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==Description==
==Description==
Chronic gastritis is often characterised by persistent vomiting of variable frequency and appearance. The underlying cause is unknown but chronic gastritis can be classified according to its histological appearance.
Chronic gastritis is often characterised by persistent [[vomiting|vomiting]] of variable frequency and appearance. The underlying cause is unknown but chronic gastritis can be classified according to its histological appearance.
'''Lymphocytic-plasmacytic gastritis''' which may be an immune response to numerous antigens. [[Helicobacter|''Helicobacter felis'']] has been suggested as a cause for such a reaction in dogs and cats.
'''Lymphocytic-plasmacytic gastritis''' which may be an immune response to numerous antigens. [[Helicobacter|''Helicobacter felis'']] has been suggested as a cause for such a reaction in dogs and cats.
'''Eosinophilic gastritis''' which may result from an allergic reaction to food antigens.
'''Eosinophilic gastritis''' which may result from an allergic reaction to food antigens.
===Radiography===
===Radiography===
Plain abdominal radiography is usually unremarkable. Contrast radiography may reveal thickening or irregularity of the gastric rugae.
Plain abdominal radiography is usually unremarkable. Contrast radiography may reveal thickening or irregularity of the gastric rugae.
===Biopsy===
===Biopsy===
Biopsy of the stomach followed by histological examination should always be performed and are required for a definitive diagnosis. They should be taken via endoscopy as this is less invasive than via surgery.
Biopsy of the stomach followed by histological examination should always be performed and are required for a definitive diagnosis. They should be taken via endoscopy as this is less invasive than via surgery.
===Endoscopy===
===Endoscopy===
Gastroscopy can be used to visualise the gastric mucosa. Varying degrees of hyperaemia, hypertrophy and haemorrhage may be evident. However, if no endoscopic lesions are visualised, chronic gastritis cannot be ruled out.
Gastroscopy can be used to visualise the gastric mucosa. Varying degrees of hyperaemia, hypertrophy and haemorrhage may be evident. However, if no endoscopic lesions are visualised, chronic gastritis cannot be ruled out.
==Treatment==
==Treatment==
===General Approach===
Removal of the underlying cause should be the aim.
Removal of the underlying cause should be the aim.
Elimination diet in cases where lesions are infiltrated with eosinophils, plasma cells or lymphocytes as determined via biopsy as this may reflect a hypersensitivity to dietary protein. This may include feeding a homemade or veterinary restricted-protein or hypoallergenic diet.
Elimination diet in cases where lesions are infiltrated with eosinophils, plasma cells or lymphocytes as determined via biopsy as this may reflect a hypersensitivity to dietary protein. This may include feeding a homemade or veterinary restricted-protein or hypoallergenic diet.
===Lymphocytic-plasmacytic gastritis===
May resond to dietary therapy alone. [[Gastroprotective Drugs|gastroprotectants]] such as sucralfate and cimetidine may be beneficial.
[[Steroids|corticosteroids]] can be used in moderate-severe cases as a means of immunomodulation.
[[Steroids|corticosteroids]] can be used in moderate-severe cases as a means of immunomodulation.
Azathioprine may be used in conjunction with corticosteroids in cases that fail to respond to corticosteroids alone. The white cell count should be monitored from 2 weeks after the first dose and treatment should be stopped if the count falls to less than 4x10e9/L.
===Eosinophilic gastritis===
A strict elimination diet is often successful, the addition of [[Steroids|corticosteroid]] therapy may be required in cases that do not respond to dietary therapy alone.
Azathioprine can be used in addition in those cases that fail to respond.
[[Gastroprotective Drugs|gastroprotectant]] administration should be routine.
===Atrophic gastritis===
Is more difficult to treat than lymphocytic-plasmacytic or eosinophilic gastritis, diets low in fat and fibre may help to control signs.
[[Steroids|corticosteroids]] are thought to be beneficial as it is thought that the disease is immune-mediated.[[Gastroprotective Drugs|gastroprotectants]] are advised. Additionally prokinetics may be used to empty the stomach.
===Granulomatous gastritis===
This is difficult to treat. It does not respond well to diet or [[Steroids|corticosteroid]] therapy.
==Prognosis==
==Prognosis==
Lymphocytic-plasmacytic gastritis - Good prognosis with approprate therapy.
Canine eosinophilic gastritis - Good.
Feline eosinophilic gastritis - Poor.
==References==
==References==