Jejunal perforation and septic abdomen resulting from a choristoma in a dog.

A 4.6-year-old spayed female German shepherd dog was admitted to a specialty hospital emergency service upon referral for suspected gastrointestinal foreign body obstruction. Free abdominal fluid was collected, and results of cytologic evaluation were consistent with a septic abdomen. An abdominal barium study revealed free gas and intraperitoneal barium, along with an obstructive gas pattern within the small bowel. Ultrasonography revealed a full-thickness jejunal perforation. On exploratory laparotomy, the perforation was noted to be located mid-jejunum with no associated mass or foreign material. A resection and anastomosis were completed. Histopathologic evaluation of the affected jejunal tissue showed aberrant gastric glandular epithelium consistent with a gastric choristoma, or heterotopic gastric tissue. Key clinical message: Clinicians should consider gastric glandular choristoma as a differential diagnosis in cases of seemingly idiopathic small intestinal perforation with no known cause (i.e., foreign body penetration, neoplasia, NSAID use), and histopathologic evaluation should always be done to obtain a definitive diagnosis.

Perforation jéjunale et abdomen septique résultant d'un choristome chez un chien. Une chienne berger allemand stérilisée âgée de 4,6 ans a été admise dans le service d'urgence d'un hôpital spécialisé après avoir été référée pour une suspicion d'obstruction gastro-intestinale par un corps étranger. Du liquide abdominal libre a été prélevé et les résultats de l'évaluation cytologique étaient compatibles avec un abdomen septique. Un examen abdominal à l'aide de baryum a révélé du gaz libre et du baryum intrapéritonéal, ainsi qu'un patron de gaz obstructif dans l'intestin grêle. L'échographie a révélé une perforation sur toute l'épaisseur jéjunale. Lors d'une laparotomie exploratoire, il a été constaté que la perforation était située au milieu du jéjunum, sans masse ni corps étranger associé. Une résection et une anastomose ont été réalisées. L'évaluation histopathologique du tissu jéjunal affecté a montré un épithélium glandulaire gastrique aberrant compatible avec un choristome gastrique ou un tissu gastrique hétérotopique.Message clinique clé :Les cliniciens doivent considérer le choristome glandulaire gastrique comme diagnostic différentiel dans les cas de perforation de l'intestin grêle apparemment idiopathique sans cause connue (i.e. pénétration d'un corps étranger, néoplasie, utilisation d'AINS), et une évaluation histopathologique doit toujours être effectuée pour obtenir un diagnostic définitif.(Traduit par Dr Serge Messier).

ACUTE ABDOMINAL COMPARTMENT SYNDROME DURING COLONOSCOPY IN A WESTERN LOWLAND GORILLA (GORILLA GORILLA GORILLA).

A novel case report of acute abdominal compartment syndrome (ACS) with respiratory and hemodynamic collapse during colonoscopy in a western lowland gorilla (Gorilla gorilla gorilla), notably, without colonic perforation is presented here. ACS is a rapidly progressive and sustained increase in intra-abdominal pressure leading to shock with multisystem organ failure. Surgical intervention was mandatory, and abdominal decompression was immediately life-saving, although the patient died 1 wk later of surgical complications. Colonoscopy is a widely performed procedure that is generally considered safe, and serious complications during colonoscopy are rare. ACS has been previously reported during colonoscopy with perforation in four cases (human)1,4,6,8. In this instance there was no evidence of perforation, representing not only a rare complication of the procedure, but also a novel cause of ACS. This is the first report of ACS in a nonhuman primate and of nonperforation-associated ACS in human or nonhuman primates.

Duodenal perforation in a puppy with canine parvovirus infection.

