Gastric Ulceration - Dog



See also Pathology in WikiPath

Signalment

  • Sled dogs

Description

Is a round or oval punched out lesions ranging from 1-4 cm in diameter caused by damage to the gastric mucosa.

There are many disease associations including:

Causes of gastric ulceration
Disease Type E.g.
Hypotension Shock, Sepsis
Drug - induced Non-steroidal anti-inflammatory drugs (NSAIDs)
Idiopathic Stress, exercise induced
Inflammatory Gastritis
Neoplastic Adenocarcinoma, lymphosarcoma, leiomyoma
Metabolic/endocrine Hypoadrenocorticism, liver disease, uraemia, disseminated intravascular coagulation, mastocytosis and hypergastrinaemia

Gastric ulceration is caused by damage to the gastric mucosa through the above mechanisms. NSAIDs directly damage the mucosa and interfere with the prostaglandin synthesis. Gastric ulceration is worsened by the use of NSAIDs in combination with corticosteroids. This risk can be minimised by using cyclooxygenase-1 (COX-1) sparing NSAIDs (carprofen, meloxicam and deracoxib.

Gastric acid hypersecretion following mast cell degranulation of histamine and gastrin secretion from gastrinomas is a major cause of gastric ulceration. Sled dogs and equine race horses are prone to gastric ulceration.

Diagnosis

History and Clinical Signs

History may involve:

  • Access to toxins and drugs such as NSAIDs

Clinical Signs:

  • Vomiting
  • Haematemesis
  • Malaena
  • Pale mucous membranes
  • Abdominal pain
  • Weakness
  • Inappetance
  • Hypersalivation
  • Circulatory comprimise

Haematology

  • Anaemia - regenerative initially, may progress to microcytic, hypochromic and minutely regenerative.
  • Thrombocytosis
  • Lack of stress leucogram (and lymphocytosis and eosinophilia) supportive of hypoadrenocorticism
  • Examination of the buffy coat may detect mastocytosis
  • Neutrophilia and a left shift - signs of inflammation or gastric perforation
  • May show abnormalities in haemostasis

Biochemistry

  • Dehydration - azotaemia
  • Hepatic disease - increased liver enzymes and bilirubin, decreased urea, albumin and cholesterol
  • Renal disease - azotaemia
  • Hypoadrenocorticism - Sodium:Potassium ratio of less than 27:1
  • Vomiting will lead to electrolyte and acid-base abnormalities - metabolic alkalosis, hypokalaemia and hypochloraemia

Urinalysis

  • Dehydration - Hypersthenuria
  • Renal disease - Isosthenuria

Plain radiography

Positive Contrast Radiography

Ultrasonography

Endoscopy and Biopsy

Treatment

Fluid therapy

Acid-base correction

Mucosal protectants

Prophylaxis

Anti-emetics

Analgesia

Antibiotics

Surgery

Prognosis

Depends upon the cause

References