 (18%) dogs, including 13 with and 15 without IRA. Intraoperative complications occurred in 10 of 153 (7%) dogs, all involving intestinal damage during attempted manual reduction. The median duration of follow-up after discharge was 334 days (interquartile range, 15-990; range, 1-3302). Postoperative complications occurred in 53 of 153 (35%) dogs, including 22 of 153 (14%) with severe (grade 3 or 4) events. Diarrhea, regurgitation, and septic peritonitis were the most common postoperative complications; intussusception recurred in four of 153 (3%) dogs, all within 72 hours postoperatively. Fourteen-day postoperative mortality rate was 6%. CONCLUSION: Surgical treatment of intestinal intussusception was curative in most dogs, even when an underlying cause was not identified. Surgical complications were common, including a 14% risk of life-threatening short-term complications. CLINICAL SIGNIFICANCE: Surgical treatment of intestinal intussusception offers an excellent prognosis, but the potential life-threatening complications should be considered.

Characteristics and long-term outcomes of dogs with gastroesophageal intussusception.

OBJECTIVE: To determine long-term outcomes and factors associated with those outcomes in dogs with gastroesophageal intussusception (GEI). ANIMALS: 36 dogs with GEI evaluated at 16 veterinary hospitals from January 2000 through January 2018. PROCEDURES: Medical records of included dogs were reviewed to collect information regarding signalment, clinical signs, physical examination findings, blood work and diagnostic imaging results, surgical findings, and outcome. Factors were evaluated for associations with various outcomes. RESULTS: Median age of dogs with GEI was 13.2 months, and males (72% [26/36]) and German Shepherd Dogs (33% [12/36]) were most common. Vomiting (67% [24/36]) and regurgitation (33% [12/36]) were the most common clinical signs. Ten of 36 (28%) dogs were euthanized without treatment, and 26 (72%) underwent treatment (25 surgically and 1 endoscopically). Twenty-three of the 26 (88%) treated dogs survived to discharge; median survival time was 995 days. At last follow-up, 15 of the 23 (65%) surviving dogs remained alive and 8 (35%) had died for reasons related to persistent regurgitation (n = 6) or reasons unrelated to GEI (2). Of the 10 dogs for which owners were contacted, 7 had persistent regurgitation, the severity of which was reduced through managed feedings. Dogs with acute (≤ 7 days) clinical signs or a previous diagnosis of megaesophagus were more likely to have persistent regurgitation than were dogs without these factors. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment should be considered for dogs with GEI given the high rate of survival to discharge and median survival time. Although persistent regurgitation was common after treatment, a satisfactory outcome was possible with medical management, including managed feedings and medications.