A 2-month-old puppy was brought to a veterinary hospital with diarrhea, vomiting, and anorexia. The test for canine parvovirus was positive, and she was hospitalized for supportive care. Her gastrointestinal symptoms initially improved; however, vomiting and lethargy developed again in the second week of hospitalization. Abdominal ultrasonography results were suspicious of a duodenal perforation. Cytology of the abdominal effusion confirmed septic peritonitis; therefore, emergency exploratory laparotomy was performed. The surgery was successful, and the puppy recovered fully. When symptoms recur or deteriorate in patients with parvoviral infection, surgically curable complications may be disregarded if supportive therapy is continued without additional investigative examinations. This report highlights the usefulness of abdominal ultrasound in conjunction with fluid cytology to identify subsequent complications when the clinical signs of parvovirus deteriorate. Key clinical message: This case report demonstrates duodenal perforation as a complication of parvoviral infection. Abdominal ultrasonography and peritoneal fluid cytology can be crucial for the early recognition of intestinal complications requiring immediate successful perioperative treatment.

Perforation duodénale chez un chiot infecté par le parvovirus canin. Un chiot de 2 mois a été amené dans un hôpital vétérinaire avec de la diarrhée, des vomissements et de l'anorexie. Le test de dépistage du parvovirus canin était positif et l'animal a été hospitalisé pour des soins de soutien. Ses symptômes gastro-intestinaux se sont initialement améliorés; cependant, des vomissements et une léthargie se sont à nouveau développés au cours de la deuxième semaine d'hospitalisation. Les résultats de l'échographie abdominale étaient suspects d'une perforation duodénale. La cytologie de l'épanchement abdominal a confirmé une péritonite septique; par conséquent, une laparotomie exploratrice d'urgence a été réalisée. L'opération a été un succès et le chiot s'est complètement rétabli. Lorsque les symptômes réapparaissent ou s'aggravent chez les patients atteints d'une infection parvovirale, les complications soignables chirurgicalement peuvent être ignorées si le traitement de soutien est poursuivi sans examens d'investigation supplémentaires. Ce rapport souligne l'utilité de l'échographie abdominale en conjonction avec la cytologie du liquide péritonéal pour identifier les complications ultérieures lorsque les signes cliniques associés au parvovirus se détériorent.Message clinique clé :Ce rapport de cas démontre une perforation duodénale comme complication d'une infection parvovirale. L'échographie abdominale et la cytologie du liquide péritonéal peuvent être cruciales pour la détection précoce des complications intestinales nécessitant un traitement per-opératoire immédiat réussi.(Traduit par Dr Serge Messier).

Colonic perforation in 4 dogs following treatment with meloxicam.

OBJECTIVE: To describe the clinical findings and treatment of 4 dogs that developed colonic perforation shortly after meloxicam administration. SERIES SUMMARY: Three cases were treated with meloxicam for variable nonspecific signs including lethargy and pyrexia. Hemorrhagic diarrhea developed following meloxicam administration in 2 cases. Gastrointestinal perforation was suspected on diagnostic imaging leading to exploratory celiotomy in all 3 cases. Partial colectomy was performed in 2 cases and suture repair with serosal patching in 1 followed by broad spectrum antimicrobials. All 3 dogs recovered from surgery well. One dog that had undergone perineal herniorrhaphy and received meloxicam perioperatively collapsed and died 7 days postsurgery. Postmortem examination revealed ulceration and perforation of the ascending colon with resultant generalized septic peritonitis. Histopathologic findings in all cases showed full thickness infiltration of the colonic wall with inflammatory cells along with ulceration and perforation. Thrombosis of vessels underlying the ulcerated areas was also noted. NEW OR UNIQUE INFORMATION PROVIDED: This report suggests that colonic perforation may be a complication of nonsteroidal anti-inflammatory drug use in some cases. To the authors' knowledge, this has not previously been described in dogs. Colonic perforation associated with NSAIDs administration may be more commonly identified in dogs with concurrent morbidities. Caution may be warranted when using NSAIDs in dogs with colonic pathology or possible risk factors to develop such pathology. Prompt diagnosis and treatment is essential for a positive outcome.

A Novel Presentation of Tuberculosis with Intestinal Perforation in a Free-Ranging Australian Sea Lion (Neophoca cinerea).

