A 5 yr old, male, neutered mixed-breed dog was referred for persistent vomiting 2 wk following a pyloric biopsy for a pyloric outflow obstruction. Histopathology at the time of initial surgery was suggestive of pythiosis. Following referral, the dog underwent radical surgical treatment with a Billroth II procedure, partial pancreatectomy, and cholecystoduodenostomy. Histopathology and serology confirmed the diagnosis of pythiosis and medical treatment consisting of itraconazole and terbinafine was started postoperatively. Serology titers were checked again at 8, 12, and 24 wk postoperatively revealing a positive response to treatment and no reoccurrence of pythiosis. Since surgery, the patient experienced waxing and waning elevations of liver values and laparoscopic liver biopsies 10 mo postoperatively revealed hepatic cirrhosis with fibrosis, bile duct hyperplasia, and chronic inflammation. This report documents successful treatment of pyloric/duodenal pythiosis and the long-term (17 mo) consequences associated with the Billroth II, partial pancreatectomy, and biliary rerouting in the dog.
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November/December 2015
Case Reports|
November 01 2015
Surgical and Medical Treatment of Pyloric and Duodenal Pythiosis in a Dog
David Lee Dycus, DVM, MS;
David Lee Dycus, DVM, MS
From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
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Cory Fisher, DVM, MS;
Cory Fisher, DVM, MS
From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
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Ryan Butler, DVM, MS
Ryan Butler, DVM, MS
From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
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J Am Anim Hosp Assoc (2015) 51 (6): 385–391.
Citation
David Lee Dycus, Cory Fisher, Ryan Butler; Surgical and Medical Treatment of Pyloric and Duodenal Pythiosis in a Dog. J Am Anim Hosp Assoc 1 November 2015; 51 (6): 385–391. doi: https://doi.org/10.5326/JAAHA-MS-6217
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