In people and animals, extensive resection of the small intestine can result in a condition known as SBS. Affected individuals typically develop a variety of nutritional and metabolic disturbances, including malabsorption, weight loss, diarrhea, and fluid and electrolyte abnormalities. Although the amount of intestine that must be removed for SBS to develop has not been clearly defined, it is generally thought that human patients in which ≥ 50% of the small intestine is resected are at risk for developing SBS.1–3
Although intestinal resection is a relatively common procedure in dogs and cats, resection of ≥ 50% of the small intestine appears to be uncommon in clinical practice, likely because most dogs and cats with lesions that would require such extensive resection would generally be euthanized because of a perceived poor prognosis. Nevertheless, experimental studies4–7 and isolated clinical reports8–11 provide some information on the effects of extensive small intestinal resection in dogs. Clinical signs reported in dogs that have undergone extensive small intestinal resection include chronic watery diarrhea, fluid and electrolyte abnormalities, and weight loss.8,9 However, specific criteria for the diagnosis of SBS in dogs have not been determined, and there has been no consistent correlation between extent of small intestinal resection and overall outcome.11
To the authors’ knowledge, only 7 dogs with signs consistent with SBS have been described in the veterinary literature,8–11 and no cases involving cats have been reported. Thus, it is not known how often dogs and cats that undergo extensive small intestinal resection develop clinical signs consistent with SBS or what the outcome of affected animals is. The purposes of the study reported here, therefore, were to determine the outcome of dogs and cats that underwent extensive resection of the small intestine and identify factors associated with outcome.
Systat, version 10.0, SPSS Inc, Chicago, Ill.
GIA50 Premium, USSC, Norwalk, Conn.
TA Premium, USSC, Norwalk, Conn.
Maxon, USS/DG, Norwalk, Conn.
Monosof, USS/DG, Norwalk, Conn.
Low Residue Adult/Canine, Iams Co, Dayton, Ohio.
Maximum Calorie Canine/Feline, Iams Co, Dayton, Ohio.
Prescription Diet Canine i/d, Hill's Pet Nutrition Inc, Topeka, Kan.
EN Gastroenteric Canine formula, Nestlé Purina PetCare, St Louis, Mo.
Tender Vittles, Nestlé Purina PetCare, St Louis, Mo.
Pro Plan Adult Cat Food, Nestlé Purina PetCare, St Louis, Mo.
Prescription Diet Canine r/d, Hill's Pet Nutrition Inc, Topeka, Kan.
Cuthbertson EM, Eigfillan RS, Burhenne HJ. Massive small bowel resection in the Beagle, including laboratory data in severe undernutrition. Surgery 1970; 68: 698–705.
Feldman EJ, Dowling RH, McNaughton J, et al. Effect of oral versus intravenous nutrition on intestinal adaptation after small bowel resection in the dog. Gastroenterology 1976; 70: 712–719.
Wilmore DW, Dudrick SJ, Daly JM, et al. The role of nutrition in the adaptation of the small intestine after massive resection. Surg Gynecol Obstet 1971; 132: 673–680.
Uchiyama M, Iwafuchi M, Matsuda Y. Intestinal motility after massive small bowel resection in conscious canines: comparison of acute and chronic phases. J Pediatr Gastroenterol Nutr 1996; 23: 217–223.
Williams DA, Burrows CF. Short bowel syndrome—a case report in a dog and discussion of the pathophysiology of bowel resection. J Small Anim Pract 1981; 22: 262–275.
Joy CL, Patterson JM. Short bowel syndrome following surgical correction of a double intussusception in a dog. Can Vet J 1978; 19: 254–259.
Jeejeebhoy KN. Short bowel syndrome. In: Kinney JM, Jeejeebhoy MB, Hill GL, et al, eds. Nutrition and metabolism in patient care. Philadelphia: WB Saunders Co, 1988; 259–265.
Weiming Z, Ning L, Jieshou L. Effect of recombinant human growth hormone and enteral nutrition on short bowel syndrome. JPEN J Parenter Enteral Nutr 2004; 28: 377–381.
Gouttebel MC, Saint-Aubert B, Astre C, et al. Total parenteral nutrition needs in different types of short bowel syndrome. Dig Dis Sci 1986; 31: 718–723.
Reid IS. The significance of the ileocolic valve in massive resection of the gut in puppies. J Pediatr Surg 1975; 10: 507–510.
Allard JP, Jeejeebhoy KN. Nutritional support and therapy in the short bowel syndrome. Gastroenterol Clin North Am 1989; 18: 589–601.
Messing B, Crenn P, Beau P, et al. Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome. Gastroenterology 1999; 117: 1043–1050.
Mayr JM, Schober PH, Weissensteiner U, et al. Morbidity and mortality of the short-bowel syndrome. Eur J Pediatr Surg 1999; 9: 231–235.
Scolapio JS, Fleming CR. Short bowel syndrome. In: Shils ME, Olson JA, eds. Modern nutrition in health and disease. 9th ed. Philadelphia: The Williams & Wilkins Co, 1999; 1135–1140.
Scott RB, Sheehan A, Chin BC, et al. Hyperplasia of the muscularis propria in response to massive intestinal resection in rat. J Pediatr Gastroenterol Nutr 1995; 21: 399–409.
Williamson RC. Intestinal adaptation (first of two parts). Structural, functional and cytokinetic changes. N Engl J Med 1978; 298: 1393–1402.
Hanson WR, Osborne JW, Sharp JG. Compensation by the residual intestine after intestinal resection in the rat. I. Influence of amount of tissue removed. Gastroenterology 1977; 72: 692–700.
Byrne TA, Morrissey TB, Nattakom TV, et al. Growth hormone, glutamine, and a modified diet enhance nutrient absorption in patients with severe short bowel syndrome. JPEN J Parenter Enteral Nutr 1995; 19: 296–302.
Scolapio JS, Camilleri M, Fleming CR, et al. Effect of growth hormone, glutamine, and diet on adaptation in short-bowel syndrome: a randomized, controlled study. Gastroenterology 1997; 113: 1074–1081.
Thompson JS, Quigley EM, Palmer JM, et al. Luminal shortchain fatty acids and postresection intestinal adaptation. JPEN J Parenter Enteral Nutr 1996; 20: 338–343.
Levine GM, Deren JJ, Yezdimir E. Small-bowel resection: oral intake is the stimulus for hyperplasia. Dig Dis Sci 1976; 21: 542–546.
Park JH, Vanderhoof JA. Growth hormone did not enhance mucosal hyperplasia after small-bowel resection. Scand J Gastroenterol 1996; 31: 349–354.
Beiler HA, Steinorth J, Zachariou Z. Poor effect of glutamin and human-EGF on autologic-allotopic transplanted ileum mucosa. Eur J Pediatr Surg 2004; 14: 14–20.
Jeejeebhoy KN, Langer B, Tasallas G, et al. Total parenteral nutrition at home: studies in patients surviving 4 months to 5 years. Gastroenterology 1976; 71: 943–953.
Schalamon J, Mayr JM, Hollwarth ME. Mortality and economics in short bowel syndrome. Best Pract Res Clin Gastroenterol 2003; 17: 931–942.
Cronk DR, Ferguson DC, Thompson JS. Malnutrition impairs postresection intestinal adaptation. JPEN J Parenter Enteral Nutr 2000; 24: 76–80.
Short bowel syndrome