Pale Mucous Membranes Research Articles

Clinico-Haemato-Biochemical Changes and Therapeutic Efficacy of Diminazene Aceturate and Artesunate against Bovine Babesiosis in Kashmir Valley

Background: The purpose of the study trial was to assess therapeutic efficacy of diminazene aceturate and artesunate with respect to clinical, haematological and biochemical changes in the cattle affected by babesiosis. Methods: For the analysis, a total of 16 clinically affected cattle were selected, with eight animals in each group. Eight healthy cattle were also selected under the control group. Clinical symptoms, blood smear microscopy and PCR-based molecular tools were used to confirm babesiosis. For the therapeutic trial, Groups I and II received treatment with diminazene aceturate and artesunate, respectively and the efficacy was estimated on the basis of survival rate, and improvement in the clinico-haemato-biochemical parameters. Result: The major clinical signs recorded were persistent high fever, pale mucous membranes, presence of ticks, decreased ruminal motility and haemoglobinuria. In diseased cattle (n=16) Hb, PCV, and TEC levels were significantly (P less than 0.05) low but with a significant (P less than 0.05) increase in TLC as compared to the control group (n=8). Significantly (P less than 0.05) neutrophilia, lymphopenia, hypoglycaemia, hypoproteinemia, hypoalbuminaemia, was recorded in the diseased group. Moreover, significantly (P less than 0.05) increased levels of BUN, creatinine, AST, LDH and iron were recorded in the infected animals. Group I treated with diminazene aceturate was the most effective and cost- efficient treatment for bovine babesiosis compared to Group II treated with Artesunate.

Some haematological and biochemical parameters assessments in sheep infection by Haemonchus contortus

The study was conducted on (100) sheep naturally infested with Haemonchus contortus, (1-3 years old), in Tikrit city, from ist January 2014 to 31th May 2014. Affected sheep exhibited clinical signs included, emaciation, weakness, pale mucous membranes, rough, easily detached and lusterless coat. Ten ml of blood samples were collected from the jugular vein of all the sheep's using disposable syringes, then take 2.5 ml from blood sample was used to determine CBC the Red blood cells (RBC), white blood cells (WBC) , Haemoglobin estimation (Hb), Packed cells Volume (PCV). The study showed reduction in RBC, hemoglobin, hematocrit and neutrophils (4.7±0.68), (6±0.74), (18±0.19), and (20±0.73) respectively. And reveled leukocytosis; Lymphocyte, eosinophil's and monocyte (11.6± 0.41), (65± 0.51), (10± 0.64) and (5± 0.29) respectively in infected sheep. and the remind samples were centrifuged at 3000 rpm for 10 minute and serum was separated and stored at -20 °c until used for measure the biochemical change by use spectrophotometer. The results showed a significant decrease (P < 0.05) in the rates of total protein concentration, albumin , iron, and zinc (5.02± 0.59 g/dl), (1.7 ± 0.45g/dl), (89.3 ± 12.41 µg/dl), (42.37± 16.22 µg/dl) respectively in the serum of infected sheep according the compared with normal sheep.

A biomaterial-based therapy using a sodium hyaluronate/bioglass composite hydrogel for the treatment of oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a chronic, inflammatory and potentially malignant oral disorder. Its pathophysiology is extremely complex, including excessive collagen deposition, massive inflammatory infiltration, and capillary atrophy. However, the existing clinical treatment methods do not fully take into account all the pathophysiological processes of OSF, so they are generally low effective and have many side effects. In the present study, we developed an injectable sodium hyaluronate/45S5 bioglass composite hydrogel (BG/HA), which significantly relieved mucosal pallor and restricted mouth opening in OSF rats without any obvious side effects. The core mechanism of BG/HA in the treatment of OSF is the release of biologically active silicate ions, which inhibit collagen deposition and inflammation, and promote angiogenesis and epithelial regeneration. Most interestingly, silicate ions can overall regulate the physiological environment of OSF by down-regulating α-smooth muscle actin (α-SMA) and CD68 and up-regulating CD31 expression, as well as regulating the expression of pro-fibrotic factors [transforming growth factor-β1 (TGF-β1), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and tissue inhibitors of metalloproteinase-1 (TIMP-1)] and anti-fibrotic factors [interleukin-1β (IL-1β)] in macrophage. In conclusion, our study shows that BG/HA has great potential in the clinical treatment of OSF, which provides an important theoretical basis for the subsequent development of new anti-fibrotic clinical preparations. STATEMENT OF SIGNIFICANCE: Oral submucous fibrosis (OSF) is a chronic, inflammatory and potentially malignant mucosal disease with significant impact on the quality of patients' life. However, the existing clinical treatments have limited efficacy and many side effects. There is an urgent need for development of specific drugs for OSF treatment. In the present study, bioglass (BG) composited with sodium hyaluronate solution (HA) was used to treat OSF in an arecoline-induced rat model. BG/HA can significantly inhibit collagen deposition, regulate inflammatory response, promote angiogenesis and repair damaged mucosal epithelial cells, and thereby mitigate the development of fibrosis in vivo.

