Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland.
Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Switzerland.
Res Vet Sci. 2022 Sep;146:28-33. doi: 10.1016/j.rvsc.2022.03.014. Epub 2022 Mar 17.
Prevalence of inflammatory enteropathy versus lymphoma in dogs undergoing gastroduodenoscopy has not been evaluated. This retrospective study assessed outcome from 195 client-owned dogs scheduled to undergo upper gastrointestinal endoscopy as the next diagnostic step.
Cases were grouped into the following diagnoses according to WSAVA guidelines: lymphoplasmacytic enteritis (LPE), eosinophilic enteritis (EE), mixed-cell enteritis (ME), histologically normal biopsies (N), and lymphoma (L). Clinical signs, and preendoscopic results from laboratory and ultrasonography examinations, were compared among groups.
LPE was diagnosed in 133 (68%), EE in 17 (9%), ME in 9 (5%), 32 (16%) dogs had histologically normal biopsies. Four (2%) dogs were diagnosed with lymphoma. Vomiting was the most frequent clinical sign (61%), followed by weight loss (43%), and diarrhea (39%). Vomiting also predominated when looking at individual histological disease categories, however clinical signs did not differ significantly between groups. Dogs with lymphoma were more likely to have ultrasonographic abnormalities, had significantly lower haematocrit, albumin and total protein concentrations compared to dogs with LPE and histologically normal biopsies.
Lymphoma was rarely found in this group of dogs with nonspecific results of pre-endoscopic work-up. Our results provide first reference for clinicians when discussing the possibility of a step-up therapeutic approach (such as multiple dietary trials) with owners before pursuing endoscopy. Understanding the likelihood of finding lymphoma is important in that histologic documentation of inflammatory enteropathy alone has limited therapeutic consequences. Future studies are needed to validate these findings in dogs undergoing combined upper and lower gastrointestinal endoscopy and biopsies.
尚未评估行胃镜检查的犬中炎症性肠病与淋巴瘤的患病率。本回顾性研究评估了 195 例因上消化道内镜检查作为下一步诊断而接受检查的患犬的结果。
根据 WSAVA 指南，病例被分为以下诊断组：淋巴浆细胞性肠炎（LPE）、嗜酸性粒细胞性肠炎（EE）、混合细胞性肠炎（ME）、组织学正常活检（N）和淋巴瘤（L）。比较了各组之间的临床症状以及实验室和超声检查的内镜前结果。
诊断为 LPE 的患犬有 133 例（68%），EE 为 17 例（9%），ME 为 9 例（5%），32 例（16%）患犬组织学活检正常。4 例（2%）犬诊断为淋巴瘤。呕吐是最常见的临床症状（61%），其次是体重减轻（43%）和腹泻（39%）。在观察各个组织学疾病类别时，呕吐也占主导地位，但各组之间的临床症状无显著差异。患有淋巴瘤的犬更有可能出现超声异常，与 LPE 和组织学正常活检的犬相比，其红细胞压积、白蛋白和总蛋白浓度显著降低。
在这组非特异性内镜前检查结果的犬中，很少发现淋巴瘤。我们的结果为临床医生在与主人讨论在进行内镜检查之前采用逐步治疗方法（如多次饮食试验）的可能性时提供了参考。了解发现淋巴瘤的可能性很重要，因为炎症性肠病的组织学诊断本身的治疗意义有限。需要进一步的研究来验证这些发现，以评估在上消化道和下消化道联合内镜检查和活检的犬中是否适用。
