Gastric neoplasia best treated surgically
Nov 01, 2003
Signalment: Canine, Labrador Retriever/Collie cross, 7 years old, male neutered, 57 lbs.
Clinical history: The dog presents with poor appetite and moderate lethargy for two months and weight loss. The results of the Ehrlichia canis and Lyme disease tests are negative and the Rocky Mountain spotted fever test is positive at 1:128. Therapy has included tetracycline.
Physical examination: The findings include rectal temperature 102.6° F, heart rate 120/min, slightly pale mucous membranes, and normal capillary refill time. Normal heart and lung sounds are heard. Abdominal distension, thinness, and generalized muscle wasting are noted.Laboratory results: A complete blood count, serum chemistry profile and urinalysis are outlined in Table 1.
Ultrasound examination: Thorough abdominal ultrasonography was performed.
Cytologic examination: About 1,300 milliliters of ascitic fluid was removed prior to further ultrasonographic evaluation. Fine needle aspirations of the stomach wall and sample of ascitic fluid for cytologic examination were collected and submitted for laboratory evaluation.
The cytologic results indicate gastric wall adenocarcinoma and neoplastic effusion secondary to disseminated carcinoma (carcinomatosis).
Case management: In this case, gastric wall adenocarcinoma with metastatic spread is the clinical diagnosis. Clinically, there is not much one can do for this case with this histopathologic diagnosis. Chemotherapy may be attempted but carries a grave prognosis.
Other malignant tumors include leiomyosarcoma and lymphoma. Benign tumors (adenomas and leiomyomas) are uncommon and affect older dogs (average age being 16 years).
Diagnostic considerations Dogs with gastric adenocarcinoma usually present with vomiting, anorexia and weight loss. The duration of clinical signs is from weeks to months. Definitive diagnosis of neoplasia requires full-thickness biopsy of the stomach. However, a tentative diagnosis may be made based on supportive signalment and history. Clinical pathology findings are inconsistent. Pre-renal azotemia, hypokalemia, hypochloremia, metabolic alkalosis, anemia and hypoalbuminemia can occur because of chronic vomiting.
Survey and contrast radiography, endoscopy and ultrasonography may be used in the diagnosis of gastric adenocarcinoma in dogs.