Encapsulating peritoneal sclerosis

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Laparoscopic view of a dog with EPS, showing how abdominal organs are invisible since they are encapsulated by a thick fibrous membranous tissue[1]

Encapsulating peritoneal sclerosis (EPS) is a rare disease of dogs which appears similar to peritonitis and is characterized by the formation of sheets of fibrous tissue covering the abdominal organs, which consists of a proliferation of fibroconnective tissue in the peritoneum associated with a chronic inflammatory infiltrate[2].

Most affected dogs develop ascites, prominent peritoneal and serosal fibrosis and intestinal adhesions, however, other clinical parameters are variable, indicating multifactorial etiology of canine EPS as suggested in humans.

Possible etiologic factors of canine EPS include steatitis[3], leishmaniasis[4], Histoplasma capsulatum[5], fiberglass ingestion[6], chronic bacterial peritonitis, foreign body peritonitis[7] and past history of abdominal surgery[8].

Clinically affected dogs present with anorexia, vomiting, weight loss, abdominal distension due to ascites, abdominal pain and a palpable abdominal mass.

Preoperative diagnosis is difficult and most cases are diagnosed at the time of laparotomy.

Exploratory laparotomy usually reveals a fibrous membrane encapsulating the abdominal organs.

Use of prednisolone may resolve symptoms in the short-term. Aggressive surgery including enterolysis and open abdominal lavage and the addition of tamoxifen has proven effective on some cases.

Pre- and post-operative steroid therapy has been proved beneficial in human EPS patients with abdominal inflammation, but prognosis with most canine cases is poor.

References

  1. Izawa T et al (2011) Encapsulating peritoneal sclerosis associated with abnormal liver development in a young dog. J Vet Med Sci 73(5):697-700
  2. Boothe HW et al (1991) Sclerosing encapsulating peritonitis in three dogs. J Am Vet Med Assoc 198(2):267-270
  3. Hardie EM et al (1994) Sclerosing encapsulating peritonitis in four dogs and a cat. Vet Surg 23(2):107-114
  4. Adamama-Moraitou KK et al (2004) Sclerosing encapsulating peritonitis in a dog with leishmaniasis. J Small Anim Pract 45(2):117-121
  5. Clemans JM et al (2011) Retroperitoneal pyogranulomatous and fibrosing inflammation secondary to fungal infections in two dogs. J Am Vet Med Assoc 238(2):213-219
  6. Hardie, EM et al (1994) Sclerosing encapsulating peritonitis in four dogs and a cat. Vet Surg 23:107–114
  7. Etchepareborde S et al (2010) Use of tamoxifen in a German shepherd dog with sclerosing encapsulating peritonitis. J Small Anim Pract 51(12):649-653
  8. Bellenger, CR & Rothwell, TL (1991) Sclerosing encapsulating peritonitis in a dog. Aust Vet Practit 21:131– 134
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