Académique Documents
Professionnel Documents
Culture Documents
From the Department of Small Animal Surgery1 and the Department of Veterinary Pathology2, Justus-Liebig-
University, Giessen, Germany
Summary Zusammenfassung
To date there have been no claims Darminvagination bei der Die Diagnose wurde bei 90% (17/19)
of a breed predilection for intus- Maine Coon: Eine Übersicht der Maine Coons sonographisch
susception in Maine Coon cats. über 19 Fälle gestellt. Eine Enterektomie und
The medical records of 19 Maine Omentopexie erfolgten bei 88%
Coons with gastrointestinal tract in- Einleitung (15/17), bei 12% (2/17) war eine
tussusception diagnosed between Darminvaginationen werden manuelle Reduktion der Invagina-
2000 and 2012 were reviewed to häufig bei der Europäischen Kurz- tion erfolgreich. Das Jejunum war
determine history, physical exami- haarkatze beschrieben. Eine Ras- mit 84% (16/19) am häufigsten be-
nation, diagnostic imaging, surgery seprädisposition der Maine Coon troffen. Die Überlebensrate lag bei
and outcome and to compare the für diese Erkrankung wurde bisher 74% (14/19). Drei Katzen wurden in-
histology with the aim of identify- nicht untersucht. traoperativ euthanasiert und zwei
ing possible predisposing factors. Katzen wurden aufgrund postope-
Intussusception was diagnosed in Material und Methoden rativer Komplikationen (septische
25 cats, of which 76% (19/25) re- Im Zeitraum 2000–2012 wurden Peritonitis, Aspirationspneumonie)
presented Maine Coons and were 19 Maine Coons mit Darminvagi- euthanasiert. Eine histologische Un-
further analyzed. The median age nation untersucht. Retrospektiv tersuchung erfolgte bei 68% (13/19)
of the affected Maine Coons was wurden die Angaben aus Anam- der Maine Coons, jedoch ohne Hin-
one year (range three months – nese, bildgebender Diagnostik und weise auf eine mögliche Ursache.
five years) with 74% (14/19) being chirurgischer Therapie sowie vor- Bereits bestehende ursächliche Er-
younger than two years. Clinical liegende histologische Befunde krankungen konnten ebenfalls bei
and physical findings were similar untersucht, um mögliche prädispo- keiner der betroffenen Katzen nach-
to those of previous studies in cats nierende Faktoren zu identifizieren. gewiesen werden. Bei sechs Katzen
with intussusception. The median wurde anamnestisch eine chroni-
duration of clinical signs was two Ergebnisse sche Magen-Darmerkrankung ver-
days (range 1–21 days). Diagnosis Bei insgesamt 25 Katzen wurde mutet und drei Katzen erkrankten
was made ultrasonographically in eine Invagination diagnostiziert. post partum.
90% (17/19) of the cases, including Hiervon waren 76% (19/25) Maine
those following surgery. Enterecto- Coons. Das mediane Alter der Maine Schlussfolgerungen
my and omentopexy were perfor- Coons lag bei einem Jahr (drei Mo- Die vorliegende Untersuchung
med in 88% (15/17); in two cases naten bis fünf Jahren), hiervon beschreibt ein vermehrtes Auftre-
(12%, 2/17) manual reduction was waren 74% (14/19) jünger als zwei ten von Darminvaginationen bei
successful. Entero-enteric intus- Jahre. Die Befunde aus Anamnese der Maine Coon. Eine Ursache
susception was most commonly und klinischer Untersuchung waren konnte nicht festgestellt werden.
localized within the jejunum (84%; vergleichbar mit den Befunden vor- Weitere Untersuchungen sind er-
16/19). The long-term survival rate heriger Untersuchungen. Die medi- forderlich, um eine mögliche Ras-
was 74% (14/19), with no signs of ane Dauer der klinischen Sympto- seprädisposition für diese Erkran-
recurrence on follow-up. Three cats matik betrug zwei Tage (1–21Tage). kung zu verifizieren.
