Page 704 - Problem-Based Feline Medicine

696 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

Failure to demonstrate a wheal and flare response fol- Diagnosis
lowing intradermal injection of histamine (1:1000)
The gastritis and gastric ulcer disease are diagnosed by
indicates a defect in the sympathetic innervation of
endoscopy and histologic examination of the stom-
cutaneous blood vessels.
ach and duodenum.
GASTRINOMA However, to make a definitive diagnosis of
Zollinger–Ellison syndrome, a serum gastrin level
Classical signs must be obtained along with the finding of a discrete
tumor on the pancreatic islets. Very high levels of
● Chronic vomiting unresponsive to routine serum gastrin are obtained in cats with gastrinoma.
therapy for gastritis and gastric ulcer
disease.
Differential diagnosis
These are rare tumors of the GI tract, so even finding
Pathogenesis elevated serum gastrin levels is not sufficient, since
there are other causes for elevations in serum gastrin
Chronic gastritis and gastric ulcer disease are pro-
levels (e.g. chronic renal failure, etc.).
duced secondary to a gastrin-secreting tumor that
arises from the pancreatic islet cells (called Other causes of chronic gastritis, including Helicobacter
Zollinger–Ellison syndrome). spp., liver disease and pancreatitis should be explored.
This is a rare disease that has only been described in
three older cats. Treatment
The pancreatic tumor may occur as a solitary lesion, or Surgical removal of the tumor, if possible, is the treat-
there may be multiple lesions on the liver due to metas- ment of choice. Management of the gastritis and gastric
tasis. ulcer disease is as for other primary causes of this prob-
lem (see section on gastritis for details, page 680).
Clinical signs
Typical signs include chronic vomiting, weight loss
and anorexia in a cat previously diagnosed with gas-
tritis or gastric ulcers on histopathologic examination
of the stomach, but unresponsive to routine therapy.

RECOMMENDED READING
August JR. Consultations in Feline Internal Medicine, 2001.
Rosser J. In: August J (ed) Food Hypersensitivity: New Recommendations for Diagnosis and Management. WB
Saunders Company, Consultations in Feline Internal Medicine, 1997, pp. 209–214.
Guilford WG, Jones BR, Markwell PR, et al. Food sensitivity in cats with chronic idiopathic gastrointestinal
problems. J Vet Intern Med 2001; 15: 7–13.
Kirk’s Current Veterinary Therapy XIII, 2000.
Krecic MR. Comp. Cont. Ed., 2003; 23 (11): pp. 951–973.