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Small intestine: chronic disease

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Abstract

The major clinical manifestations of chronic small intestinal disease, namely diarrhoea, vomiting and weight loss, reflect perturbations in the digestive and absorptive function of the small intestine and its resident bacterial population. This chapter considers a variety of infectious diseases and chronic enteropathies.

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Figures

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34.10 Thickening of the intestinal wall in a 12-year-old Domestic Shorthaired cat presented for the investigation of chronic diarrhoea and weight loss of 6 months’ duration. Note the prominent muscularis, which can be seen with both inflammatory diseases and intestinal lymphoma. Histopathology of duodenal and ileal mucosal biopsy samples was compatible with moderate to severe intestinal inflammation. Final diagnosis: lymphoplasmacytic enteritis.
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34.11 Ultrasonographic changes in the intestinal mucosa of an 18-month-old English Bulldog presented for the investigation of severe weight loss and chronic diarrhoea. Note the hyperechoic mucosal striations (arrowed), which are highly suggestive of intestinal lymphangiectasia. Milky fluid may be seen oozing when intestinal biopsy samples are taken. Histopathology revealed severe intestinal lymphangiectasia with mild neutrophilic inflammation. Final diagnosis: primary intestinal lymphangiectasia causing protein-losing enteropathy. (Courtesy of Gerard McLauchlan, Small Animal Medicine Department, University of Glasgow)
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34.12 Endoscopic changes in the duodenum of dogs with chronic inflammatory enteropathies. (a) Hyperaemia, ulceration and mucosal friability are visible. (b) The duodenal mucosa is very irregular and the individual villi cannot be appreciated.
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34.13 Endoscopic changes in the duodenum characteristic of lymphangiectasia with the white spots being dilated lacteals.
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34.16 (a) Computed tomography angiogram of a dog with respiratory complications associated with protein-losing enteropathy (PLE). Note the filling defects in the main caudal lobar arteries (arrowed), consistent with pulmonary thromboembolism. (b) Post-mortem examination revealing a large thrombus in the pulmonary artery (arrowed) of a dog that died from thromboembolic complications of PLE secondary to chronic inflammatory enteropathy. (b, Reproduced with permission of Linda Morrison, Department of Veterinary Pathology, University of Edinburgh)

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