Chronic Hypertrophic Pyloric Gastropathy in Cats

 

Pyloric stenosis, or chronic hypertrophic pyloric gastropathy, is the narrowing of the pyloric canal due to an overgrowth of muscles of that region. This region of the stomach connects with the first part of the small intestine called the duodenum. The exact cause of the disease is still unknown; it is rarely found in cats.

 

Symptoms and Types

 

The severity of symptoms directly correlates to the extent of the pyloric canal's narrowing; these include chronic, intermittent vomiting (often several hours after eating), loss of appetite, and weight loss. Vomiting may contain undigested or partially digested food, and does not settle with the administration of drugs.

 

Causes

 

The exact cause for chronic hypertrophic pyloric gastropathy is still unknown, though it is believed to be either congenital (existing at birth) or acquired later in life. Risk factors that may play a role in influencing the disease process include:

 

• Tumors
• Chronic stress
• Chronic gastritis
• Stomach ulcers
• Chronic increase in gastrin (hormone that stimulate secretion of HCL in stomach) levels

 

Diagnosis

 

Your cat's veterinarian will take a detailed history from you and perform a complete physical examination and laboratory tests on the animal. The results of routine laboratory tests, including complete blood profile, biochemistry profile, and urinalysis, may be variable depending upon the underlying cause. In cats with severe ulceration, for example, anemia may be present. X-rays, meanwhile, may reveal a distended stomach due to stenosis of the pyloric canal. For more detailed results, your veterinarian may perform a gastrointestinal barium contrast study, in which barium sulfate is given orally to help highlight the location and extent of the narrowing on X-rays.

 

Another technique called fluoroscopy is sometimes employed. This imaging technique obtains real-time moving images of internal structures of the cat on camera with the use of a fluoroscope. The veterinarian may also employ endoscopy for detailed evaulation, in which he or she will look directly into the stomach and duodenum using an endoscope, a rigid or flexible tube that is inserted into the stomach and duodenum to visually inspect and take pictures of the region. Abdominal ultrasonography may also help in identifying the narrowing of the pyloric canal.

 

 

Treatment

 

Treatment depends upon the severity of the problem. After reaching a diagnosis, your veterinarian will decide the treatment, including surgery if required. Surgery is most commonly employed to correct the pyloric canal narrowing. Fluid therapy, meanwhile, is used to stabilize a dehydrated animal due to chronic vomiting.

 

Living and Management

 

Proper nutrition (highly digestible, low fat diet) and activity restrictions will be instilled by the veterinarian, especially when the cat has undergone surgery. If recurrence of the defect should occur, a more aggressive surgical intervention will be required.

 

Overall prognosis after surgery is excellent and most animals respond well. However, in the case of neoplasia, prognosis is not good.