We detail a novel presentation of tuberculosis associated with intestinal perforation in an endangered Australian sea lion (Neophoca cinerea) from South Australian waters and confirm the presence of this disease in the region of highest pup production. In February 2017, a 3-yr-old juvenile male died shortly after hauling out at the Kingscote beach on Kangaroo Island. On postmortem examination, we found a mid-jejunal intestinal perforation and partial obstruction (from a strangulating fibrous and granulomatous mesenteric mass), a marked multicentric abdominal fibrosing granulomatous lymphadenitis, and a large volume serosanguinous peritoneal effusion. Acid-fast bacteria were detected postmortem in cytologic preparations of the mesenteric lymph node and in histologic sections of jejunum and the encircling mass. Mycobacterial infection was confirmed by positive culture after 3 wk. Molecular typing using mycobacterial interspersed repetitive-unit-variable-number tandem-repeat typing with 12-locus analysis identified Mycobacterium pinnipedii. This case highlights the need for vigilance of zoonotic disease risk when handling pinnipeds, including in the absence of specific respiratory signs or grossly apparent pulmonary pathology. Increased serologic population surveillance is recommended to assess the species' risk from this and other endemic diseases, especially given its endangered status.

Case report: Intestinal perforation and secondary peritonitis due to Acanthocephala infection in a black-bellied pangolin (Phataginus tetradactyla).

A case of Acanthocephala infection in a 5-year-old female rehabilitated and released black-bellied pangolin (Phataginus tetradactyla), which was part of a post-release monitoring program of a pangolin research operation in the Central African Republic, is described. This represents the first report of Acanthocephala infection in this species, which lead to intestinal perforation, secondary peritonitis and ultimately to the death of the animal concerned. It is of relevance to alert the pangolin conservation and research community to a so far unreported cause of death. A case history and necropsy findings, as well as preliminary parasite identification and genetic characterization which potentially revealed a new gigantorhynchid taxon are presented.

Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats.

BACKGROUND: Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described. HYPOTHESIS/OBJECTIVES: To characterize endoscopic ICC perforations in dogs and cats. ANIMALS: Thirteen dogs and 2 cats. METHODS: This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed. RESULTS: Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4-26 kg (median, 10.3 kg) and cats 4.6-5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1-5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months. CONCLUSIONS AND CLINICAL IMPORTANCE: Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy.

Anaplastic Large T-Cell Lymphoma in the Intestine of Dogs.

Anaplastic large T-cell lymphoma (ALTCL) is a rare subtype of non-Hodgkin T-cell lymphoma that occasionally occurs in the gastrointestinal tract of humans. Enteropathy-associated T-cell lymphoma (EATL) type 1 is the most common type of intestinal lymphoma in dogs, and ALTCL has not previously been reported in the intestinal tract of dogs. Thirteen dogs with intestinal masses diagnosed as intestinal lymphoma with anaplastic morphology were reviewed. Clinical data, including treatment protocols, were available for 11 cases. Immunohistochemistry for CD3, CD20, and CD30 was performed for all cases in addition to PCR for Antigen Receptor Rearrangements (PARR) for assessment of clonality. Eight (62%) of the cases presented with intestinal perforation, and all cases had 1 or more masses arising from the small intestine. Histologically, all cases were characterized by transmural infiltrates of large, CD3-positive and frequently CD30-positive cells. Neoplastic T cells had marked anisocytosis and anisokaryosis, prominent nucleoli, and occasionally indented to reniform nuclei. There was abundant necrosis and inflammation with occasional vascular invasion within neoplastic masses. All cases had a monoclonal T-cell receptor γ gene rearrangement. The median survival time was 5 days, with 1 dog surviving 2 years after the initial diagnosis. ALTCL can occur as an aggressive transmural lymphoma in the gastrointestinal tract of dogs and commonly causes intestinal perforation. ALTCL can be differentiated from EATL type 1 and might have implications for accurate prognostication and selection of therapeutic options in the future.

Clinical features, diagnostic methods, treatments, and outcomes associated with ingested wires in the abdomen of horses: 16 cases (2002-2013).

