Ultrasonographic features of presumed gastric wall edema in 14 dogs with pancreatitis

Abstract

Background Gastric wall edema has not been reported as a complication of acute pancreatitis in dogs. Objective To describe the ultrasonographic features of gastric wall thickening in dogs with acute pancreatitis. Animals Fourteen dogs with ultrasonographic evidence and clinical diagnosis of acute pancreatitis, with ultrasonographic evidence of increased gastric wall thickness (>5 mm). Methods A retrospective search in the medical records from 2014 to 2016 was performed to identify dogs that had ultrasonographic evidence of acute pancreatitis, that had increased thickness of the gastric wall and that were diagnosed with acute pancreatitis clinically. The gastric wall changes such as thickness, layering appearance, echogenicity, distribution of lesions, and perigastric changes were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Results Mean gastric wall thickness was 9.9 ± 4.0 mm (SD). A complete loss of wall layering was observed in 2 dogs. Thickening of the submucosal layer was observed in 12 dogs, and 5 of them had concurrent muscularis layer thickening. The echogenicity of thickened submucosal layer was intermediate hyperechoic. Lacy appearances were present within the thickened submucosal layer in 7 dogs and in the muscularis layer of 1 dog. Thickening was focal in 12 dogs and adjacent to the diseased pancreas. Subsequent resolution of gastric wall thickening was observed in 3 dogs (range 3‐28 days) via follow‐up ultrasound. One dog underwent necropsy, and gastric wall edema was confirmed histopathologically. Conclusions and Clinical Importance Findings indicated that gastric wall thickening presumably because of edema could be a complication of acute pancreatitis.

Association between abdominal ultrasound findings, the specific canine pancreatic lipase assay, clinical severity indices, and clinical diagnosis in dogs with pancreatitis

“…Pancreatic cyst‐like lesions also occur in the subacute phase of pancreatitis . Other nonspecific changes include abdominal effusion, ileus, gastric wall thickening, and lateral displacement of the duodenum . Anecdotally veterinary practitioners might use abdominal ultrasound (AUS) in conjunction with clinical signs and supportive clinical pathology screening, in the absence of a quantitative pancreatic lipase assay, for the diagnosis of pancreatitis and assessment of disease severity.…”

“…16 Other nonspecific changes include abdominal effusion, ileus, gastric wall thickening, and lateral displacement of the duodenum. 13,15,17 Anecdotally veterinary practitioners might use abdominal ultrasound (AUS) in conjunction with clinical signs and supportive clinical pathology screening, in the absence of a quantitative pancreatic lipase assay, for the diagnosis of pancreatitis and assessment of disease severity. In addition, although prior studies have documented potential ultrasonographic abnormalities seen with pancreatitis, the individual contribution of each abnormality to a CDx of pancreatitis in dogs has not been evaluated.…”

Ultrasonographic features and prevalence of presumed gastric wall edema in dogs with hypoalbuminemia

“…10 In veterinary medicine, gastric and duodenal wall edema has been described in a dog with experimentally induced hypoalbuminemia 11 and gastroduodenal intussusception, 12 and in dogs with pancreatitis. 13 Reported ultrasonographic features of gastric wall edema in dogs with pancreatitis were thickened submucosal layer with preservation of mucosal layer. 13 The specific ultrasonographic features of gastric wall edema in those cases may warrant clinical decision of a follow-up ultrasonographic evaluation.…”

“…13 Reported ultrasonographic features of gastric wall edema in dogs with pancreatitis were thickened submucosal layer with preservation of mucosal layer. 13 The specific ultrasonographic features of gastric wall edema in those cases may warrant clinical decision of a follow-up ultrasonographic evaluation.…”

Ultrasonographic findings of gastrointestinal histoplasmosis in dogs

“…In human literature submucosal thickening is attributed to active inflammation. 19,20 Muscularis thickening was seen concurrently with submucosal thickening in three dogs and was suspected to be due to chronic inflammation and infiltration;…”