Small Animal Abdominal and Metabolic Disorders Q&A 15

This squash preparation was made from a gastric mucosal biopsy taken from a chronically vomiting dog.

Question	Answer		Article
What is the white arrow indicating?	Two parallel, long, thin spiral organisms within the background matrix of cellular debris. These spirochaetes within the stomach are most commonly Helicobacter spp. They survive within the acidic environment of the stomach by producing the enzyme urease and surrounding themselves with a protective alkaline layer.		[[|Link to Article]]
What significance might this have in this dog?	In humans the presence of Helicobacter infections is strongly correlated with chronic gastritis, gastric and duodenal ulcers, and gastric neoplasia such as carcinoma and lymphoma. In veterinary medicine, Helicobacter spp. have been isolated from both normal dogs and cats and in diseased animals; however, there is no increased prevalence in either population. At this time, many studies are in progress to investigate the role of these organisms in canine and feline gastric disease, but there is no evidence to suggest that Helicobacter infection is an important factor in the development of gastritis or gastric ulcers in dogs and cats.		[[|Link to Article]]
Assuming no other significant lesions or causes of the vomiting are found, how should this dog be treated?	If no underlying organic disease is found on investigation, dietary management should perhaps be attempted initially to rule out dietary intolerances or food hypersensitivities. The decision to treat for Helicobacter infection should reflect the degree of inflammation seen on mucosal histopathology in response to the presence of the organisms; the success of this therapy should be determined by the improvement in histological lesions and eradication of the organism. Triple therapy with amoxycillin (10 mg/kg p/o q8h), metronidazole (4 mg/kg p/o q8h) and bismuth subcitrate (1–2 mg/kg p/o q8h) may be used for 14 days. Additional therapy with cimetidine (5–10 mg/kg p/o q8h) or omeprazole (2 mg/kg q24h) has been thought to be effective as well.		[[|Link to Article]]