Page 582 - Clinical Small Animal Internal Medicine

550 Section 6 Gastrointestinal Disease

Gastritis resulting from inflammatory bowel disease, Environmental history may also give clues towards
VetBooks.ir systemic disorders, and neoplasia is more common in identification of uncommon causes of feline gastritis.
The nematode Ollulanus tricuspis is found in cats
middle‐aged to older companion animals. Breed‐related
gastritis, however (seen in Norwegian lundehunds,
common in tropical, temperate areas worldwide. Feline
Rottweilers, and basenjis) can occur at any age. throughout the US, whereas Aonchotheca putorii is more
Adenocarcinomas develop in middle‐aged dogs (<10 dirofilariasis occurs more commonly in the mid‐west
years) more frequently than other gastric neoplasms, and south‐east, with a higher prevalence also reported in
and are usually located in the pyloric antrum or gastric northern California and Florida.
body (greater curvature). Collies, German shepherd
dogs, Staffordshire terriers, Bouviers des Flandres,
Norwegian elkhounds, and Belgian shepherds have History and Clinical Signs of Gastritis
been identified as breeds at higher risk for developing
gastric carcinoma. Male dogs are overrepresented The duration (acute versus chronic) and severity of signs
among dogs with gastric neoplasms in some reports, in dogs and cats with gastritis and gastric ulceration vary
although a sex predisposition is not yet widely recog- depending on the underlying etiology. Clinical signs can
nized. The Norwegian lundehund is at higher risk for range from overt gastrointestinal signs to only weight
development of neuroendocrine carcinoma secondary loss. For animals with “garbage gut” or those that have
to chronic, severe atrophic gastritis. Lymphoma is ingested caustic substances, toxins, ulcerogenic medica-
more prevalent in older cats, while middle‐aged cats tions or foreign bodies, the onset of clinical signs is often
are more likely to be diagnosed with inflammatory rapid (usually within a few hours). Clinical signs in
bowel disease. No breed predispositions are recog- patients with gastric foreign body obstruction often
nized for primary gastric cancer in cats, but one report include lethargy, inappetence, vomiting, and antisocial
exists of two related Persians with confirmed gastritis or “hiding” behavior. Owners should be questioned
and adenocarcinoma. regarding the possibility of exposure to yarn, string,
Large‐breed, deep‐chested and working dogs (Great tinsel, needles or hair ties accessible in the house.
Danes, standard poodles, Irish wolfhound, Newfound- Intoxications secondary to chocolate (theobromine),
land, Weimaraner, mastiff and hound breeds, German macadamia nuts, mycotoxins (e.g., mushrooms, sago
shepherd dogs) are at higher risk for gastric dilation‐ palms, blue‐green algae, molds), and marijuana should
volvulus (GDV) and secondary ulceration. be considered in dogs exhibiting vomiting in association
Young to middle‐aged, spayed female dogs are more with an acute onset of neurologic abnormalities.
likely to develop hypoadrenocorticism and gastritis sec- Viral etiologies should be suspected when there is an
ondary to vomiting. Breeds such as the standard poodle, outbreak of gastrointestinal signs in multiple dogs from
Novia Scotia duck tolling retriever, Rottweiler, Great the same shelter or household. Viral gastroenteritis can
Dane and Portuguese water dog are overrepresented. cause inappetence, fever, lethargy, vomiting, and small
Geographic location influences the risk of development bowel diarrhea. Distemper is known to cause severe
of fungal gastritis. Histoplasma capsulatum is one of the neurologic signs, but manifests as gastrointestinal (inap-
most common canine mycotic pathogens in the United petence, vomiting, diarrhea) and respiratory signs early
States and manifests primarily with signs of gastrointesti- in the course of infection.
nal disease in young to middle‐aged dogs. Histoplasma As the vast majority of episodes of drug‐induced gas-
spp. infection should be ruled out in dogs displaying signs tritis and GI ulceration in the dog are caused by NSAID
of gastrointestinal disease that are living in endemic use (with or without steroids), a full drug history should
regions such as the mid‐western, southern, and Gulf be obtained for any dog (or cat) presenting with signs of
Coast regions of the US, as well as Central America. gastric disease. Dogs receiving chronic NSAID therapy
There is a higher prevalence of histoplasmosis in males with gastrointestinal signs should be regularly evaluated
compared to females, with pointers, Weimeraners, and for gastritis. A change as subtle as hyporexia should raise
Brittany spaniels identified as predisposed breeds. concern. A recent history of antibiotic administration
Pythium insidiosum has been documented in dogs with a preceding development of clinical signs should raise
travel history to or residing in tropical regions, the Gulf suspicion for an adverse reaction to medication.
Coast and mid‐western states, and northern California. Infectious gastritis should be suspected if there is
Male Labrador retrievers and German shepherd dogs are travel history to an endemic area or there has been inges-
overrepresented. Dogs infected with parvovirus, distem- tion of uncooked or raw foods. Vomiting in animals with
per virus, and coronavirus are often younger (less than pythiosis or histoplasmosis is often accompanied by
3 years of age), unvaccinated and from multidog environ- other clinical signs including diarrhea, cutaneous
ments (kennels, shelters). lesions, lymphadenopathy, and ocular abnormalities