title: Surgical and Medical Treatment of Pyloric and Duodenal Pythiosis in a Dog.
abstract: A 5 yr old, male, neutered mixed-breed dog was referred for persistent vomiting 2 wk following a pyloric biopsy for a pyloric outflow obstruction. Histopathology at the time of initial surgery was suggestive of pythiosis. Following referral, the dog underwent radical surgical treatment with a Billroth II procedure, partial pancreatectomy, and cholecystoduodenostomy. Histopathology and serology confirmed the diagnosis of pythiosis and medical treatment consisting of itraconazole and terbinafine was started postoperatively. Serology titers were checked again at 8, 12, and 24 wk postoperatively revealing a positive response to treatment and no reoccurrence of pythiosis. Since surgery, the patient experienced waxing and waning elevations of liver values and laparoscopic liver biopsies 10 mo postoperatively revealed hepatic cirrhosis with fibrosis, bile duct hyperplasia, and chronic inflammation. This report documents successful treatment of pyloric/duodenal pythiosis and the long-term (17 mo) consequences associated with the Billroth II, partial pancreatectomy, and biliary rerouting in the dog.
authors.affiliation: From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
authors.forename: David Lee
authors.initials: DL
authors.lastname: Dycus
authors.affiliation: From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
authors.forename: Cory
authors.initials: C
authors.lastname: Fisher
authors.affiliation: From the Department Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group (VOSM), Annapolis Junction, MD (D.L.D.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS (D.L.D., C.F., R.B.).
authors.forename: Ryan
authors.initials: R
authors.lastname: Butler
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D019587:Dietary Supplements; D004283:Dog Diseases / Q000473:pathology / Q000628:therapy*; D004285:Dogs; D004378:Duodenal Diseases / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D009281:Naphthalenes / Q000627:therapeutic use; D020799:Pancrelipase / Q000627:therapeutic use; D011708:Pylorus / Q000473:pathology; D058968:Pythiosis / Q000628:therapy*; D013272:Stomach Diseases / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D005765:Gastrointestinal Agents; D009281:Naphthalenes; D017964:Itraconazole; D020799:Pancrelipase; D000077291:Terbinafine