Comparison of Histopathologic Findings in Biopsies from the Duodenum and Ileum of Dogs with Enteropathy

Abstract

Background: In the investigations of dogs with chronic small intestinal diarrhea collection of ileal biopsies lengthens procedural time and has been of uncertain value.Objectives: To evaluate whether there was agreement between histologic changes present in samples of duodenal and ileal mucosa, and hence to provide initial information in the process of determining whether collection of ileal biopsies is clinically justified.Animals: 40 dogs with chronic small and large intestinal diarrhea from which endoscopic (in 30 cases) or surgical (in 10 cases) duodenal and ileal biopsies had been collected.Methods: Samples were reviewed concurrently by two observers (MJD and MDW) using the scoring system developed by the World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group. Comparisons were made by kappa analysis.Results: Microscopic pathology was observed in 30 cases. Only eight out of this 30 (27%) had the same histopathologic diagnosis in both the duodenum and the ileum. This dropped to 3 out of 30 (10%) if different disease severity was also considered as disagreement. Microscopic pathology would have been found in 60% and 80% of the 30 cases, if only duodenal or ileal biopsies respectively, had been available.Conclusions and clinical importance: There was poor agreement between histopathological findings from duodenal versus ileal biopsies with abnormalities sometimes being more readily detected in the ileum. Routine collection of ileal plus duodenal samples appears warranted when concurrent small and large intestinal diarrhea is present.

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“…Ileal biopsy is being recognized as potentially providing valuable information not always found in duodenal or colonic biopsies a , 53,54 . The endoscopist usually can obtain ileal biopsies (either by passing the endoscope into the ileum or blindly passing biopsy forceps through the ileo‐colic valve) in dogs and cats.…”

A Randomized, Open-Label, Positively-Controlled Field Trial of a Hydrolyzed Protein Diet in Dogs with Chronic Small Bowel Enteropathy

“…Alternatively, it may relate to variability in the reliability of histopathologic interpretation of gastrointestinal biopsy specimens, as previously documented 17 . A final possibility is that more substantial histopathologic changes existed in other regions of the small intestine, given the recent demonstration that severity of duodenal pathology is not reflective of ileal pathology 18 . Indeed, many gastroenterologists now recommend that the ileum routinely be assessed when investigating dogs presenting with small intestinal diarrhea.…”

Serum concentrations of canine alpha1-proteinase inhibitor in cobalamin-deficient Yorkshire Terrier dogs

“…3,5 In some dogs, intestinal lymphangiectasia can only be seen in the ileum. 5 Cobalamin (COB) absorption occurs exclusively in the ileum of dogs.…”