*E-Mail: joyce@verschoof.de
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Wiener Tierärztliche Monatsschrift – Veterinary Medicine Austria 102 (2015)
were euthanized during surgery and two cats were eu- chronic gastro-intestinal tract disease and three cats
thanized because of post-surgery complications (septic were post-parturient queens. The results indicate that
peritonitis due to foreign-body perforation; aspiration Maine Coons have a high susceptibility for gastrointes-
pneumonia). Histology was evident for 68% (13/19) of tinal intussusception. No predisposing factors could
the Maine Coons. Histological examination revealed be identified. Further research is necessary to verify a
no underlying cause. No previously managed diseases possible breed predilection for the disease.
were obvious but six cases were suspected to have
Introduction
Gastrointestinal tract intussusception in dogs has Siamese and Burmese (KAVANAGH, 1981; LEVITT and
been well characterized in the literature (LEVITT and BAUER, 1992; BELLENGER and BECK, 1994; CULVENOR,
BAUER, 1992; OAKES et al., 1994; RALLIS et al., 2000; 1997). Only one case series noticed a majority of affected
APPLEWITHE et al., 2001) but there is less informa- cats to be Maine Coons (THIEL et al., 2008).
tion concerning cats (LEVITT and BAUER, 1992; This retrospective study aimed to analyse possible
BELLENGER and BECK, 1994). Three larger case predisposing factors leading to gastro-intestinal intus-
series have been published, relating to twelve cats susception in the Maine Coon and to identify breed-
(BELLENGER and BECK, 1994), 13 cats (THIEL et al., related histological findings.
2008) and 20 cats (BURKITT et al., 2009), but most
publications about intussusception in cats have been Materials and Methods
individual case reports (DEMETRIOU et al., 1999;
MARTINEZ et al., 2001; OWEN et al., 2005; SCHWANDT, A review was conducted of the medical records and histologi-
cal results of Maine Coons examined at the Veterinary Clinic of the
2008). Risk factors that predispose to intussusception Justus-Liebig University Giessen (Germany), Small Animal Surge-
have been described for dogs and may be applicable ry, identified with gastrointestinal intussusception between Janu-
to cats. The disease has been associated with intestinal ary 2000 and December 2012. Maine Coons were included in the
study when historical information was available and a diagnosis of
parasitic infestation, alimentary foreign bodies, viral-
gastrointestinal tract intussusception was confirmed at surgery.
induced enteritis, intestinal masses and prior surgery Medical records of the affected Maine Coons were reviewed
(OAKES et al., 1994; DEMETRIOU et al., 1999; RALLIS with regard to history, physical examination, diagnostic imaging,
et al., 2000; APPLEWITHE et al., 2001). However, as in surgery, histological findings and outcome. Historical information
included duration and type of clinical signs and previously treated
dogs, most cases of gastrointestinal intussusception diseases. Findings on physical examination included body condi-
in cats appear to be idiopathic (WILSON and BURT, tion, hydration status and vital signs as well as special findings on
1974; LEVITT and BAUER, 1992; THIEL et al., 2008). A abdominal palpation. Abdominal radiographs were taken in lateral
coincidence with puerperium as described in women and dorsal recumbency. If performed, abdominal ultrasonography
included examination of all intra-abdominal organs. All diagnostic
has been reported. Hormonal changes in the postpartum images were examined by a board-certified radiologist. Intussus-
period may predispose to intussusception (DOHERTY ception was diagnosed on a transverse ultrasonographic section
et al., 2000). when a target-like mass was observed that consisted of outer hy-
Histological examination of tissue samples of ani- perechoic and inner hypoechoic concentric rings around a circular
hyperechoic centre (Fig. 2).
