Mesenteric torsion in dogs - Jivaonline.net

CLINICAL REPORTMESENTERIC TORSION IN A DOGJoseph Cyrus, Basavanagowda M.T., Shahid Vaseem S.A., and Md. Abasid Hussain,Compassion Unlimited Plus Action (CUPA) Animal Care Hospital,R. T. Nagar, Bangalore, Karnataka, INDIA, 560 032.HISTORYAND CLINICAL SIGNSA one and half year old cachexic GermanShepherd crossbred, previously diagnosed withexocrine pancreatic deficiency and currently onenzyme replacement therapy was presented with anacute onset of abdominal distension after food intakein the morning and respiratory difficulty. The dogwas recumbent and on physical examination, paleand dry mucous membranes, sunken eye balls withprolonged capillary refill time and a temperature of98.4°F was observed. Heart rate of 150 beats/min, aweak pulse, and a tense painful abdomen was evidentupon palpation. A plain radiograph (Figure 1.)revealed extensive gas filled and dilated intestinalloops and a subsequent abdominal ultrasoundconfirmed the same. Due to the immediate nature ofdistress and emergency laparotomy was indicated.body or any devitalisation were seen along the entirelength of the of the intestines. Multiple nick incisionsand pricks with 18G needles were made along the entirelength of the intestines to facilitate removal of air andcontents and correction of the mesenteric twisting.Despite removal of air and contents, no motility wasvisualized in any segment of the intestines. Smallsegments of the intestines were collected for fullthickness biopsies. Nick incisions were closed withsimple interrupted sutures.JIVA Vol. 9 Issue 1 April 2011SURGICAL INTERVENTIONA midventral approach through the lineaalba was used for the laparotomy which revealedmesenteric twisting with excessive uniformdistension of the intestine with absence of peristalsis(Figure 2). The contents were a mixture of foulsmelling gas and fluid. No evidence of any foreign40Despite repeated metoclopramide(Perinorm®) bolus intravenous infusions and fluidtherapy no peristalsis could be observed in any segmentof the intestine. An atrophic shrunken pancreas wasobserved during the course of the surgical explorationand no attempts to biopsy the pancreas was made. Theabdomen was closed using standard procedures andfluid therapy was instituted to overcome shock andhyptertonic fluid support was initiated to facilitatetissue reperfusion.Subsequently the animal developedcomplications and succumbed the same day. The biopsyof the intestine on histopathology revealed extensive

CLINICAL REPORTulcerations devoid of any inflammatory or neoplasticcells.DISCUSSIONIntestinal hypomotility are not well characterized indogs to be associated with primary causes. Secondarycauses include prior surgery, pertitonitis, pancreatitis orparvoviral infections. However as in malabsorptivedisorders, undigested and osmotically active particlesin the intestinal lumen are know to decrease transit timehowever are responsive to prokinetics likemetoclopramide (Allenspach and Gaschen, 2008).However the latter did not hold true in this case. Themalabsorption may be attributed to exocrine pancreaticinsufficiency however the reason for hypomotilityremains unknown. However, a increased prevalence ofmesenteric torsion have been reported in GermanShepherd dogs in Finland with pancreatic acinar atropy,a major cause of exocrine pancreatic insufficiency(Williams, 2005) but has not been reported anywhereelse.Mortality associated with mesenteric torsion isalmost 100%, especially in GermanShepherds(Westermarck and Rimaila-Parnanen, 1989).Prompt surgical intervention has been associated withpoor survival in this breed as was in this clinical case.Most deaths reported are during recovery fromanaesthesia and is usually the result from a combinationof hypovolemia, bacterial translocation due to mucosalbarrier breakdown and subsequent toxemia.Reperfusion injury with the correction of mesenterictorsion is also believed to be associated with therelease of reactive oxygen species which havedeleterious effects on tissues and is believed to set inwithin the first few minutes of surgical correction(Junius,Appeldoorn, and Schrauwen, 2004).Diagnosis of mesenteric torsion is difficultas clinical signs are nonspecific and the condition isrelatively rare, however association with exocrinepancreatic insufficiency or German Shepherd dogsshould warrant radiographic examination andemergency explorative laparotomy to increase theodds of survival.REFERENCESAllenspach, K. And Gaschen, F. P., Small IntestinalDiseases. In: Small Animal Gastroenterology,Steiner, J.M., (ed.),Schlutersche, 2008Junius, G., Appeldoorn, A. M. and Schrauwen, E.,2004. Mesenteric volvulus in the dog:aretrospective study of 12 . J. Small Anim.Pract., 45:104-107Westermarck, E. and Rimaila-Parnanen, E.,1989Mesenteric torsion in dogs with exocrinepancreatic insufficiency: 21 cases (1978-1987).JAm Vet Med Assoc ;195(10):1404-1406.Williams, D.A.2005, Disease of the exocrinepancreas. In: BSAVA Manual of Canine andndFeline Gastroenterology, 2 Ed., Edt. Hall, E.J.,Simpson, J. W.AndWilliams, D. A., BSAVA, .INFOMANIA Anwers1. Gastronomy2. Umami3. Scoville scale4. Complete loss of taste5. Mono sodium Glutamate(Ajinomoto)6. The Omnivore's Dilemma7. A diet which includes fish but no meat.8. Cuisine9. Shawarma10. Sundae11. Porotta12. Poussin13. Taste14. Oenology15. NutrigenomicsJIVA Vol. 9 Issue 1 April 201141