Prevalence of oral injuries and salivary changes in patients with chronic renal failure on hemodialysis: systematic review and meta-analysis

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes.

A CLINICAL NOTE ON CANINE TRYPANOSOMIASIS

Trypanosomes are widely distributed extra erythrocytic protozoan of animals. Wereported a Trypanosomes infection from the blood of a bulldog. An 18 months old male was presentedin the Pet Hospital of RCVetS, Lahore, Pakistan with a history of anorexia, emaciation, and pyrexia.Clinical examination of the dog indicated pale mucosa due and increase capillary refill time.Microscopic examination of blood films confirmed the Trypanosomes infection. Hematologicalanalysis of the blood of the dog indicated a decrease in Total erythrocyte count, hemoglobinconcentration, and Pack cell volume except for erythrocyte sedimentation rate. Differential leukocytecount revealed all parameters were unremarkable except Neutropenia, Eosinophilia, Lymphocytosis,and Thrombocytopenia. Serum analysis showed hyperproteinemia, elevated bilirubin, Blood ureanitrogen (BUN), Hypoglycaemia, and a decreased level of Gamma-glutamyl transferase (GGT). Thisdirected us to work on heamo parasites in companion animals.

Paratuberculose clínica bovina: primeiro relato no estado do Pará

ABSTRACT The objective of this work was to describe the clinical, pathological, and serological aspects of paratuberculosis in a bullock on dairy and beef farm in the municipality of Inhangapí, state of Pará. The animal was raised extensively and presented progressive weight loss, pale mucous membranes, and chronic diarrhea. A blood sample was collected for serology by the indirect ELISA technique. Due to the unfavorable prognosis, the animal was euthanized and necropsied. At necropsy, there was thickened and wrinkled intestinal mucosa, enlarged mesenteric lymph nodes and liquid intestinal contents with a brown color. Organ fragments were fixed in 10% buffered formaldehyde, embedded in paraffin wax, cut, and stained by hematoxylin and eosin and by Ziehl-Neelsen techniques. Histopathology showed intense granulomatous infiltration with Langhans giant cells in the lamina propria and submucosa of the small intestine, Peyer patches and mesenteric lymph nodes. Ziehl-Neelsen staining revealed many intralesional acid-fast bacilli. Antibody searching against Mycobacterium avium (subsp.) paratuberculosis was positive. The diagnosis of paratuberculosis was based on epidemiological, clinical, pathological, and serological data. This is the first report of clinical paratuberculosis, confirmed by pathology and serology, in a bullock in the state of Pará.

Pitiose cutânea em equídeos no Bioma Amazônico

ABSTRACT: The study aimed to describe the clinicopathological aspects of 37 cases of pythiosis, 34 in horses and three in mules, from properties located in the Amazon biome of Pará, Brazil. The clinical signs observed in the animals were weakness, poor-to-regular nutritional status, pale mucous membranes, itching at the lesion site, and lameness when the limbs were affected. The lesions were located on the lips, nostrils, rib region, thoracic and abdominal walls, scapular, distal limbs, foreskin, perineum and udder. Macroscopically, ulcerative and granulation-tissue-like masses were observed, with fistulous tracts filled with yellowish and foul-smelling serosanguinous discharges. In the biopsy, it was possible to visualize white and firm areas with foci of yellowish necrotic material and hardened masses, called kunkers. The histopathological examination showed a pyogranulomatous inflammatory reaction with the presence of Pythium insidiosum hyphae, which were impregnated with black, confirming the diagnosis of pythiosis in equids in the Amazon biome, being the first report of the disease in mules in the region.