mals with intussusception is prudent and may help In all cats that underwent surgery, a ventral midline laparotomy
in identifying the underlying cause of the disease, al- was performed with routine examination of the gastrointestinal tract
though the procedure is not commonly reported in and abdominal viscera. The anatomic localization and the length
the veterinary literature. Only few reviews have inves- of the intussusception were recorded. The method of correction
included manual reduction and/or enterectomy with omentopexy or
tigated the value of histopathologic examination in enteroplication. Monofilamentous resorbable sutures, employed in
identifying possible underlying causes of the disease a simple interrupted pattern, were used for the enterectomy. When
(SCHWANDT, 2008; BURKITT et al., 2009; LEVIEN and the intestinal suture was additionally secured via omentopexy, the
omentum majus was pulled around the intestine and fixated with a
BAINES, 2011). BURKITT et al. (2009) noticed a bimodal
simple suture. For both omentopexy and enteroplication, monofi-
age distribution: gastrointestinal tract intussusception lamentous suture material was also used. If present, other atypical
appeared to be associated with gastrointestinal lym- abdominal findings were recorded and examined. Abdominal closure
phoma and inflammatory bowel disease in older cats was performed routinely. Pathological examinations of the intus-
suscepted regions or biopsies of surgically obtained lymph nodes
(≥6 years), whereas in younger cats (<1 year) idiopathic were evaluated for possible underlying diseases. After discharge
intussusception was obvious. In addition, underlying of the cats, the owners were contacted by telephone to follow up
neoplasia was more often histologically evident in cats on recurrence of intussusception.
than in dogs (LEVIEN and BAINES, 2011). This study also
suggested an improvement in identifying the underlying Results
cause by submission of additional biopsies. Multiple
biopsies have been shown to maximize the sensitivity Between 2000 and 2012, 25 cats were presented at
of histopathology (WILLARD et al., 2008; WASHABAU our clinic with gastrointestinal intussusception, with
et al., 2010). Most cats in previous reports were domestic 76% (19/25) representing Maine Coons. In total, 2.2%
shorthairs: a breed predilection has been described for (276/12,545) of the cats presented during this time
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Wiener Tierärztliche Monatsschrift – Veterinary Medicine Austria 102 (2015)
were Maine Coons. Medical records for the 19 Maine the abdominal changes were not distinguishable from
Coons with gastrointestinal intussusception met the those caused by gastroenteritis or ileus due to other
criteria for inclusion in the study. Five Maine Coons causes. In none of the cases was contrast radiography
were sexually intact males, seven were neutered males, performed. Additional sonographic examination was
six were sexually intact females and one was a spayed performed on 90% (17/19) of the cats. A definitive diag-
female. The median age was one year (range: three nosis of intestinal intussusception was obtained ultraso-
months – five years). Fourteen (74%) of the 19 Maine nographically in all 17 cats. Further sonographic findings
Coons were younger than two years. included mesenteric lymph node hypertrophy (n=6), a
Historical information was available for all Maine gastric foreign body with signs of gastric perforation
Coons. The median duration of clinical signs was two and peritonitis (n=1) and mild ascites with generalized
days (range: 1–21 days). Acute onset of clinical signs lymph node hypertrophy and peritonitis (n=1), which was
was observed in 13 cats (1–2 days) and six cats had diagnosed as FIP (feline infectious peritonitis).
clinical signs in more than seven days (7–21 days). The A complete blood analysis was available in 47%
most common clinical symptoms were vomiting (n=11), (9/19) of the cases. Findings included general
depression (n=9), anorexia (n=7), weight loss (n=4) non-specific signs of mild inflammation with leu-
and diarrhoea (n=3). Dehydration (n=7), poor body kocytosis (n=5) and neutrophilia (n=5), decreased
condition (n=7) and fever (n=1) were found on physical electrolytes (potassium, chloride) (n=9), mild decrease
examination. All cats that showed clinical signs for of triglycerides and cholesterol (n=4) and mildly to
more than seven days had had chronic medical con- moderately increased urea (n=8).
