• 1.

    Giuffrida MA, Brown DC. Small intestine. In: Tobias KM, Johnston SA, eds. Veterinary Ssurgery: Small Animal. Elsevier Saunders; 2018:17321760.

    • Search Google Scholar
    • Export Citation
  • 2.

    Folaranmi S, Rakoczy G, Bruce J, et al. Ileocaecal valve: how important is it? Pediatr Surg Int. 2011;27:613615.

  • 3.

    Morita H, Mochiki E, Ogawa A, et al. Effects of denervation at ileocecal junction and ileocecal resection in dogs. Neurogastroenterol Motil. 2012;24(1):8693.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Weser E. The management of patients after small bowel resection. Gastroenterology. 1976;71(1):146150.

  • 5.

    Kelly DG, Tappenden KA, Winkler MF. Short bowel syndrome: highlights of patient management, quality of life, and survival. JPEN J Parenter Enteral Nutr. 2013;38(4):427437.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Myrvold H, Jindel MS, Isenberg HD, Stein TA, Scherer J, Wise L. The nipple valve as a sphincter substitute for the ileocecal valve: prevention of bacterial overgrowth in the small bowel. Surgery. 1994;96(1):4247.

    • Search Google Scholar
    • Export Citation
  • 7.

    Chardavoyne R, Isenberg HD, Tindel M, Stein TA, Sampson-Scherer J, Wise L. Microbiologic efficacy of a surgically constructed nipple valve. Am J Surg. 1984;147(2):230233.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Matarese LE. Nutrition and fluid optimization for patients with short bowel syndrome. JPEN J Parenter Enteral Nutr. 2012;37(2):161170.

  • 9.

    Lambert GM. Does intestinal resection affect the absorption of essential vitamins, minerals and bile salts? An overview of the literature. Ostomy Wound Manage. 2008;54(6):3647.

    • Search Google Scholar
    • Export Citation
  • 10.

    Malbert CH. The ileocolonic sphincter. Neurogastroenterol Motil. 2005;17(1):4149.

  • 11.

    Jeppesen PB. Spectrum of short bowel syndrome in adults: intestinal insufficiency to intestinal failure. JPEN Parenter Enteral Nutr. 2014;38(1S):8S13S.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Grossman RM, Sumner JP, Lopez DJ, et al. Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats. J Am Vet Med Assoc. 2021;259(11):12921299.

    • Search Google Scholar
    • Export Citation
  • 13.

    Levitt L, Bauer MS. Intussusception in dogs and cats: a review of thirty-six cases. Can Vet J. 1992;33(10):660664.

  • 14.

    Lopez DJ, Holm SA, Korten B, Baum JI, Flanders JA, Sumner JP. Comparison of patient outcomes following enterotomy versus intestinal resection and anastomosis for treatment of intestinal foreign bodies in dogs. J Am Vet Med Assoc. 2021;258(12):13781385.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Gazet JC, Kopp J. The surgical significance of the ileocecal junction. Surgery. 1964;151:861865.

  • 16.

    Gorman SC, Freeman LM, Mitchell SL, Chan DL. Extensive small bowel resection in dogs and cats: 20 cases (1998-2004). J Am Vet Med Assoc. 2006;228(3):403407.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Sweet DC, Hardie EM, Stone EA. Preservation versus excision of the ileocolic junction during colectomy for megacolon: a study of 22 cats. J Small Anim Pract. 1994;35:358363.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Fernandez Y, Seth M, Murgia D, Puig J. Ileocolic junction resection in dogs and cats: 18 cases. Vet Q. 2017;37(1):175181.

  • 19.

    Kholoussy MA, Yang Y, Bonacquisti K, Witkowski T, Takenaka K, Matsumoto T. The competence and bacteriological effect of telescoped intestinal valve after small bowel resection. Am Surg. 1986;52(10):555559.

    • Search Google Scholar
    • Export Citation
  • 20.

    Richardson DJ, Griffen WO. Ileocecal valve substitutes as bacteriologic barriers. Am J Surg. 1972;123(2):149153.

  • 21.

    Thompson JS, Quigley EM, Adrian TE. Factors affecting outcome following proximal and distal intestinal resection in the dog: an examination of the relative roles of mucosal adaptation, motility, luminal factors, and enteric peptides. Dig Dis Sci. 1999;44(1):6374.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Thompson JS, Quigley EM, Palmer JM, West WW, Adrian TE. Luminal short-chain fatty acids and postresection intestinal adaptation. JPEN Parenter Enteral Nutr. 1996;20(5)338343.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    The World Small Animal Veterinary Association Global Veterinary Development. Nutritional assessment guidelines. https://wsava.org/wp-content/uploads/2020/01/WSAVA-Nutrition-Assessment-Guidelines-2011-JSAP.pdf. WSAVA. Accessed August 5, 2022.

    • Search Google Scholar
    • Export Citation
  • 24.

    Purina Institute. Purina fecal scoring chart. Purina. https://www.purinainstitute.com/sites/g/files/auxxlc381/files/2021-04/fecal-chart.pdf. Accessed August 5, 2022.

    • Search Google Scholar
    • Export Citation
  • 25.

    Reid IS. The significance of the ileocecal valve in massive resection of the gut in puppies. J Pediatr Surg. 1975;10(4):507510.

