Purulent fibrous and necrotizing ileitis secondary to intussusception associated with infection by Giardia intestinalis and Cystoisospora felis in a cat - case report

Jéssica Karoline De Oliveira Chaves,Diefrey Ribeiro Campos,Emily Andressa Santos Lima,Cecília Lopes Da Conceição,Debora Azevedo Borges,Fabio Barbour Scott

doi:10.29374/2527-2179.bjvm107320

Abstract

Intussusception is the prolapse of an intestinal segment in the lumen of the adjacent intestinal loop.Although usually idiopathic, one of the predisposing factors is intestinal parasitism. The aim of this reportis to describe the unusual case of ileo-ileal intussusception in a kitten co-parasitized by Cystoisosporafelis and G. intestinalis A three-month-old mixed breed cat was treated after suffering from intermittentvomiting, prostration, progressive weight loss, abdominal discomfort, and diarrhea for two days. Thepresence of numerous Giardia intestinalis cysts and C. felis oocysts were detected in feces samples. Thetherapeutic protocol did not produce the expected result, and the patient evolved to hypovolemic shockand perished. During emergency care, it was possible to detect a palpable cylindrical abdominal massin the caudal region of the abdomen. At necropsy, necrotizing purulent fibrinous ileitis secondary tointussusception was observed. Intestinal hyper-peristalsis associated with intense parasitism by theseprotozoa suggested the participation of these parasites in the genesis of the disease. Early diagnosis ofinfection by these parasites is vital to improve patient life quality and the accuracy of intussusceptionprognosis due to intestinal disorders caused by parasitism.

Highlights

Intussusception is a pathology characterized by the invagination or prolapse of an intestinal segment called the intussuscept into the lumen of the adjacent portion of the intestine called the intussuscipiens (Patsikas et al, 2003; Patsikas et al, 2005; Levitt & Bauer, 1992; Baral, 2015), resulting in reduction of the intestinal lumen and total or partial obstruction of the segment, which can cause ischemia, necrosis and intestinal ruptures in serious cases (Levitt & Bauer, 1992)
The diversity of unspecific clinical signs of gastrointestinal disease frequently causes difficulties in the diagnosis and clinical care of patients, but usually the best sign is detected by abdominal palpation, revealing a firm tubular structure, present in the majority of affected cats (Baral, 2015), as observed in the present case and reported by Patsikas et al (2003), who described it in 100% of the evaluated animals in their study
Levitt & Bauer (1992), analyzing 9 cats and 27 dogs, observed that 51% of the animals suffered from enterocolic intussusception and 49% enteroenteric intussusception, with restriction of the jejunum or ileum

Summary

Introduction

Intussusception is a pathology characterized by the invagination or prolapse of an intestinal segment called the intussuscept into the lumen of the adjacent portion of the intestine called the intussuscipiens (Patsikas et al, 2003; Patsikas et al, 2005; Levitt & Bauer, 1992; Baral, 2015), resulting in reduction of the intestinal lumen and total or partial obstruction of the segment, which can cause ischemia, necrosis and intestinal ruptures in serious cases (Levitt & Bauer, 1992) This disorder can occur in any portion of the gastrointestinal tract, but in small animals like dogs and cats its appearance is usually observed in the ileocolic segment (enterocolic portion) (Patsikas et al, 2003; Patsikas et al, 2005; Levitt & Bauer, 1992; Burkitt et al, 2009). In the remaining organs (kidney, spleen, liver, heart and lung), no microscopic changes were observed

Discussion

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Conclusion