ditions pretreated by the local veterinarian. Four cats Intussusception occurred in 84% (16/19) of the
were treated with antibiotics (amoxicillin-clavulanic cases within the jejunum (Fig. 3). Duodeno-colonic
acid (n=3), enrofloxacin (n=1)) and antiemetics (meto- intussusception was found in one cat and jejuno-colic
clopramide) because of vomiting. One cat was treated intussusception in two animals (Fig. 4). The length of
for food intolerance (with Royal
Canin® Sensitivity Control diet) and
one showed signs of dysphagia.
This latter cat was subsequently
diagnosed with FORL (feline
odontoclastic resorptive lesions).
Three cats had been lactating on
clinical presentation for a median
of five weeks (range 4–5 weeks).
Information on vaccination and
deworming status was available
for 14 cats, nine of which were
regularly dewormed and eleven of
which were vaccinated, with 82%
(9/11) vaccinated and dewormed.
No faecal examination was per-
formed at our clinic.
Information on clinical findings of
abdominal palpation was available
for 15 cats. In 87% (13/15) of them,
an intra-abdominal mass was pal-
pable, located in the medial-cranial
(n=9) and medial-caudal (n=4) part
of the abdomen.
Abdominal radiographs in dorsal
and lateral recumbency were taken
in 79% (15/19) of the cases. Radio-
logical signs of intestinal luminal
obstruction were identified, such
as multiple loops of various diame-
ters of gas-dilated and fluid-filled
small intestine. Depending on Fig. 1a,b: Lateral and ventrodorsal projection of the abdomen of an one year old Maine
the severity of obstruction, the Coon; gas and fluid filled intestinal loops of various diameters showing a mild gravel sign./
Laterolaterale und ventrodorsale Röntgenaufnahme des Abdomens einer einjährigen Maine
bowel appeared turgid with sharp Coon; die Dünndarmschlingen stellen sich teilweise gas- und flüssigkeitsgefüllt dar in un-
loops (Fig. 1). The radiographs of terschiedlicher Ausprägung mit teilweise fein granuliertem Inhalt.
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Discussion
According to previous reports,
Burmese and Siamese are the cat
breeds most susceptible to gas-
trointestinal tract intussusception
(KAVANAGH, 1981; LEVITT and
BAUER, 1992; BELLENGER and
BECK, 1994; CULVENOR, 1997),
although some reports did not
identify any breed predisposition
(BURKITT et al., 2009). In the present
study, 75% of the cats diagnosed with
gastrointestinal tract intussusception
in 2000–2012 were Maine Coons. In
Fig. 3: Jejuno-jejunal intussusception; the oral part of the jejunum is dilated with mild se- the overall population of cats treated
rosal bleedings and discolouration of the intussusceptum./Invagination des Jejunums; oral
der Invagination stellt sich das Jejunum dilatiert dar, die Serosa weist Blutungen auf und in our hospital during that time, Maine
das Intussuszeptum ist dunkel verfärbt. Coons represented only 2.2%.
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Wiener Tierärztliche Monatsschrift – Veterinary Medicine Austria 102 (2015)
Tab. 1: Histologic diagnoses of 13 cats diagnosed with intestinal intussusception and surgical findings/Histologische Diagnose sowie
intraoperative Befunde von 13 Katzen mit Darminvagination
Number of
Histologic diagnoses Surgical findings
affected cats
intussusceptions in otherwise healthy infants has intussusception, consistent with the report of BURKITT
been suspected to be the cause of a significant in- et al. (2009). The decision to perform an enterectomy was
crease in the disease 3–14 days after vaccination based on the surgeon’s overall evaluation of intestinal
(MURPHY et al., 2001). Viral-induced enteritis has also viability. Failure to achieve complete manual reduction
been reported as a possible cause in dogs (RALLIS or the presence of severe serosal adhesions and/or
et al., 2000; EVERMANN et al., 2005). The retrospec- intestinal wall defects led to intestinal resection. As de-
tive character of this study meant that information on scribed by LEVITT and BAUER (1992), serosal adhesions
recent vaccinations or possible related gastrointestinal reflected the consequences of vascular compromise
symptoms was not consistently present. of the intussusceptum and were independent of the
On clinical evaluation, signs of dehydration were re- duration of clinical signs. In two cats, manual reduction
lated to vomiting. Fever on presentation in one cat was only was successful, although there was no information
consistent with septic peritonitis, which was not related on long-term follow-up for more than two years.
