Lola’s GI Hypomotility
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Transcript of Lola’s GI Hypomotility
LOLA’S GI HYPOMOTILITYMason Savage, DVM
Patient: Lola Anna; #164024ACC#: 154960
History Lola - 6 year old female spayed DLH Referred in to Internal Med for:
Evaluation of a 3 month history of weight loss in the face of a ravenous appetite
Evaluation of 3 episodes of acute lethargy with decreased responsiveness requiring hospitalization.
Physical Examination GI: bladder is largely distended and
mildly thickened bowel loops are appreciated
Otherwise, unremarkable
Diagnostics Planned to begin with basic bloodwork However, unable to draw blood from
patient… so began with imaging
Thoracic Radiographs
Normal cardiopulmonary structures
Thoracic Radiographs
Stomach and cranial intestine moderately gas and fluid distended, otherwise unremarkable.
Abdominal Ultrasound
Abdominal Ultrasound Findings very similar to feline
dysautonomia
Abdominal Ultrasound
Feline Dysautonomia Feline Dysautonomia
Paper from 2010 describing common imaging findings in patient’s with this disease
Disease is autonomic ganglia degeneration Leads to failure of autonomic nervous system
Often accompanied with concurrent sypathetic nervous system dysfunctions (dilated pupils, elevated 3rd eyelids, …)
Possible sex (male) predisposition and geographic (Midwest) distribution?
Feline Dysautonomia Imaging findings
Feline Dysautonomia Imaging findings
Lola Case Progress Hospitalized overnight
Following day was laterally recumbent and non-responsive
Lola Case Progress Venous Blood Gas revealed extreme
acidemia pH of 6.8
Patient eventually diagnosed with d-lactic acidosis secondary to severe exocrine pancreatic insufficiency
Lola Case Progress
D-lactic acidosis 2’ to Severe EPI
D-lactate is produced by from bacterial flora in intestine
Reports of d-lactic acidosis in people seen with short-bowel syndrome secondary to GI surgery
Can be accompanied by GI dysmotility
Single case report (2005) in cat with similar ultrasonographic findings