Lola’s GI Hypomotility

LOLA’S GI HYPOMOTILITYMason Savage, DVM

Patient: Lola Anna; #164024ACC#: 154960

History Lola - 6 year old female spayed DLH Referred in to Internal Med for:

Evaluation of a 3 month history of weight loss in the face of a ravenous appetite

Evaluation of 3 episodes of acute lethargy with decreased responsiveness requiring hospitalization.

Physical Examination GI: bladder is largely distended and

mildly thickened bowel loops are appreciated

Otherwise, unremarkable

Diagnostics Planned to begin with basic bloodwork However, unable to draw blood from

patient… so began with imaging

Thoracic Radiographs

Normal cardiopulmonary structures

Thoracic Radiographs

Stomach and cranial intestine moderately gas and fluid distended, otherwise unremarkable.

Abdominal Ultrasound

Abdominal Ultrasound Findings very similar to feline

dysautonomia

Abdominal Ultrasound

Feline Dysautonomia Feline Dysautonomia

Paper from 2010 describing common imaging findings in patient’s with this disease

Disease is autonomic ganglia degeneration Leads to failure of autonomic nervous system

Often accompanied with concurrent sypathetic nervous system dysfunctions (dilated pupils, elevated 3rd eyelids, …)

Possible sex (male) predisposition and geographic (Midwest) distribution?

Feline Dysautonomia Imaging findings

Feline Dysautonomia Imaging findings

Lola Case Progress Hospitalized overnight

Following day was laterally recumbent and non-responsive

Lola Case Progress Venous Blood Gas revealed extreme

acidemia pH of 6.8

Patient eventually diagnosed with d-lactic acidosis secondary to severe exocrine pancreatic insufficiency

Lola Case Progress

D-lactic acidosis 2’ to Severe EPI

D-lactate is produced by from bacterial flora in intestine

Reports of d-lactic acidosis in people seen with short-bowel syndrome secondary to GI surgery

Can be accompanied by GI dysmotility

Single case report (2005) in cat with similar ultrasonographic findings