Small Animal Abdominal and Metabolic Disorders Q&A 14
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This question was provided by Manson Publishing as part of the OVAL Project. See more Small Animal Abdominal and Metabolic Disorders Q&A. |
These ultrasound images are of the abdomen of an 18-week-old German Shepherd Dog with an acute history of lethargy, vomiting and haemorrhagic diarrhoea. A double-layered tubular structure is visible.
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| What is the most likely diagnosis? | The ultrasound image is characteristic of an intussusception. |
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| What would you expect to be able to palpate within the abdomen? | A cylindrical/sausage-shaped, doughy mass in the mid-abdomen. Faecal material might have a similar feel but should deform with gentle pressure. |
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| How would you confirm the diagnosis? | Plain and barium contrast radiographs might be helpful in identifying an intussusception. A ‘coiled-spring’ appearance seen on barium enema can also be helpful. Ileocolic intussusception may protrude through the anus. It can be distinguished from a rectal prolapse by the ability to pass a probe (such as a thermometer) through the anus alongside the intussusceptum. In this case the results of abdominal palpation and ultrasound imaging are sufficient to justify an exploratory laparotomy. |
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| How would you treat this dog and prevent recurrence? | Surgical reduction of the intussusception is attempted at laparotomy, but often the presence of adhesions and bowel necrosis necessitates intestinal resection and end-to-end anastomosis. Postoperatively, feeding of liquid/soft food is reinstituted early in the recovery phase. Prolonged withholding of food is likely to delay healing and increase the risk of wound dehiscence. Attempts to prevent recurrence by giving antimuscarinic agents (e.g. hyoscine [Buscopan Compositum]) do not have a sound physiological basis as they cause ileus, delaying restoration of normal intestinal peristalsis. Enteroplication, by suturing adjacent loops of bowel, is the only guaranteed method of preventing recurrence. |
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