Pyothorax in a cat due to Acinetobacter spp. infection : a case report

A 3-month-old kitten weighing 1.05 kg was presented to the University veterinary hospital at Kokkalai in Thrissur district of Kerala, India, with the complaint of open-mouth breathing, lethargy and complete anorexia for the past three days, and weight loss. Detailed clinical examination revealed inspiratory dyspnoea without stridor, tachypnoea, muffled lung and heart sounds on auscultation, pale mucous membrane, and weak pulse. Haematology revealed leukocytosis with granulocytosis and monocytosis. Thoracic radiography, ultrasonography and thoracocentesis confirmed pyothorax. Microbial culture of thoracic aspirate revealed heavy growth of Acinetobacte spp. The cat responded to parenteral therapy with ceftiofur followed by cefixime orally for 21 days. Doxycycline was prescribed for concurrent mycoplasmosis. Thoracic radiograph 10 days later revealed a significant reduction in pleural fluid. A review of the case two months later found that the kitten recovered uneventfully. A rare case of Acinetobacter spp. associated pyothorax and its medical management in a cat is reported. The clinical manifestations, radiographic changes and ultrasonographic findings were discussed.

Autochthonous Babesia canis infections in 49 dogs in Germany.

Vector-borne diseases are of increasing importance in Germany. Since 2015, autochthonous cases have been increasingly documented in Berlin/Brandenburg. Describe autochthonous Babesia canis infection in the Berlin/Brandenburg region. Forty-nine dogs with autochthonous B. canis infection. Evaluation of history, clinical signs, laboratory abnormalities, treatment, and outcome. Dogs were presented between March and August (9) and September and January (40) in the years 2015-2021. Historical and clinical findings were lethargy (100%), pale mucous membranes (63%), fever (50%), and pigmenturia (52%). Common clinicopathological findings were thrombocytopenia (100%), anemia (85%), intravascular hemolysis (52%), pancytopenia (41%), and systemic inflammatory response syndrome (SIRS; 37%). Babesia detection was based on blood smear evaluation (n=40) and PCR targeting the 18S rRNA gene of piroplasms (n=49). Sequencing indicated 99.47% to 100% identity to B. canis sequences from GenBank. All dogs were treated with imidocarb (2.4-6.3mg/kg; median, 5mg/kg); 8 dogs received 1, 35 received 2, and 1 dog each received 3, 4, or 5 injections, respectively. Continued PCR-positive results were detected in 7 dogs after the 1st, in 5 after the 2nd, in 2 after the 3rd, and in 1 28 days after the 4th injection. Four dogs were euthanized and 3 dogs died. Autochthonous B. canis infections in Berlin/Brandenburg were associated with severe clinicopathological changes, SIRS, and multiorgan involvement. Testing by PCR during and after treatment is advisable to monitor treatment success. Screening of blood donors in high-risk areas and year-round tick protection is strongly recommended.

Myeloproliferative Syndrome - A Diagnosis on the Border Between Medical Specialties

Abstract Background. Myeloproliferative disorders define a vast and heteregenous group of neoplastic entities, characterized by malignant proliferation of blood cells. These may affect multiple tissues, some of these malignancies involving organs in which there is lymphoid tissue. Case report. A 81-year-old female patient was admitted to the Department of Internal Medicine with moderate-to-intense spontaneous pain in the left hypochondrial and in the left abdominal flank, associated with generalized fatigue and loss of appetite. According to the personal medical history, the patient is known with type II diabetes mellitus, being under treatment with oral antidiabetics (metformin 1000 mg), and arterial hypertension under treatment with candesartan. Upon admission, the physical examination revealed cutaneous and mucosal pallor and marked physical weakness. Abdominal palpation revealed pain in the left hypochondrial and in the left abdominal flank, associated with firm and massive splenomegaly, descending towards the umbilicus. Abdominal ultrasound confirmed massive splenomegaly, associated with moderate hepatomegaly. Blood analysis revealed several modifications, indicative of hypochromic normocytic anemia, associated with lymphocytosis, thrombocytopenia and neutropenia. C-reactive protein (CRP) serum levels were in normal range upon admission. All of these modifications suggested a possible leukemogenous or lymphoid malignancy, which resulted in the patient's transfer towards the Department of Hematology, for further investigations. Conclusions. Massive splenomegaly, associated with anemia and thrombocytopenia in elderly patients, should always indicate a leukemogenous or lymphoid malignancy and a thorough differential diagnosis and collaboration between internists and hematologists is required.

