Abstract

To assess the utility of abdominal ultrasonography in the diagnostic work-up of dogs with diarrhoea. Retrospective cross-sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work-up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records. Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work-up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound-guided fine-needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive. These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea.

Highlights

  • Diarrhoea, an increase in volume, frequency and/or water-content of faeces, is a common reason for dogs to be presented for veterinary consultations

  • abdominal ultrasonography (AUS) results were associated with subsequent work-up as follows: no abnormalities on AUS and dietary trial; focal thickening of the intestinal wall, loss of intestinal wall layers and/or enlarged abdominal lymph nodes and ultrasound-guided fine needle aspirates (FNA); diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and small intestinal foreign body and coeliotomy

  • Score 3: No utility – AUS was normal and cause of diarrhoea was subsequently shown to be unassociated with morphologic lesions; or if abnormalities were found by AUS, the findings were non-specific signs of diarrhoea; or abnormalities found by AUS were considered unrelated to diarrhoea

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Summary

Introduction

An increase in volume, frequency and/or water-content of faeces, is a common reason for dogs to be presented for veterinary consultations. Many causes of diarrhoea have been recognised, including dietary indiscretion, parasitism, viral or bacterial infections, inflammatory bowel disease (IBD), lymphangiectasia, gastrointestinal neoplasia and metabolic disorders (Allenspach, 2013). Many dogs with acute diarrhoea are managed satisfactorily with empirical treatment, diagnostic work-up is indicated, in dogs with recurrent or chronic diarrhoea. A trial period with an elimination diet or hydrolysed diet is indicated in dogs with suspected food responsive disease (Burgener et al 2008, Allenspach, 2013, Allenspach et al, 2016). Endoscopic biopsies may be useful, in differentiation of IBD from neoplasia (Allenspach, 2013)

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