Introduction

• Causes:
  • Foreign body obstruction Stomach: foreign body.
  • Chronic hypertrophic pyloric gastropathy (CHPG) Stomach: chronic hypertrophic gastritis , and rarely hypergastrinemia associated HPG gastrinoma.
  • Congenital pyloric stenosis Stomach: pyloric stenosis.
  • Intra- or extra-luminal neoplastic disease Stomach: neoplasia.
  • Fungal granulomas.
• Apart from gastric foreign bodies, the most common cause is CHPG in middle-aged small breeds (<l0 kg), eg Dachshund, Cavalier King Charles Spaniel, Lhasa Apso, Shi Tzu.
• Signs: vomiting.
• Diagnosis: radiographic demonstration of delayed gastric emptying, gastroscopy with biopsy, expoloratory laparotomy.
• Treatment: pyloromyotomy Pyloromyotomy , pyloroplasty or pyloric resection. technique selected depends on the type of pyloric disease and age of animal.
• Prognosis: depends on cause.

Pathogenesis

Etiology

• Foreign body obstruction.
• CHPG - benign/paraneoplastic.
• Congenital pyloric stenosis.
• Intra- or extraluminal neoplastic disease.

Predisposing factors

• CHPG benign has unknown etiology, but can be associated with increased gastrin with gastrinoma.

Pathophysiology

• Gastric foreign body Stomach: foreign body.
• CHPG Stomach: chronic hypertrophic gastritis.
• Gastric neoplasia Stomach: neoplasia.

• Brachycephalic breeds.
• Hypertrophy of gastropyloric smooth muscle.
• Prevents adequate opening of pylorus.
  Clinical signs only seen once on solid foods.
• Normally food ground down by pyloric antrum to particle size <2 mm before emptying into duodenum.
• Maximal pyloric opening 5-6 mm.
• Inability to open adequately leads to gastric retention and/or delayed gastric emptying.

Timecourse

• Onset of signs usually at weaning in congenital forms.
• Progressive onset in adult forms.

Diagnosis

Treatment

Outcomes