OBJECTIVE To describe clinical features, diagnostic methods, treatments, and outcomes associated with ingested wire foreign bodies in the abdomen of horses. DESIGN Retrospective case series. ANIMALS 16 client-owned horses with ingested wire in their abdomens that were evaluated at a veterinary teaching hospital between April 2002 and February 2013. PROCEDURES Data for each case were collected from medical records and owners and then reviewed. Differences in clinicopathologic variables between horses that did (survivors) or did not (nonsurvivors) survive to discharge from the hospital were assessed. RESULTS The median duration of clinical signs prior to admission was 5.5 days (range, 0.5 to 1,095 days). Survivors (n = 4) had significantly lower median WBC count, neutrophil count, and plasma total protein concentration, compared with nonsurvivors (12), and all survivors underwent surgical treatment. Peritoneal fluid analysis revealed suppurative or septic peritonitis in all 8 horses tested. The presence of wire was confirmed by abdominal radiography (n = 6), exploratory laparotomy (2), and necropsy (8). The median length of ingested wire was 6 cm; wire had perforated viscera in 13 horses, 10 of which subsequently developed abdominal abscesses. CONCLUSION AND CLINICAL RELEVANCE Abdominal perforation by wire should be considered a differential diagnosis for horses with peritonitis and abdominal abscesses. Radiography is useful for detection of wire foreign bodies in the abdomens of horses. Given the guarded prognosis for affected horses suggested by results of the present study, early and aggressive treatment, including exploratory laparotomy to retrieve the wire and address perforations, peritonitis, and abscesses, should be considered.

Ileocolic Perforation Secondary to Disk Battery Ingestion in a Dog.

A 7 yr old spayed female shih tzu was evaluated for anorexia of 4 days duration. Conservative treatment for gastroenteritis had been administered by another veterinarian 2 days before presentation. Abdominal radiography revealed two round, disk-shaped, metallic-opacity foreign objects within the bowel with loss of serosal detail. Exploratory laparotomy was performed and revealed circumferential full-thickness necrosis and perforation of the intestines at the ileocolic junction with a small amount of peritoneal effusion. Two disk batteries were palpated in the colon and milked out of the rectum. An ileocolic anastomosis was performed without complication. However, the dog died following cardiopulmonary arrest shortly after extubation. Disk batteries are capable of causing severe tissue necrosis due to the generation of electric current when prolonged contact with mucosal surfaces occurs. Immediate removal is recommended to prevent gastrointestinal perforation and potential fatalities.

Post-chemotherapy perforation in cats with discrete intermediate- or large-cell gastrointestinal lymphoma.

Objectives Gastrointestinal (GI) perforation is a well described complication of GI lymphoma in people, commonly occurring within days of initiation of chemotherapy. There are no studies documenting the prevalence of GI perforation in cats with intermediate- or large-cell GI lymphoma or whether it is associated with induction of chemotherapy. The objectives of this study were to document the prevalence and timing of post-chemotherapy perforation in cats with discrete GI masses caused by intermediate- or large-cell lymphoma. Methods Cats with a diagnosis of intermediate- or large-cell lymphoma based on cytologic or histopathologic examination of a mass lesion of the GI tract and treated with chemotherapy were identified by searching the patient record database of three large specialty referral hospitals. Cats undergoing surgical resection of a GI mass prior to chemotherapy were excluded from the study. A clinical diagnosis of GI perforation was made using ultrasound findings and analysis of abdominal fluid. Results Twenty-three cats with intermediate- (n = 3) or large-cell (n = 20) lymphoma were included in the study. GI perforation was confirmed in 4/23 cats (17%), and occurred at 23, 56, 59 and 87 days after induction. There was no association between tumor size, the presence of hypoproteinemia or suppurative inflammation within the mass at the time of diagnosis and subsequent perforation. Post-hoc analysis revealed that the magnitude of weight loss within 15-28 days of diagnosis was greater in cats with perforation. Conclusions and relevance In this pilot study, we found that post-chemotherapy GI perforation in cats with intermediate- or large-cell GI lymphoma occurs. Acute perforation after induction of chemotherapy was not documented. Larger prospective studies are needed to determine risk factors associated with perforation and whether surgical excision would reduce the risk of subsequent GI perforation in these patients.

IMAGING DIAGNOSIS - RADIOGRAPHY, ULTRASONOGRAPHY, AND COMPUTED TOMOGRAPHY OF A GIANT FECALOMA CAUSING STERCORAL PERFORATION OF THE COLON IN A DOG WITH A PROSTATIC ABSCESS.