to intussusception but to a gastric perforation with a In human medicine, sonography is used to estima-
foreign body. Findings on abdominal palpation were te the severity of intussusceptions in children when
similar to those of others (THIEL et al., 2008; BURKITT deciding between primary conservative treatment
et al., 2009) and may represent a useful diagnostic aid (ultrasound-guided gas or liquid-contrast enema) or a
(BELLENGER and BECK, 1994). surgical approach (DANEMAN and NAVARRO, 2004).
With regard to diagnostic imaging, radiography was In veterinary medicine, a surgical approach through a
useful for identifying signs of intestinal obstruction. midline laparotomy remains the only possible treatment
However, consistent with other reports, we found in deciding between manual reduction and surgical re-
that abdominal sonography provides a more specific section. As PATSIKAS et al. (2003) only examined non-
diagnosis of intussusception (LEVITT and BAUER, reducible intussusceptions, there are little clinical data
1992; PATSIKAS et al., 2003; BURKITT et al., 2009). to compare sonographic information and the reducibility
The ultrasonic pathognomonic appearance of intus- of intussusception in cats. In the aforementioned study,
susception in dogs and cats has been well described non-reducible intussusceptions in cats were found to
(PATSIKAS et al., 2003) and is readily transferable to have multiple hyperechoic and hypoechoic concentric
the present study. rings. However, in 15 young dogs with intussusception,
Surgical management involved enterectomy in color doppler ultrasonography was found to repre-
84% of the cats, with most having an entero-enteric sent a useful method for predicting the reducibility of
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Wiener Tierärztliche Monatsschrift – Veterinary Medicine Austria 102 (2015)
single biopsy specimens in maximizing the sensitivity performed, which represents a limitation of the present
of histopathology (EVANS et al., 2006; WASHABAU study. As reported by BURKITT et al. (2009), no gross
et al., 2010). LEVIEN and BAINES (2011) recognized or histological evidence of infection was discovered in
an improvement in diagnosing intestinal diseases any of the 13 Maine Coons.
by submitting additional biopsy samples, although
the population of cats in their study differed from Conclusion
the Maine Coons in the present study with respect
to age and underlying disease. Whether additional Of the affected cats, 76% with intestinal intussuscep-
intestinal biopsies would have changed the histolo- tion were Maine Coons and 74% were young. The re-
gical outcome (i.e. the diagnosis of intussusception sults suggest that young Maine Coons are predisposed
of idiopathic origin) remains unclear. Further studies to gastrointestinal tract intussusception. Histologically,
of the efficacy of multiple biopsy samples in young no signs of an underlying disease could be identified.
cats with intussusception are required to achieve an Intussusception remained idiopathic in young Maine
improvement in histopathological diagnosis. In parti- Coons. Whether additional biopsies of affected Main
cular, when treating cases of inflammatory intestinal Coons would improve the sensitivity of histopathology
diseases, additional biopsies are warranted (LEVIEN is yet to be investigated. Further statistical evidence
and BAINES, 2011). is needed to prove a breed predilection for intestinal
Histopathological diagnosis revealed FIP in one intussusception in the Maine Coon.
