Emphysematous hepatitis, emphysematous gastritis, and pneumatosis coli in a 5-month-old Shiba Inu dog

Abstract

A 5-month-old spayed female Shiba Inu dog was presented because of acute vomiting, diarrhea, and weakness. The dog had undergone elective ovariohysterectomy, received nonsteroidal anti-inflammatory medication, and undergone an intestinal biopsy 1 d before presentation. On physical examination, the dog was in shock and had abdominal pain. There were an increased hematocrit, band neutrophilia with toxic change, and elevated urea concentration and liver enzyme values. Abdominal ultrasound revealed gas foci within the gastric wall, hepatic parenchyma, and colonic wall, consistent with emphysematous infection. Fecal analysis revealed low levels of Clostridium perfringens alpha toxin gene. The dog was treated medically with intravenous fluids, antimicrobial therapy, gastric decompression, and supportive treatments. Rapid clinical improvement was noted, accompanied by improvements on repeat abdominal ultrasonography examinations and blood work. A positive outcome was observed in this dog. The etiology for emphysematous infection was unclear, with multiple risk factors reported in human literature. In this case, administration of nonsteroidal anti-inflammatory medication, preexisting enteropathy, and recent abdominal surgery may have contributed to disease development. This is the first report of concurrent emphysematous gastritis, pneumatosis coli, and emphysematous hepatitis in a dog. This case report could aid practitioners in recognizing, diagnosing, and treating emphysematous infections in dogs with acute abdominal symptoms. Key clinical message: This is the first report of concurrent emphysematous gastritis, pneumatosis coli, and emphysematous hepatitis in a dog. The report provides information regarding the pathogenesis of, risk factors for, and diagnosis and treatment of emphysematous infections.

FIGURE 1

A — Ultrasonographic image of the dog’s stomach showing multiple gas foci (arrows) within the gastric wall, consistent with emphysematous gastritis. The luminal surface is mildly roughened (star). B — Ultrasonographic image of the dog’s colon showing gas foci (arrows) within the colonic wall, consistent with pneumatosis coli.

FIGURE 2

A — Ultrasonographic image of the dog’s small intestine showing ulceration and enteritis. These are fluid-filled with altered wall layering, increased mucosal echogenicity, and multifocal sloughing (arrows). B — Ultrasonographic image of the dog’s liver showing multiple gas foci (arrows) within the parenchyma, consistent with emphysematous hepatitis. There is a diffuse decrease in hepatic echogenicity.

FIGURE 3

A — Ultrasonographic image of the dog’s stomach and liver on Day 2. There is marked improvement in the amount of gas within the gastric wall (arrows) and hepatic parenchyma (star). The gastric luminal surface is roughened with gas foci dissecting the mucosa and there is moderate thickening of the mucosal and submucosal layers. B — Ultrasonographic image of the dog’s colon on Day 2. There is resolution of the previously described gas within the colonic wall (stars). C — Ultrasonographic image of the dog’s liver on Day 2. There are only a few gas foci remaining (arrows). The liver remains mildly decreased in echogenicity.