A mixed-breed dog presented with tenesmus, hematochezia, and abdominal distension of 2 weeks duration. Radiography showed a large round mass with a "soap-bubble" appearance and shell-like mineralization in the caudal abdomen. Computed tomography revealed a lamellate mineralized mass 8 cm in diameter and containing air in the descending colon and prostatic abscess. Heterogeneously contrast-enhanced, irregularly thickened colonic wall with intramural and peritoneal free gas indicated stercoral colonic perforation. Surgical intervention revealed a tumor-like giant fecaloma in the descending colon adjoining the prostate with extensive wall rupture and fecal peritonitis. Hypothetically, prostatic inflammation may affect colonic motility with resultant fecaloma formation.

SUCCESSFUL MANAGEMENT OF CECAL PERFORATION AND FOCAL PERITONITIS IN A GORILLA (GORILLA GORILLA GORILLA).

An 18-yr-old female Western lowland gorilla ( Gorilla gorilla gorilla) presented with acute-onset severe lethargy, bloody vaginal discharge, decreased appetite, and an abnormal posture. The gorilla was diagnosed with a ruptured cecal blind sac with severe adhesions to the right ovary. A typhlectomy and unilateral ovariectomy were performed. Histologic examination identified a severe transmural circumferential typhlitis with rupture and adhesions to the infundibulum and chronic typhlitis. Postoperative management included antibiotics, analgesics, short-term dietary modifications, and probiotics for suspect oral candidiasis. The gorilla made a full clinical recovery and was pregnant within 1 yr of surgery. To the authors' knowledge, this is the first case of successful management of typhlitis in a gorilla. Typhlitis and intestinal rupture should be considered as a differential diagnosis for acute onset severe abdominal pain in gorillas.

Vascularized pedicle jejunal graft for closure of large duodenal defect in a dog.

A Labrador retriever dog was presented for intestinal obstruction resulting in devitalization of portions of the duodenum. A severe perforation, accounting for 70% duodenal circumference, was present at the level of the duodenal papilla. A vascularized jejunal graft was used to close the perforation, representing novel utilization of this grafting technique.

Greffe jéjunale d'un pédicule vascularisé pour la fermeture d'un grand défaut duodénal chez un canidé. Un Labrador retriever a été présenté pour un blocage intestinal qui produisait la dévitalisation de portions du duodénum. Une perforation grave, représentant 70 % de la circonférence duodénale, était présente au niveau de la papille duodénale. Une greffe jéjunale vascularisée a été utilisée pour fermer la perforation, ce qui représente une nouvelle utilisation de cette technique de greffe.(Traduit par Isabelle Vallières).

Successful management of jejunojejunal anastomosis dehiscence by extra-abdominal exteriorization and bandaging in a cat with septic peritonitis.

Duodenal and jejunal resections were performed in a cat with septic peritonitis due to small intestinal perforations by a linear foreign body. Three days later jejunal resection and anastomosis were repeated due to dehiscence of the anastomosis site. This segment of intestine was exteriorized through the body wall and managed with bandages for 5 days before it was surgically replaced into the abdomen. The cat made a full recovery.

Gestion réussie d'une déhiscence d'une anastomose jéjunojéjunale par l'extériorisation extraabdominale et des pansements chez un chat atteint de péritonite septique. Des résections duodénale et jéjunale ont été réalisées chez un chat atteint de péritonite septique en raison de petites perforations intestinales par un corps étranger linéaire. Trois jours plus tard, la résection jéjunale et l'anastomose ont été répétées en raison d'une déhiscence du site de l'anastomose. Ce segment de l'intestin était extériorisé au travers de la paroi du corps et il a été géré à l'aide de pansements pendant 5 jours jusqu'à ce qu'il soit replacé dans l'abdomen par une chirurgie. Le chat s'est complètement rétabli.(Traduit par Isabelle Vallières).

FOCUSED ASSESSMENT WITH SONOGRAPHY AS AN AID FOR THE DIAGNOSIS OF GASTROINTESTINAL PERFORATION IN A BOBCAT ( FELIS RUFUS ).