case. A second cat had septic peritonitis because of a
perforating gastric foreign body. Whether intussuscep-
tion in this case was secondary to the foreign body is Fazit für die Praxis:
unclear but it has been described to have a role in the Die vorliegende Untersuchung beschreibt ein ver-
aetiology of intestinal intussusceptions (PAPAZOGLOU mehrtes Auftreten von Darminvaginationen bei jungen
et al., 2003). Based on histology, another cat showed Katzen der Rasse Maine Coon. Eine gemeinsame
muscular thickening but no underlying cause could be Ursache konnte nicht festgestellt und eine Rasse-
identified. Enteritis secondary to a parasitic infection disposition statistisch nicht verifiziert werden; trotz-
may have been an underlying cause, as described dem scheint es ratsam, besonders bei jungen Main
in young dogs (LEVITT and BAUER, 1992; BURKITT Coons mit gastrointestinalen Symptomen frühzeitig
et al., 2009). However, faecal examination was not eine mögliche Darminvagination abzuklären.
References
APPLEWITHE, A.A., HAWTHORNE, J.C., CORNELL, K.K. (2001): GFÖRER, S., FIEGEL, H., ROLLE, U. (2009): Invagination. Monats-
Complications of enteroplication for the prevention of intussu- schr Kinderheilk 157, 917–924.
sception recurrence in dogs: 35 cases (1989–1999). J Am Vet KAVANAGH, M.F. (1981): Intussusception in Siamese cats. Vet Rec
Med Assoc 219, 1415–1418. 109, 165.
BELLENGER, C.R., BECK, J.A. (1994): Intussusception in 12 cats. LEVIEN, A.S., BAINES, S.J. (2011): Histological examination of the
J Small Anim Pract 35, 295–298. intestine from dogs and cats with intussusception. J Small Anim
BURKITT, J.M., DROBATZ, K.J., SAUNDERS, H.M., WASHABAU, Pract 52, 599–606.
R.J. (2009): Signalement, history, and outcome of cats with gas- LEVITT, L., BAUER, M.S. (1992): Intussusception in dogs and cats:
trointestinal tract intussusceptions: 20 cases (1986–2000). J Am a review of thirty-six cases. Can Vet J 10, 660–664.
Vet Med Assoc 234, 771–776. MARTINEZ, N.I., COOK, W., TROY, G.C., WALDRON, D. (2001): In-
CULVENOR, J.A. (1997): Peritonitis following intestinal anastomo- termittend gastroesophageal intussusception in a cat with idio-
sis and enteroplication in a kitten with intussusception. Aust Vet pathic megaesophagus. J Am Anim Hosp Assoc 37, 234–237.
J 75, 175–177. MURPHY, T.V., GARGUILLO, P.M., MASSOUDI, M.S., NELSON, D.B.,
DANEMAN, A., NAVARRO, O. (2004): Intussusception Part 2: An JUMAAN, A.O., OKORO, C.A., ZANARDI, L.R., SETIA, S., FAIR,
update on evolution of management. Pediatr Radiol 34, 97–108. E., LEBARON, C.W., WHARTON, M., LIVENGOOD, J.R. (2001):
DEMETRIOU, J.L., WELSH, E.M. (1999): Rectal prolaps of an ile- Intussusception among infants given an oral rotavirus vaccine.
ocaecal neoplasm associated with intussusceptions in a cat. J N Engl J Med 344, 564–572.
Feline Med Surg 1, 253–256. NASH, J.M., BELLENGER, C.R. (1998): Enteroplication in cats, using
DOHERTY, D., WELSH, E.M., KIRBY, B.M. (2000): Intestinal intus- suture of N-butyl cyanocrylate adhesive. Res Vet Sci 65, 253–258.
susception in five postparturient queens. Vet Rec 146, 614–616. OAKES, M.G., LEWIS, D.D., HOSGOOD, D., BRALE, B.S. (1994):
EVANS, S.E., BONCZYNSKI, J.J., BROUSSARD, J.D., HAN, E., Enteroplication for prevention of intussusception recurrence in
BAER, K.E. (2006): Comparison of endoscopic and full-thickness dogs: 31 cases (1978–1992). J Am Vet Med Assoc 205, 72–75.
biopsy specimens for diagnosis of inflammatory bowel disease OWEN, M.C., MORRIS, P.J., BATEMAN, R.S. (2005): Concurrent
and alimentary tract lymphoma in cats. J Am Vet Med Assoc gastro-esophageal intussusception, trichobezoar and hiatal her-
229, 1447–1450. nia in a cat. N Z Vet J 53, 71–374.
