Objective—To evaluate the signalment, clinical signs, diagnosis, treatment, and outcome associated with esophageal obstruction caused by a dental chew treat in dogs.
Design—Retrospective case series.
Procedures—Medical records were contributed from 19 hospitals via responses to a questionnaire that was developed for veterinarians who managed the cases.
Results—Esophageal obstructions with the dental chew treat occurred primarily in small dogs (26/31 [83.9%]). The most common clinical signs were gagging, regurgitation, vomiting, anorexia, and lethargy. Diagnosis was usually made via survey thoracic radiography. Obstructions were most commonly located in the distal portion of the esophagus (23/31; 74.2%). Esophageal lesions were moderate or severe in 86.7% (26/30) of the dogs. Orad endoscopic removal of the foreign bodies was uncommon (8/31 [25.8%]); most were pushed into the stomach. Thoracotomy was necessary in 6 dogs. Esophageal strictures developed in 6 of 25 (24%) dogs that survived initial hospitalization. Overall mortality rate was 25.8%.
Conclusions and Clinical Relevance—Esophageal obstructions with a dental chew treat were difficult to remove orally via endoscopy, resulted in moderate or severe esophageal damage, frequently were associated with stricture formation, and were associated with a high mortality rate.
Case Description—An 8-year-old male Golden Retriever was evaluated because of an 8-week history of intermittent diarrhea with melena and hematochezia that were not responsive to medical treatment and resulted in severe anemia.
Clinical Findings—Exploratory celiotomy with intestinal and colonic biopsy revealed mild enterocolitis but did not result in diagnosis of the cause of melena and hematochezia. Endoscopy of the upper portion of the gastrointestinal tract and colonoscopy were performed. Multifocal areas of coalescing, tortuous mucosal blood vessels were observed in the cecum and all regions of the colon. A diagnosis of vascular ectasia (VE) was made on the basis of the endoscopic and histologic appearance of the lesions.
Treatment and Outcome—An ileorectal anastamosis was performed. Melena and hematochezia resolved within 3 days after surgery, and the anemia resolved within 6 weeks after surgery. Surgical resection of the cecum and colon and feeding of a highly digestible diet resulted in long-term (22 months) resolution of clinical signs.
Clinical Relevance—Initial exploratory celiotomy with intestinal and colonic biopsy failed to reveal the VE lesions responsible for the melena, hematochezia, and anemia. Endoscopic evaluation was necessary for detection of the colonic VE lesions. Surgical resection of the cecum and colon and feeding of a highly digestible diet may result in a favorable outcome in affected dogs.
Objective—To determine whether substantial interobserver
variation exists among diagnostic pathologists
for descriptions of intestinal mucosal cell populations
and whether histopathologic descriptions
accurately predict when a patient does not have clinically
evident intestinal disease.
Sample Population—14 histologic slides of duodenal,
ileal, or colonic tissue from 10 dogs and 3
Procedure—Each histologic slide was evaluated
independently by 5 pathologists at 4 institutions.
Pathologists, who had no knowledge of the tissues'
origin, indicated whether slides were adequate for
histologic evaluation and whether the tissue was normal
or abnormal. They also identified the main infiltrating
cell type in specimens that were considered
abnormal, and whether infiltrates were mild, moderate,
severe, or neoplastic.
Results—Quality of all slides was considered adequate
or superior by at least 4 of the 5 pathologists.
For intensity of mucosal cellular infiltrates, there was
uniformity of opinion for 1 slide, near-uniformity for 6
slides, and nonuniformity for 7 slides. Five dogs did
not have clinical evidence of intestinal disease, yet
the pathologists' descriptions indicated that their
intestinal tissue specimens were abnormal.
Conclusions and Clinical Relevance—Substantial
interobserver variation was detected. Standardization
of pathologic descriptions of intestinal tissue is necessary
for meaningful comparisons with published
articles. Clinicians must be cautious about correlating
clinical signs and histopathologic descriptions of
intestinal biopsy specimens. (J Am Vet Med Assoc