Yersiniose fatal por Yersinia enterocolitica em um zogue-zogue (Plecturocebus brunneus)

ABSTRACT: We described a case of fatal septicemic yersiniosis in a young adult brown titi monkey (Plecturocebus brunneus) which presented lethargy and severe anemia. Postmortem external assessment revealed marked dehydration and pale pink mucous membranes. The main gross findings included enlarged liver with yellow pinpoints, enlarged spleen with yellow nodules, mucosal ulcerations in the large intestine, enlarged mesenteric lymph nodes, and pulmonary hemorrhage. Histology revealed necrosuppurative hepatosplenitis with intralesional colonies of rod-shaped gram-negative bacteria, ulcerative colitis, reactive lymphoid hyperplasia, and fibrinous and hemorrhagic pneumonia. Bacterial culture and identification using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry confirmed the diagnosis of yersiniosis by Yersinia enterocolitica. This study indicated that yersiniosis should be considered as a differential diagnosis of death in brown titi monkeys.

Severe anemia and neutrophilic leukocytosis resembling Sweet’s syndrome in a dog

Sweet’s syndrome is a rare inflammatory condition characterized by the presence of neutrophilic infiltrate of the skin. We describe a case of severe anemia and neutrophilia with post-mortem findings resembling Sweet's syndrome in a five-years-old female Labrador Retriever with bilateral epistaxis, hematemesis, hyporexia, pale oral mucosa, and fever. Laboratory analysis evidenced severe unresponsive anemia, thrombocytopenia, and leukocytosis. Biochemistry showed hypoalbuminemia and increased ALT and SAP activities. The patient was transfused and received doxycycline and prednisone for one week without improvement. Two further blood transfusions were administered. Bone marrow analysis showed a mild erythroid hypoplasia, granulocytic hyperplasia, myeloid to erythroid ratio of 6.01:1 (reference: 0.9:1 – 1.76:1) without dysplasia, mild megakaryocytic hyperplasia, and increased iron stores. Macrophages were slightly increased in number with erythrophagocytosis, and immune-mediated anemia was considered. Immunosuppressive treatment was prescribed to reduce red blood cell destruction, but no improvement after one week was observed, and euthanasia was performed. Necroscopic findings resembled those described for the systemic form of Sweet's Syndrome. Bone marrow histopathology showed remarkably increased granulopoiesis and destruction of platelets and erythrocytes. Sweet's syndrome is frequently associated with hematologic malignancy or drug exposure. Leukemia was excluded after bone marrow analysis because no increase in blast population was seen as well as no signs of dysplasia. Previous treatment could be related to the development of Sweet's syndrome, which might be the primary event. Although rare, this syndrome should be considered in the differential diagnosis of dermatosis and leukocytosis when infectious agents are not identified.

Mycoplasma haemofelis infection and its correlation with feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) in cats in Southern Brazil

A cross-sectional study was conducted on 274 cats in Southern Brazil to estimate the prevalence of Mycoplasma haemofelis PCR, associated factors, and its correlation with ELISA for FeLV and FIV. The apparent prevalence of M. haemofelis was 6.6% (18/274) (95% CI: 3.6–9.5%), of which 33.3% (6/18) had co-infection with FeLV, 5.6% (1/18) with FIV, and 5.6% (1/18) with both. Male cats were more likely to be positive for M. haemofelis [OR: 7.07 (1.97–25.34)]. Only three M. haemofelis-positive cats showed related clinical changes, such as mucosal pallor. A statistically significant difference was observed between M. haemofelis-positive cats and the negative control group for age, hemoglobin concentration, packed cell volume, and rod neutrophil counts. Mycoplasma haemofelis is prevalent in southern Brazil, with a higher risk in male cats. Most cats could be classified as asymptomatic carriers since they were healthy.

