YU Pyloroplasty for the Correction of Chronic Hypertrophic Pyloric Gastropathy in Canines
Background: One of the causes of delay gastric emptying is the chronic hypertrophic pyloric gastropathy, unusual disease that can occur in acquired or congenital form. It is characterized by hypertrophy of the antral mucosa, by thickening of the muscular layer, or by hyperplasia of the pylorus. The animals are presented with a history of chronic intermittent vomiting. Treatment is based on surgical correction through techniques such as pyloromyotomy or transverse or Y-U pyloroplasty. Thus, the aim was report three cases of pyloric stenosis by hypertrophy in dogs of the breeds, Fila Brasileiro, English Bull Terrier and American Pitbull Terrier, emphasizing the diagnosis and therapy instituted.
Cases: All animals in this study reached the Veterinary Hospital of the Federal University of Mato Grosso with a history of chronic intermittent vomiting. The findings of physical and laboratory examinations in all animals were unspecific, with those important to rule out other causes of vomiting. Contrast radiographic evaluation revealed marked stomach distension and delayed gastric emptying, indicated gastric outflow obstruction. In one case, a video endoscopy was performed. The images reveal hyperemia of the gastric mucosa with small areas of bleeding around the stomach. It was observed intense production of gastric juice and the presence of the same reflux. In the pyloric antrum, a thick fold reddish gastric mucosa, which partially obstructed the pyloric ostium. There was very little motility during the examination. As therapeutic approach for all cases, we opted for performing the surgical technique of pyloroplasty in Y-U, consisting of enlarging the diameter of the antral pyloric region in an attempt to create a broader pylorus, what make possible an emptying a gastric rapidly. All the pacients remained in hospital in the postoperative period receiving medications intravenously. Postoperative fluid based on Ringer’s lactate solution and administration of ondansetron (0.2 mg/kg every 8 h), sucralfate (30 mg/ kg every 12 h), sulfadoxine to trimethoprim (20 mg/kg every 12 h) and meloxicam (0.2 mg/kg every 24 h). Twelve h of fasting after the surgical procedure without vomiting, the dog received light past food. An average of three to four days post-surgical discharged with recommendations to keep antibiotic therapy for ten days and light diet. The fifteenth day of surgery, the patients returned for removal of skin spots, with good general condition and satisfactory healing. No cases of vomiting were reported. As the case one returned to perform the monitoring gastograma. The dog was anesthetized and giving the contrast. On radiographs, there was a slight delay in gastric emptying, which can be explained by the anesthesia used for contrast administration, as described in the literature. The images showed stomach and intestines in size, shape and normal position. The technique was satisfactory in reducing clinical signs in all these cases, confirmed by the absence of vomiting in the post-operative period.
Discussion: The surgical technique used, pyloroplasty Y-U consists of traspor a part of the antral wall to the pyloric region in an attempt to create a broader pylorus, and possibly a time soon gastric emptying. It was possible to demonstrate with only three cases the pyloroplasty Y-U proved to be a simple and effective technique for the treatment of hypertrophic pyloric stenosis with a favorable prognosis in all cases. Thus, disease should be considered in the differential diagnosis in cases of gastric outflow obstruction, regardless of patients age.
Keywords: dog, hypertrophy, pylorus.
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