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| ==Introduction== | | ==Introduction== |
| This is an uncommon condition where there is '''thickening or hypertrophy of the pyloric circular smooth-muscle''' layer that results in delayed gastric emptying of solid foods. | | This is an uncommon condition where there is '''thickening or hypertrophy of the pyloric circular smooth-muscle''' layer that results in delayed gastric emptying of solid foods. |
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− | It is primarily reported in '''young male dogs and brachycephalic breeds''' such as the Boxer and Boston terrier. It is rare in cats, but occurs almost excusively in '''young Siamese cats'''. | + | It is primarily reported in '''young male dogs and brachycephalic breeds''' such as the Boxer and Boston terrier. It is rare in cats, but occurs almost exclusively in '''young Siamese cats'''. |
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− | Concurrent '''megaoesophagus''' is often present in cats, suggesting an underlying autonomic disorder. | + | Concurrent '''[[megaoesophagus]]''' is often present in cats, suggesting an underlying autonomic disorder. |
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| One proposed aetiology for the disease is that it is caused by the '''excessive secretion of gastrin''', which has a potent trophic effect on pyloric smooth muscle and on the mucosa. | | One proposed aetiology for the disease is that it is caused by the '''excessive secretion of gastrin''', which has a potent trophic effect on pyloric smooth muscle and on the mucosa. |
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| Clinical signs are seen in kittens and puppies which have '''just been weaned''', since outflow of solid foods is affected. | | Clinical signs are seen in kittens and puppies which have '''just been weaned''', since outflow of solid foods is affected. |
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− | The main sign is '''vomiting''' partially digested food without bile, usually several hours after eating. | + | The main sign is '''[[vomiting]]''' partially digested food without bile, usually several hours after eating. |
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| The animal may appear '''stunted''' and '''aspiration pneumonia''' may be present. | | The animal may appear '''stunted''' and '''aspiration pneumonia''' may be present. |
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| Delayed gastric emptying should be diagnosed on radiographic studies. | | Delayed gastric emptying should be diagnosed on radiographic studies. |
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− | '''Radiographic signs''' may include gastric distention or delayed emptying of contrast material (swallowed barium or barium-impregnant polyethylene spheres, BIPS) | + | '''Radiographic signs''' may include gastric distention or delayed emptying of contrast material (swallowed barium or barium-impregnated polyethylene spheres, BIPS) |
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| '''Ultrasonography''' may demonstrate thickening of the pyloric area. | | '''Ultrasonography''' may demonstrate thickening of the pyloric area. |
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| In cats, treatment is difficult and often unsuccessful. | | In cats, treatment is difficult and often unsuccessful. |
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− | '''Medical therapy''' includes: prokinetic drugs such as metoclopramide, cisapride and erythromycin | + | '''Medical therapy''' includes: prokinetic drugs such as metoclopramide, cisapride and erythromycin. Dietary manipulation such as feeding a low-fat diet or liquid food to encourage gastric emptying. |
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− | Dietary manipulation such as feeding a low-fat diet or liquid food to encourage gastric emptying. | |
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| '''Surgical techniques''' can also be used: | | '''Surgical techniques''' can also be used: |
− | | + | :''Fredet-Ramstedt pyloromyotomy'': longitudinal incision through the serosa, muscularis and submucosa to permit bulging of the mucosa, relieving constriction of the pylorus. The incision is left open. |
− | ''Fredet-Ramstedt pyloromyotomy'': longitudinal incision through the serosa, muscularis and submucosa to permit bulging of the mucosa, relieving constriction of the pylorus. The incision is left open. | + | :''Heineke-Mikulicz pyloroplasty'': similar incision but this one penetrates the mucosa and enters the pyloric lumen. The incision is closed transversely in a simple interrupted pattern penetrating all tissue layers. |
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− | ''Heineke-Mikulicz pyloroplasty'': similar incision but this one penetrates the mucosa and enters the pyloric lumen. The incision is closed transversely in a simple interrupted pattern penetrating all tissue layers. | |
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| '''Post-operative care''' includes: providing fluids to maintain fluid balance, providing bland food within 24 hours. | | '''Post-operative care''' includes: providing fluids to maintain fluid balance, providing bland food within 24 hours. |
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− | [[Category:To Do - Helen]] | + | {{review}} |
− | [[Category:To Do - Review]] | + | |
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| + | [[Category:Gastric Diseases - Dog]][[Category:Gastric Diseases - Cat]] |
| + | [[Category:Expert Review - Small Animal]] |