Diabetes mellitus in domestic cats: clinical cases from veterinary practice

The aim: to analyze clinical cases of diabetes mellitus in cats and establish the effectiveness of clinical and laboratory research and treatment of animals with the help of insulin therapy.
 Materials and methods. The material for the study were domestic cats admitted to the veterinary medicine clinic "Doctor Vet" (Lviv).
 Results. Clinical case 1. Cat Bonya, age 10 years, body weight 4 kg. symptoms: polyuria/polydipsia and weight loss. Examination: cachexia, weakness, pale mucous membranes, unsteady gait. Blood glucose - 20.4 mmol/l, urine analysis - pH=6.0, glucose ++++, no ketones detected. Diagnosis: diabetes. For glycemic control - caninsulin at 0.25 IU/kg every 12 hours. After the start of insulin therapy, the animal's condition improved, after 2 months - an attack of hypoglycemia, blood glucose 3.0 mmol/l. The introduction of insulin was stopped for 10 days, after 10 days the cat's appetite is normal, polyuria and polydipsia are not observed, body weight gain is 300 g, blood glucose without insulin therapy is 8.0 mmol/l.
 Clinical case 2. Cat Eva, age 12 years, body weight 6.7 kg, symptoms: polyuria/polydipsia during the last two weeks, increased appetite, diet - raw meat, meatballs, buckwheat porridge, boiled carrots, beets. Blood glucose 22.9 mmol/l, urine analysis – pH = 6.0, glucose ++++, ketones +. Diagnosis: diabetes. Treatment: Lantus 2 IU subcutaneously every 12 hours. After the start of insulin therapy, the condition improved, after 2 months, blood glucose was 9.00 - 13.0 mmol/l; 15.00 – 8.0 mmol/l, 21.00 – 12.0 mmol/l, glucose and ketones are absent in the urine.
 Conclusions. In the first clinical case, the cat there was a decrease in demand in insulin “Caninsulin” on the background of insulin therapy. In the second clinical case, insulin therapy with the help of "Lantus" insulin allows you to reach a level of glycemia at which diabetes stops progressing, the clinical condition of the animal normalizes, which indicates the effectiveness of the prescribed treatment. Thus, we can say that diabetes in small domestic animals is a rather severe endocrine pathology, which has typical clinical and laboratory symptoms and can be successfully treated with the help of a complex medical and diagnostic approach, based on insulin therapy

Clinico-morphological and Molecular Detection of Bovine Tropical Theileriosis in Cattle

Background: Theileria spp. were targeted for detection and differentiation from clinical samples using PCR in the current investigation and the diagnostic sensitivity of this method was evaluated in comparison to microscopic observations. The clinical characteristics of bovine tropical theileriosis as clinical markers were also analysed based on the PCR data. Methods: On the basis of clinical evaluation and microscopic inspection of blood smears, 200 blood samples from cattle suspected of having theileriosis were examined. To confirm the disease, the PCR method was employed by using 18S rRNA and Cyto b1 gene to confirm Theileria spp. and Theileria annulata respectively in clinical samples. Result: The results showed that microscopic examination detected 65/200 (32.50%), whereas, the PCR assay identified 120/200 (60.00%) for Theileria spp. Of the total 200 samples studied, 77 (38.50.3%) were positive for T. annulata specific PCR. Based on PCR confirmation of T. annulata infection in cattle, the predominant clinical signs were pyrexia, ticks’ infestations, anorexia, enlargement of lymph node, pale mucous membrane, lacrimation, coughing, drop in milk production and emaciation. The other clinical signs were observed as icterus, nasal discharge, salivation, melena and exophthalmia.

Gejala Klinis Ehrlichiosis Pada Pasien Anjing Di Yogyakarta

Canine monocytic ehrlichiosis is a potentially fatal disease in dogs and requires an early diagnosis to start therapy properly so that it produces a good prognosis. The research was conducted to determine ehrlichiosis in Yogyakarta based on clinical, hematological, and molecular diagnoses using the gltA gene. A total of 51 dog patients who were suspected of ehrlichiosis were performed anamnesis, clinical examination, then blood samples were taken for molecular examination with PCR. The molecular examination results of dog patients who were positive for ehrlichiosis based on PCR were 33.3% (17/51), with clinical symptoms which were 58.8% weak (10/17), 47% anorexia (8/17), 47% (8/17) gastrointestinal disorders (diarrhea and vomiting), 41.1% (7/17) pale mucosa, 35.2% (6/17) tick infestation, 35.2% (6/17) fever, 29,4% (5/17) dehydration, 11.7% (2/17) bleeding. The conclusion of this study is that the clinical of patients with erhlichiosis are very varied.

