The prevalence of subclinical gastroduodenal ulceration in dachshunds with intervertebral disc prolapse

Abstract

The primary objective of this study was to determine the prevalence of subclinical gastroduodenal ulceration (GDU) in a population of Dachshunds undergoing decompressive surgery for acute intervertebral disc prolapse (IVDP). Secondary objectives included determining the extent to which treatment with ulcerogenic drugs, prior to admission, and the severity of spinal injury, would influence the prevalence of GDU. It aimed to further establish patient risk profile components (for example: age, weight, sex or concurrent disease conditions) that might influence the prevalence of GDU and make suggestions as to whether all dogs presenting with acute IVDP should be treated with anti-ulcerogenic drugs on admission for decompressive surgery. Thirty Dachshunds were admitted into the study after a diagnosis of acute IVDP was confirmed based on clinical signs and lumbar myelography. Full histories were obtained from both the owners and the referring veterinarians. Information obtained included any previous history of spinal disease, duration of clinical signs, rate of deterioration of clinical signs and drugs administered prior to admission. A full clinical and neurological examination was performed on each patient at admission. Blood and serum chemistry samples were taken to rule out any concurrent diseases that may have contributed to the development of GDU. Three regions in the stomach (cardia, corpus and pyloris) as well as the proximal duodenum were visualised using gastroduodenoscopy. The following criteria were assessed: colour and appearance of mucosa, presence and distribution of erosion, ulceration and/or submucosal haemorrhages. These results were combined with those obtained from histopathology of pinch biopsy samples, taken from the same four regions, in order to obtain the overall prevalence. Criteria used to assess histopathology of the regions included: disruption of the epithelial lining, haemorrhage into the submucosa and infiltration of neutrophils or macrophages into the submucosa. All dogs were scoped and biopsy samples taken on the first day of admission and three to four days post-surgery. Seventy six percent of Dachshunds that presented with IVDP had visual and/or histopathologic evidence of GDU. The highest overall prevalence of GDU was shown to occur in the pyloric region of the stomach both pre- and post-surgery. No significant correlation was found between the prevalence of GDU and the administration ulcerogenic drugs prior to admission. Similarly, no correlation was found between GDU and the severity of neurological signs, the duration of clinical signs prior to admission, the length of the procedure (general anaesthesia or surgery), age weight or sex. No significant statistical difference was found between the pre- and post-surgery results. Veterinarians should be aware of this potentially serious complication when dealing with Dachshunds with acute IVDP. The judicious use of ulcerogenic drugs and early use of prophylactic anti-ulcer medication is recommended in all patients presenting with this condition.