This 2-year-old MN Labrador Retriever presented for chronic vomiting and lethargy that was not responsive to empirical medical treatment. The clinical exam revealed a low body condition score but was otherwise unremarkable. Radiographs were unremarkable. The CBC and chemistry revealed moderate leukocytosis with a left shift, mildly elevated amylase and mildly elevated total protein with mild hypoalbuminemia and hypoglycemia.
This 2-year-old MN Labrador Retriever presented for chronic vomiting and lethargy that was not responsive to empirical medical treatment. The clinical exam revealed a low body condition score but was otherwise unremarkable. Radiographs were unremarkable. The CBC and chemistry revealed moderate leukocytosis with a left shift, mildly elevated amylase and mildly elevated total protein with mild hypoalbuminemia and hypoglycemia.
Case Study
Lymphoplasmacytic Eosinophilic Gastritis in a 2 year old MN Labrador Retriever dog
Sonographic Differential Diagnosis
Neoplasia and severe inflammatory or granulomatous (i.e. pythiosis) disease with mural fibrosis.
Image Interpretation
On the single transverse image of the stomach, marked wall thickening with complete loss of mural layering is noted. The ill-defined echogenic region may suggest the presences of fibrosis possibly secondary to chronic inflammation, ischemia or necrosis in the lower right part of the image at the 4 o`clock position. The longitudinal images of the SI demonstrate similar, however less severe, findings as the stomach.
DX
Outcome
The patient responded extremely well to a duck and potato based hypoallergenic diet, tapering dose of prednisone, gastrointestinal protectants, and deworming. The patient was asymptomatic with good body condition 4 months post diagnosis.
Comments
No video is available on this patient.
Clinical Differential Diagnosis
GI pathology – IBD, Addison’s disease, pancreatitis, gastroenteritis, dietary intolerance, infectious/Helicobacter foreign body, intussusception, toxicosis, neoplasia less likely
Sampling
Surgical full thickness biopsies of the stomach revealed mild lymphoplasmacytic eosinophilic gastritis and severe enteritis of similar cell type but with granulomatous progression. Concurrent moderate neutrophilic lymphadenitis was also present.
Patient Information
Clinical Signs
- Lethargy
- Vomiting
Exam Finding
- Weight loss
Images
Blood Chemistry
- Albumin, Low
- Amylase, High
- Glucose, Low
- Total Protein, High
CBC
- Left Shift
- WBC, High
Clinical Signs
- Lethargy
- Vomiting