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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:
| 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