Introduction
Intussusception is a severe gastrointestinal disorder characterized by the invagination or telescoping of one segment of the intestine into an adjacent segment, leading to intestinal obstruction. It is recognized as a significant cause of morbidity and mortality in both humans and animals, including dogs. The condition can occur at any age but is most commonly observed in young animals, often following surgical procedures or due to underlying pathological conditions such as parasitic infections or neoplasia [1–4]. In veterinary medicine, intussusception poses diagnostic challenges due to its varied clinical presentations and the need for prompt intervention to prevent severe complications such as bowel necrosis and systemic infection [5].
This case report focuses on a 10-month-old brown male Nigerian indigenous dog (NID) presented to the Veterinary Teaching Hospital, Ahmadu Bello University Zaria, Nigeria, with a history of recent abdominal surgeries and subsequent clinical presentations. Despite appropriate postoperative care, including antibiotic therapy and dietary management, the dog exhibited progressive clinical signs, including vomiting and weakness. Necropsy findings revealed significant pathological changes, including intestinal intussusception, peritonitis, and intestinal infarction at the surgical sites, emphasizing the complexity and severity of the condition [6].
The prevalence and management of intussusception in Nigerian Indigenous dogs have not been extensively documented in the veterinary literature. Understanding the predisposing factors, clinical manifestations, and pathological mechanisms specific to this breed is crucial for improving diagnostic approaches and therapeutic strategies. This case report aimed to contribute valuable insights into the diagnosis, treatment, and outcomes associated with intussusception in Nigerian Indigenous dogs, highlighting the importance of early recognition and comprehensive management to optimize clinical outcomes and reduce mortality rates in affected animals.
Case Presentation and Examination
History and clinical signs
The carcass of a 10-month-old brown male Nigerian Indigenous dog was presented to the Necropsy Unit, Veterinary Teaching Hospital, Ahmadu Bello University Zaria, Nigeria. History revealed that the dog had no history of vaccination, and abdominal surgical procedures (gastrotomy, intestinal resection, and anastomosis) were performed on the dog 7 days before death. The dog was placed on a bland diet and penicillin-streptomycin (penstrep) antibiotics post-surgery, and the clinical signs observed before death were vomiting and weakness.
Examinations conducted
A general examination of the carcass was conducted, and the observations were emaciation and dehydration. Necropsy was then conducted, followed by observation of all the organs for the presence of gross lesions.
Pathological findings
The pathological findings observed on necropsy were congested liver (Fig. 1A), gastric hemorrhage (Fig. 1B), adhesion of peritoneum to the abdominal wall, leakage of intestinal content into the peritoneum, peritonitis, intestinal congestion with intussusception (Fig. 1C and D), and infarction at anastomosed intestinal sites (Fig. 1E).
Figure 1.
Photographs of organs from the dog showing congested liver (A), gastric hemorrhage (B), a congested segment of the intestine with intussusception (C), extended intestinal segment (D), and infarction at the anastomosed intestinal site (E).
Discussion
The findings in this study are critical as they illustrate the severe systemic impact of intussusception, ranging from localized intestinal damage to widespread peritoneal infection and inflammation. Previous studies have similarly documented that intussusception often leads to severe necrosis and systemic complications if not promptly and effectively treated [2,7,8].
The congested liver and gastric hemorrhage observed in this case suggest significant hemodynamic instability and stress. Intussusception can obstruct blood flow, leading to venous congestion and subsequent organ dysfunction. The leakage of intestinal contents into the peritoneum, resulting in peritonitis, highlights the potential for rapid systemic infection and sepsis, a common and often fatal complication as documented by Singh et al. [6]. The adhesions between the peritoneum and abdominal wall further indicate chronic inflammatory responses, a frequent sequela in prolonged cases of intussusception or post-surgical complications.
The presence of infarction at the anastomosed sites suggests that the surgical interventions, while necessary, may have predisposed the dog to further complications. Intussusception can cause compromised blood supply to affected intestinal segments, and surgical manipulation may exacerbate this by causing additional trauma and inflammatory responses. This is consistent with findings by Weisman et al. [5], who noted that post-surgical complications such as adhesions and ischemia are common in cases of intussusception, particularly when the surgical intervention is extensive.
In the present case, the obstruction might have impeded the normal flow of intestinal contents, causing acute ischemia and necrosis of the affected bowel segments. According to Applegate [1], the resulting compromised blood supply might have led to bowel tissue death, thus creating an environment conducive to bacterial overgrowth and translocation into the bloodstream and precipitating sepsis. Sepsis, a life-threatening systemic inflammatory response to infection, can
quickly progress to septic shock, characterized by profound hypotension and multi-organ failure [9]. The observed peritonitis, indicative of widespread abdominal infection, might have further exacerbated the inflammatory response, overwhelming the physiological defenses of the dog, and leading to death.
In addition, the clinical signs of vomiting and weakness suggest significant systemic effects beyond the localized intestinal damage. Persistent vomiting can cause severe dehydration and electrolyte imbalances, notably hypokalemia and metabolic alkalosis, as outlined by Singh et al. [6]. Dehydration leads to hypovolemic shock, reducing perfusion to vital organs and exacerbating the ischemic damage initially caused by the intussusception. The necropsy findings of emaciation and dehydration emphasize the chronic nature of these imbalances. Despite post-surgical interventions, including antibiotics and a bland diet, the presence of intestinal infarction and systemic infection highlights the aggressive progression of intussusception. These pathological mechanisms, as detailed by Weisman et al. [5], illustrate how the combination of local intestinal damage, systemic infection, and metabolic derangements ultimately culminates in the death of the affected dog.
Conclusion
This case, therefore, emphasizes the critical need for early diagnosis and aggressive management of intussusception in dogs. It also highlights the importance of postoperative care and monitoring for potential complications. The observations from this case align with broader veterinary literature that emphasizes the complex interplay between surgical intervention, inflammatory responses, and systemic complications in the management of intussusception. For NIDs, in particular, this case adds to the growing body of knowledge, suggesting a potentially higher risk of adverse outcomes without prompt and comprehensive veterinary care.
Acknowledgments
The technical staff of the Necropsy Unit, Veterinary Teaching Hospital, Ahmadu Bello University Zaria, Nigeria.
Conflict of interest
The authors declare no potential conflict of interest.
