Intussusception

Intussusception is an uncommon but potentially life threatening condition that can occur in cats and dogs of all ages. There are many different causes of this condition, several of which can be eliminated through good routine health practices. Treatment options are almost exclusively surgical. Surgery is often successful if the condition is caught early.

What is intussusception?
Intussusception is the sliding or telescoping of the intestine within itself. It occurs primarily in the small intestine but may occasionally occur in the large intestine. When the intestine slides within itself the blood supply to that section is greatly reduced and the tissue begins to swell and then die. The entire process can occur rapidly, which makes early detection and treatment essential.

Who gets an intussusception?
Puppies and kittens are the most likely ones to develop intussusception although it can occur in any age or species. There does not appear to be a specific breed predilection.

What causes intussusception?
There are several conditions that predispose a dog or cat to developing an intussusception. Many of these conditions affect the motility of the intestine. Intussusception is seen more commonly in puppies or kittens carrying large numbers of intestinal parasites such as roundworms, hookworms, or whipworms. Viral (e.g., parvovirus in puppies) or bacterial gastroenteritis is another common cause.  Linear foreign bodies like string in cats, or pieces of plastic, bone or wood in the dog can all lead to the development of intussusception. Tumors or recent abdominal surgery may also contribute to the development of this condition.

What are the symptoms of intussusception?
When the small intestine telescopes into itself, movement of intestinal contents is partially or completely blocked, therefore the dog or cat commonly vomits. Once the gastrointestinal tract behind the intussusception empties, stools are scant to none. Any fecal material that is passed is jelly-like, may be bloody, and not well formed. The appetite will be greatly depressed. The animal experiences severe abdominal pain, and eventually shock and then death.

How is intussusception diagnosed?
Diagnosis is usually tentatively made based on the symptoms and the palpation of a firm sausage-shaped mass in the abdomen. Diagnosis is confirmed with x-rays (usually using barium) and possibly exploratory surgery.

What are the risks associated with an intussusception?
An intussusception is serious; left untreated it will result in death. As the intestines telescope into one another, pressure restricts blood flow to the area. Portions of the intestines therefore may actually die, and toxins and bacteria may be released into the rest of the body.

What is the treatment of intussusception?
Treatment consists of either surgically "sliding" the telescoping portion of the intestine apart, or complete surgical removal of the intussusception. The size of the intussusception, amount of damage to the tissues, and the length of time the animal has had the condition will dictate which procedure is used. Post surgically the animal will have to go through a normal recovery period. If the intussusception is caught soon enough and the animal undergoes a successful surgery, most will recover completely. One recent study suggested that up to 25% of dogs that develop an intussusception would have a reoccurrence in the future. There is a surgical procedure called "enteroplication" in which the loops of intestine are attached to one another and thus reduces the incidence of reoccurrence in some pets.

What can be done to prevent an intussusceptions?
If the owner follows good deworming and vaccinating programs as well as preventing access to foreign bodies, the incidence of intussusception can be reduced. Early recognition and treatment of other intestinal diseases can also help minimize the chance of an intussusception. Finally, if the owner recognizes the symptoms of an intussusception early, and the animal receives prompt veterinary care, most animals can be successfully treated. Joe Bodewes, DVM

References
Bojrab, J. Current Techniques in Small Animal Surgery, 4th edition.  Williams & Wilkins, Baltimore, MD 1990

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