A 10-yr-old female spayed bobcat (Felis rufus) presented with a 3-day history of lethargy, anorexia, and two episodes of vomiting. An emergency field visit was scheduled to perform abdominal radiography and ultrasonography. The bobcat was assessed to be approximately 5-10% dehydrated, on the basis of decreased skin turgor and tacky mucous membranes. Free peritoneal gas, reduced abdominal serosal detail, and an abnormal-appearing right-sided intestinal segment were identified in the abdominal radiographs. However, the emergency field clinicians were not knowledgeable of these abnormalities, because the radiographs could not be processed in the field. During an initial complete abdominal ultrasound evaluation, a nondependent hyperechoic interface with reverberation artifact suggestive of intestinal or free gas and focal intestinal changes indicative of marked enteritis or peritonitis were identified. Free peritoneal fluid was not present on initial examination. In a focused abdominal sonography for trauma (FAST) scan, made after subcutaneous fluid administration, a small volume of anechoic free fluid was present in the peritoneal space. With ultrasound guidance, the fluid was aspirated and appeared grossly turbid. This fluid was subsequently confirmed as septic suppurative effusion, secondary to a foreign body-associated intestinal perforation. The use of a FAST scan is well described in human medicine, and to a limited degree in veterinary literature. This case represents a novel application of FAST scanning in an emergency field setting in a nontraumatized patient. This case report illustrates the utility of the FAST scan in yielding critical clinical information after fluid resuscitation in a zoological setting.

Spontaneous gastrointestinal perforation in cats: a retrospective study of 13 cases.

OBJECTIVES: The aim of this study was to describe the clinical characteristics and the frequency of malignant vs non-malignant causes for spontaneous gastrointestinal perforation in cats. METHODS: The medical records of cats diagnosed as having gastrointestinal perforation between August 2010 and July 2013 were reviewed. Diagnosis was confirmed by exploratory surgery. Patients with incomplete records, perforation due to external trauma, leakage at previous enterotomy or anastomotic sites, or foreign bodies were excluded. Each record was examined for different information pertaining to signalment, medical history, clinical and clinicopathological data, imaging findings, abdominal fluid examination, surgical findings, histopathological examination, treatment received after surgery and outcome. RESULTS: Thirteen cats were included. Five of these cats had concurrent illnesses, including viral upper respiratory tract disease, pancreatitis and chronic kidney disease. Two cats had previously received non-steroidal anti-inflammatory drugs and four had received corticosteroids. Clinical signs and clinicopathological abnormalities were not specific. Six of 13 patients were diagnosed during surgery with gastric perforations, four patients with duodenal perforations and three patients with jejunal perforations. Histopathological examination of the ulcerated wall was performed in 11/13 cats. Alimentary lymphoma was diagnosed in six cats. Non-neoplastic lesions (lymphocytic- plasmacytic inflammatory bowel disease, necrotic suppurative enteritis) were observed in the other five cats. The major limitation of the study was the small sample size. CONCLUSIONS AND RELEVANCE: Lymphoma may be a frequent cause of spontaneous perforation in cats. Therefore, histological examination of ulceration is essential in all cases. The direct and sole implication of anti-inflammatory administration in a gastrointestinal perforation is not clearly established in this study.

[Ulcerative colitis and proctitis in two Swiss Braunvieh cows]. / Ulzerierende Colitis und Proktitis bei zwei Braunviehkühen.

Two Swiss Braunvieh cows were referred to our clinic because of narrowing of the rectum and difficult rectal examination attributable to restricted arm movement within the pelvic cavity. Cow 1 also had perforation of the cranial rectum and cow 2 had multiple small funnel-shaped depressions in the rectal mucosa. Both cows had ultrasonographic evidence of peritonitis with thickening of the intestinal wall and fibrin and fluid accumulation in the abdominal cavity. A diagnosis of peritonitis was made in both cows, most likely caused by rectal perforation; they were euthanized and a post-mortem examination was carried out. Both cows had proctitis and ulcerative colitis with three or four perforated ulcers which were associated with fibrinopurulent peritonitis. The final diagnosis was ulcerative colitis and proctitis of unknown aetiology. Infectious causes of colitis and proctitis, including bovine viral diarrhoea, adenovirus infection and salmonellosis, and trauma and poisoning were ruled out.