Pyloric stenosis (PSt) is a rare condition in cats and can be a diagnostic challenge as ultrasonography lacks specificity in this context. Few reports describe congenital PSt in young cats presented for chronic alimentary vomiting. A retrospective study conducted on 34 cases (ECVIM 2016) suggested that acquired PSt in cats, associated with inflammatory bowel disease (IBD) is probably an underdiagnosed feature. For the first time, a prospective study conducted on 22 cats (ECVIM 2016) measured the pyloric diameter (PD) by per-endoscopic assessment, using biocompatible graduated olives: PD was reported to be between 9 to 10 mm in 22 healthy cats.

The aim of this prospective study was to describe a cohort of cats with acquired PSt confirmed by per-endoscopic measurement. All procedures were performed by the same operator (VF), using a GIF, Olympus 180 8,8 mm diameter video-gastroscope. Group A included 15 cats with acquired PSt. Cats were included in group A if PD was less than 9 mm. The control group (group B) included 12 cats presented during the same period with a normal PD. Gastrointestinal biopsies were submitted for histologic analysis in all cats (including stomach, pylorus and duodenum, n=14). Signalment, clinical signs, endoscopic and histopathological findings were compared between both groups.

Age, sex and weight were similar between groups. Chronic vomiting was the most frequent clinical complaint in both groups (100% in group A, 67% in group B). Food vomiting occurred more frequently in group A (12/15) than in group B (6/12) but this was not statistically different. Endoscopic findings were consistent with mild gastritis in both groups. Oedema and hyperaemia were frequently noted around the pylorus in group A (8/15), less in group B (2/12). Median value of the PD in group A was 7 mm, which was statistically different from group B (9 mm; p <0,05; Wilcoxon/Mann-Whitney test). Histologic changes were non-specific (lymphocytic-plasmacytic infiltration of the gastric mucosa in 6 cats in group A, in 3 cats in group B). Pyloric fibrosis was found in 11/15 cats from group A and in 4/9 cats from group B.

Our results confirm that acquired pyloric stenosis can occur in cats suffering from IBD. Pathogenic mechanisms are not clearly understood but could imply mucosal scar pyloric fibrosis. This study should be pursued with inclusion of additional cases in each group in order to increase statistical power.

Disclosures

No disclosures to report.