Comparison of gastric reactance with commonly used perfusion markers in a swine hypovolemic shock model

BackgroundThe gut has been hypothesized to be a protagonist tissue in multiple organ dysfunction syndrome (MODS) for the past three decades. Gastric reactance (XL) is a potential perfusion marker derived from gastric impedance spectroscopy (GIS), which is an emerging tool through which living tissue can be continuously measured to determine its pathophysiological evolution. This study aimed to compare the performance of XL [positive predictive values (PPV), negative predictive values (NPV), and area under the curve (AUC)] against commonly used perfusion markers before and during hypovolemic shock in swine subjects.MethodsProspective, controlled animal trial with two groups, control group (CG) N = 5 and shock (MAP ≤ 48 mmHg) group (SG) N = 16. Comparison time points were defined as T-2 (2 h before shock), T-1 (1 h before shock), T0 (shock), T1 (1 h after shock), and T2 (2 h after shock). Shock severity was assessed through blood gases, systemic and hemodynamic variables, and via histological examination for assessing inflammation-edema and detachment in the gastric mucosa. Macroscopic assessment of the gastric mucosa was defined in five levels (0—normal mucosa, 1—stippling or epithelial hemorrhage, 2—pale mucosa, 3—violet mucosa, and 4—marmoreal mucosa). Receiver Operating Characteristic (ROC) curves of perfusion markers and XL were calculated to identify optimal cutoff values and their individual ability to predict hypovolemic shock.ResultsComparison among the CG and the SG showed statistically significant differences in XL measurements at T-1, T0, T1, and T2, while lactate showed statistically significant differences until T1 and T2. Statistically significant differences were detected in mucosa class (p < 0.001) and in inflammation-edema in the gastric body and the fundus (p = 0.021 and p = 0.043). The performance of the minimum XL value per subject per event (XL_Min) was better (0.81 ≤ AUC ≤ 0.96, 0.93 ≤ PPV ≤ 1.00, 0.45 ≤ NPV ≤ 0.83) than maximum lactate value (Lac_Max) per subject per event (0.29 ≤ AUC ≤ 0.82, 0.82 ≤ PPV ≤ 0.91, 0.24 ≤ NPV ≤ 0.82). Cutoff values for XL_Min show progressive increases at each time point, while cutoff values for Lac_Max increase only at T2.ConclusionsXL proved to be an indirect and consistent marker of inadequate gastric mucosal perfusion, which shows significant and detectable changes before commonly used markers of global perfusion under the hypovolemic shock conditions outlined in this work.

Surgery Management Post Ovulatory Egg Stasis in Corn Snake (Pantherophis guttatus)

Post Ovulatory Egg Stasis or dystocia is difficulty releasing eggs. The incident was experienced by a female snake due to an obstructive tract. A four years old corn snake (Pantherophis guttatus) female with clinical symptoms that appear are anorexia for two weeks. The condition of the coelomic cavity is still large after 7 days of laying eggs. The results of physical examination showed that the snake had a distended coelomic cavity, pale mucous membrane, hard and smooth palpation when palpated. The results of x-ray examination showed that there was an oval radiopaque formation in the coelomic cavity. Coeliotomy surgery is performed to remove the eggs by the salpingotomy method. The general anesthetic used was a combination of zolazepam-tiletamine at a dose of 10 mg/kg body weight and meloxicam 0,1 mg/kg body weight was given. Postoperative therapy was oxytetracycline 10 mg/kg body weight, dexamethasone 5 mg/kg body weight and vigantol E® 0,1 mg/kg body weight. The general condition of the snake after 5 days improved and the wound had dried up. Then 2 weeks after surgery the stitches in the skin were removed when shedding of the skin.

S2675 Ischemic Gastropathy vs. Severe H. pylori Gastritis in a Patient With Extensive Vascular Disease

