Canine ileus is a secondary disease caused by a physiological or anatomical interruption in the normal peristalsis of the intestine, resulting in weak irregular contractions leading to dysmotility and temporary or permanent obstruction.
Regardless of cause, ileus usually results in hypercolonization of proximal parts of small intestine with aerobic and anaerobic microorganisms, leading to mucosal release of nitrous oxide, and inflammatory mediator that directly interferes with gastrointestinal motility.
Ileus can affect any part of the intestine from stomach to rectum, but usually involves the small intestine.
- Abdominal trauma
- Postoperative ileus - usually temporary disorder, responsive to therapy
- Drugs - morphine, codeine-based antitussives, acetaminophen
- Mechanical obstruction due to cecoliths, emphysematous pyometra, megacolon or abdominal tumors
- Gastroenteritis - e.g. canine parvovirus
- Intestinal foreign bodies
- Intestinal volvulus or intussusception
- Chronic intestinal pseudo-obstruction (leiomyositis) - predisposition in the English Bulldog and Bernese Mountain Dog
- Septic shock syndrome
- Acute tumor lysis syndrome
- Toxins - e.g. lead
- Intestinal polyposis
Clinically affected dogs usually present with anorexia, vomiting, depression and mild abdominal distension.
Chronic idiopathic pseudo-obstruction is a severe syndrome caused by intestinal neuromuscular disease resulting from disorders of myenteric plexi, abnormalities of the interstitial cells of Cajal or primary involvement of intestinal smooth muscle cells. These dogs typically present with a distended, painful abdomen, chronic anorexia, vomiting and diarrhea non-responsive to therapy.
Blood tests usually show varying degrees of metabolic alkalosis due to intestinal loss of anions.
On radiographs, anatomical ileus (due to obstruction) typically produces a nonuniform intestinal distension with a greater degree of distension than is seen with physiological ileus (often seen postoperatively). In chronic pseudo-obstructive cases, distended gas-filled loops are evident.
Ultrasonography may assist elucidation of pendulous movement of the ingesta inside a dilated bowel, invaginated intestines or an ingested intraluminal foreign body, non-uniform peristaltic activity of the dilated intestines or akinetic intestinal loops together with abdominal fluid accumulation.
Treatment includes use of prokinetic drugs such cisapride, lactulose, use of warm enemas and enteral supplementation with glutamine or S-methylisothiourea sulfate ( a nitrous oxide synthetase inhibitor).
Most cases of post-operative ileus respond to therapy.
- Vet XRay
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