EVERMANN, J.F., ABBOTT, J.R., HAN, S. (2005): Canine corona- PAPAZOGLOU, L.G., PATSIKAS, M.N., RALLIS, T. (2003): Intestinal
virus-associated puppy mortality without evidence of concur- foreign bodies in dogs and cats. Compendium 25, 830–842.
rent canine parvovirus infection. J Vet Diagn Invest 17, 610–614. PATSIKAS, M.N., PAPAZOGLOU, L.G., PAPAIOANNOU, N.G.,
36
Wiener Tierärztliche Monatsschrift – Veterinary Medicine Austria 102 (2015)
SAVVAS, I., KAZAKOS, G.M., DESSIRIS, A.K. (2003): Ultrasono- THIEL, C., WIGGER, A., KRAMER, M. (2008): Darminvagination bei
graphic findings of intestinal intussusceptions in seven cats. J der Katze – eine retrospective Studie. Tierärztl Prax 36, 357–362.
Feline Med Surg 5, 335–343. WASHABAU, R.J., WILLARD, M.D., HALL, E.J., JERGENS, A.E.,
PATSIKAS, M.N., PAPAZOGLOU, L.G., JAKOVLJEVIC, S., MANSELL, J., MINAMI, T., BILZER, T.W. (2010): Endoscopic, bi-
DESSIRIS, A.K. (2005): Color doppler ultrasonography in pre- opsy, and histopathologic guidelines for the evaluation of gast-
diction of the reducibility of intussuscepted bowel in 15 young rointestinal inflammation on companion animals. J Vet Int Med
dogs. Vet Radiol Ultrasound 46, 313–316. 24, 10–26.
PFÜNDER, A., HAHN, H., SPITZER, I., EMMRICH, P. (1999): Inva- WILLARD, M.D., MANSELL, J., FOSGATE, G.T., GAULTIERI, M.,
gination im Kindesalter. Monatsschr Kinderheilk 147, 1100–1105. OLIVIERO, D., LECOINDRE, P., TWEDT, D.C., COLLETT, M.G.,
RALLIS, T.S., PAPAZOGLOU, L.G., ADAMAMA-MORAITOU, K.K., DAY, M,J., HALL, E.J., JERGENS, A.E., SIMPSON, J.W., ELSE.,
PRASSINOS, N. (2000): Acute enteritis or gastroenteritis in young R.W., WASHABAU, R.W. (2008): Effect of sample quality on the
dogs as a predisposing factor for intestinal intussusception: a re- sensitivity of endoscopic biopsy for detecting gastric and duo-
trospective study. Vet Med A Physiol Pathol Clin Med 47, 507–511. denal lesions in dogs and cats. J Vet Int Med 22, 1084–1089.
SCHWANDT, C.S. (2008): Low-grade or benign intestinal tumors WILSON, G.P., BURT, J.K. (1974): Intussusception in the dog and
contribute to intussusception: a report on one feline and two cat: a review of 45 cases. J Am Vet Med Assoc 164, 515–518.
canine cases. J Small Anim Pract 49, 651–654. WINKELS, P., WIESER, J. (2010): Intestinale Invagination – Ursache,
TANGNER, C.H. (1982): A review of canine intestinal intussuscep- Therapie, Prophylaxe. Kleintier Konkret 6, 1–5.
tion. S West Vet 34, 203–207.
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