Introduction: Approximately half of gastric ulcers are associated with H. pylori. Conversely, gastric ulceration secondary to ischemia is rare due to the stomach’s abundant vascular supply from all three branches of the celiac artery. Here we present a case of a patient with upper gastrointestinal bleeding and concern for gastric ischemia who was diagnosed with H. pylori associated gastritis. Case Description/Methods: A 70-year-old female with severe peripheral artery disease, abdominal aortic aneurysm status post endovascular repair, hypertension, HIV, chronic kidney disease and B-cell lymphoma was admitted for pathologic right hip fracture and underwent open reduction and internal fixation. The procedure was complicated by lactic acidosis, an elevated troponin, and transaminitis in the setting of intraoperative hypotension. Six days later the patient had coffee ground emesis and melena with a lactate of 9.8 mmol/L and a hemoglobin of 6.4 g/dL, from 8.9 g/dL one day prior. 2 units of packed red blood cells were administered, anticoagulation was stopped, and a proton pump inhibitor was given. CT angiography of the abdomen and pelvis demonstrated splenic infarction, marked attenuation of multiple mesenteric vessels including the celiac artery, concern for ischemia of the stomach and cecum, and significant distention of the stomach (Figure A). Upper endoscopy demonstrated severe gastric mucosal pallor and decreased vascular pattern, diffuse linear erosions throughout the gastric fundus and body, and multiple large superficial ulcerations without active bleeding (Figure B and C). Given the appearance of the mucosa and overall clinical picture, there was concern for ischemic gastritis and biopsies were taken. Histology later revealed erosive gastritis, regenerative change and H. pylori without evidence of microthrombi or changes consistent with ischemia and the patient was started on quadruple therapy for H. pylori gastritis. She had one further episode of melena and received an additional blood transfusion before she was discharged one week later. Discussion: Our patient had extensive vascular disease and systemic hypotension with endoscopic findings highly suspicious for ischemic injury but with biopsies consistent with severe H. pylori gastritis. Although ischemic gastropathy should be considered in cases of an upper GI bleed in patients with vascular risk factors, careful histopathologic review is important for accurate diagnosis, and severe presentations of more routine diagnoses should also be considered.Figure 1.: A) CT angiography of the abdomen and pelvis demonstrating significant gastric distention. B) Esophagogastroduodenoscopy demonstrating mucosal pallor and C) large ulcerations within the gastric body.

S3539 ANCA-Associated Leukocytoclastic Vasculitis With Mesenteric Involvement

Introduction: Leukocytoclastic vasculitis (LCV) is a usually self-limiting, idiopathic small-vessel vasculitis with cutaneous symptoms. Extracutaneous manifestations should raise suspicion for underlying autoimmune conditions such as ANCA-associated vasculitis, of which LCV may be the initial manifestation. Mesenteric involvement is uncommon and usually represents advanced disease. Delay in recognition of mesenteric vasculitis can lead to progression and perforation. We present a case of gastrointestinal (GI) hemorrhage caused by ANCA-associated LCV. Case Description/Methods: A 69-year-old male with a history of bilateral inguinal hernia repair was admitted for post-surgical groin wound infection. He was started on antibiotics and underwent mesh removal, washout, and debridement. He developed shock, renal failure, small vessel ischemic cerebrovascular infarction, and upper extremity papular eruptions. Work-up was notable for elevated inflammatory markers, decreased C3, negative ANA, positive C-ANCA and negative P-ANCA. He met Sapporo criteria for antiphospholipid syndrome given small vessel arterial thrombosis and positive lupus anticoagulant. Shave biopsy of skin lesions confirmed LCV. He was started on IV methylprednisolone and heparin infusion. He subsequently developed melena and anemia. EGD showed grade C esophagitis, gastropathy, and diffuse erosive duodenopathy (Figure). He was diagnosed with ANCA-associated LCV with mesenteric involvement. Bleeding resolved after holding heparin and treatment with pantoprazole. He was transitioned to prednisone and started on rituximab with significant improvement. Discussion: Though uncommon, mesenteric vasculitis merits consideration in patients with abdominal pain or GI bleeding and clinical evidence of systemic autoimmune disease. Symptoms arise from intestinal ischemia which can progress to infarction and perforation if untreated. Endoscopy should be pursued with great caution due to increased perforation risk. Histopathology of superficial mucosal biopsies usually shows mucosal damage but does not yield a definitive diagnosis. Classic endoscopic findings include mucosal pallor, edema, or necrosis dispersed between normal mucosa. Ulcers and bleeding can be seen in severe cases. Timely recognition of GI manifestations of ANCA-associated LCV and initiation of therapy are pivotal in ensuring reduction of morbidity, mortality, and the need for surgery. A high index of suspicion for infarction or perforation warrants early surgical intervention.Figure 1.: Endoscopic evidence of diffuse erosive duodenopathy interspersed between normal mucosa in the setting of mesenteric vasculitis.