  • 26.

    Yanoff SR, Willard MD, Booth HW. Short-bowel syndrome in four dogs. Vet Surg. 1992;21(3):217222.

  • 27.

    Weser E. Nutritional aspects of malabsorption: short gut adaptation. Am J Med. 1979;67(6):10141020.

  • 28.

    Torres-Fuentes C, Golubeva AV, Zhdanov AV, et al. Short-chain fatty acids and microbiota metabolites attenuate ghrelin receptor signaling. FASEB J. 2019;33(12):1354613559.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Gregory CR, Guilford WG, Berry CR, Olsen J, Pederson NC. Enteric function in cats after subtotal colectomy for treatment of megacolon. Vet Surg. 1990;19(3):216220.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Gow AG, Else R, Evans H, Berry JL, Herrtage ME, Mellanby RJ. Hypovitaminosis D in dogs with inflammatory bowel disease and hypoalbuminaemia. J Small Anim Pract. 2011;52(8):411418.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Wennogle SA, Priestnall SL, Suárez-Bonnet A, Webb CB. Comparison of clinical, clinicopathologic, and histologic variables in dogs with chronic inflammatory enteropathy and low or normal serum 25-hydroxycholecalciferol concentrations. J Vet Intern Med. 2019;33(5):19952004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Center SA, Warner K, Corbett J, Randolph JF, Erb HN. Proteins invoked by vitamin K absence and clotting times in clinically ill cats. J Vet Intern Med. 2000;14(3):292297.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Smith HP, Warner ED, Brinkhous KM, Seegers WH. Bleeding tendency and prothrombin deficiency in biliary fistula dogs: effect of feeding bile and vitamin K. J Exp Med. 1938;67(6):91120.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Gastrointestinal signs and a need for nutritional management may persist long term in dogs and cats undergoing resection of the ileocolic junction: 35 cases (2008–2020)

Catherine N. StecykDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Lisa M. FreemanDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Cynthia R. L. WebsterDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Dominique G. PenninckDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Kady MarinoDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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John BergDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA

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Abstract

OBJECTIVE

To evaluate the effects of ileocecocolic junction (ICJ) resection on gastrointestinal signs, biochemical parameters, and nutritional variables in dogs and cats.

ANIMALS

20 dogs and 15 cats that underwent ICJ resection between January 2008 and June 2020.

PROCEDURES

Medical records of dogs and cats that underwent ICJ resection were reviewed, and clinical signs, laboratory abnormalities, and nutritional information were obtained. Additional follow-up information was obtained by contacting primary care veterinarians or owners. A subset of dogs (n = 6) and cats (2) were evaluated in the hospital via clinical examination, clinicopathologic testing, nutritional testing, and abdominal ultrasound.

RESULTS

Twenty dogs and 15 cats underwent resection of the ICJ for treatment of a variety of conditions. Ten of 20 dogs (50%) and 11/15 cats (73%) were reported by their owners to have a good long-term outcome based on the lack of long-term gastrointestinal signs or the ability to control gastrointestinal signs with diet and supplements alone. Despite owner-reported good outcomes, long-term diarrhea, weight loss, and muscle loss were common. Of the 6 dogs evaluated in the hospital, 3/6 (50%) had muscle loss, 2/6 (33%) had low taurine concentrations, and 1 dog each had low cobalamin, folate, 25-hydroxyvitamin D, and ionized calcium. Neither of the 2 cats evaluated in the hospital had nutritional abnormalities identified.

CLINICAL RELEVANCE

Owners should be informed of the possibility of long-term gastrointestinal clinical signs and the potential need for long-term nutritional management after ICJ resection.

Abstract

OBJECTIVE

To evaluate the effects of ileocecocolic junction (ICJ) resection on gastrointestinal signs, biochemical parameters, and nutritional variables in dogs and cats.

ANIMALS

20 dogs and 15 cats that underwent ICJ resection between January 2008 and June 2020.

PROCEDURES

Medical records of dogs and cats that underwent ICJ resection were reviewed, and clinical signs, laboratory abnormalities, and nutritional information were obtained. Additional follow-up information was obtained by contacting primary care veterinarians or owners. A subset of dogs (n = 6) and cats (2) were evaluated in the hospital via clinical examination, clinicopathologic testing, nutritional testing, and abdominal ultrasound.

RESULTS

Twenty dogs and 15 cats underwent resection of the ICJ for treatment of a variety of conditions. Ten of 20 dogs (50%) and 11/15 cats (73%) were reported by their owners to have a good long-term outcome based on the lack of long-term gastrointestinal signs or the ability to control gastrointestinal signs with diet and supplements alone. Despite owner-reported good outcomes, long-term diarrhea, weight loss, and muscle loss were common. Of the 6 dogs evaluated in the hospital, 3/6 (50%) had muscle loss, 2/6 (33%) had low taurine concentrations, and 1 dog each had low cobalamin, folate, 25-hydroxyvitamin D, and ionized calcium. Neither of the 2 cats evaluated in the hospital had nutritional abnormalities identified.

CLINICAL RELEVANCE

Owners should be informed of the possibility of long-term gastrointestinal clinical signs and the potential need for long-term nutritional management after ICJ resection.

Contributor Notes

Corresponding author: Dr. Stecyk (catherine.stecyk@gmail.com)