Pathology of the alimentary system 1

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Outline
¾ Introduction
¾ Post mortem examination of the alimentary system
¾ Pathology of the upper gastrointestinal tract
¾ Oral cavity
¾ Teeth
¾ Salivary glands and tonsils
¾ Tongue
¾ Esophagus
¾ Stomach
¾ Pathology of the lower gastrointestinal tract
¾ Small and large intestine

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Outline (cont.)
„ Intestinal diseases of carnivores (dogs and cats)
¾ Bacterial enteritis
¾ Viral enteritis
¾ Parasitic diseases
¾ Other
„ Intestinal diseases of pigs
„ Intestinal diseases of ruminants
„ Intestinal diseases of horses
„ Intestinal neoplasia
„ Pathology of the peritoneum

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References

„ Pathologic Basis of Veterinary Disease

McGavin & Zachary (2007), 4th edition, chapter 7

„ Jubb, Kennedy and Palmer’s Pathology of Domestic

Animals
Maxie (2007), 5th edition, Vol.2, chapter 1

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 Introduction
„ Oral cavity
¾ Teeth
¾ Tonsils
¾ Salivary glands
¾ Tongue
„ Esophagus
„ Stomach
„ Intestines
„ Peritoneum
„ Liver and pancreas

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 Introduction
„ Alimentary disorders are common in domestic animals
„ Disease manifestation varies according to species

„ Portals of entry of pathogens

¾ Ingestion (most common)
¾ Coughed up by the lungs and swallowed R. equi.
¾ Systemic circulation (bacteremia, viremia)
¾ Migration through the body (parasites)

Spirocerca lupi- Dog’s aorta

Common in St. Kitts but not in the US. 6
 Defense mechanisms
‡ Endogenous secretions
‡ Resident flora and fauna
‡ Gastric pH
‡ High rate of epithelial turnover
‡ Vomiting and peristalsis
‡ Innate and adaptive immune system

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 Post mortem examination of the
gastrointestinal tract

‡ Sudden death
‡ Wasting
‡ Hypoproteinemia
‡ Vomiting
‡ Diarrhea
‡ Anemia
‡ Suspected septicemia
The organs should be pink --> Normal.

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 Post mortem examination
‡ Necropsy technique
‡ Use a systematic approach
‡ Determine what is normal and what is abnormal
‡ OBSERVE!!!

Establishing an accurate etiologic diagnosis in

cases of gastrointestinal disease usually requires a
combination of diagnostic tests

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 Oral cavity
¾ Developmental anomalies
¾ Stomatitis and gingivitis
¾ Hyperplastic and neoplastic lesions
¾ Diseases of teeth
¾ Diseases of tonsils and salivary glands
¾ Diseases of the tongue

This lamb is stained yellow

because it may have been
stressed in womb. This is called
meconium staining --> arises from
stress in the womb. You can see
his really bad under bite. Ask Dr.
Castillo about this (can see his lips
but then his jaw?)

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 Developmental anomalies

¾ Agnathia
¾ Palatoschisis
¾ Cheiloschisis
¾ Epitheliogenesis imperfecta
¾ Epidermolysis bullosa

Epitheliogenesis imperfecta
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 Palatoschisis
Pathogenesis
‡ Failure of fusion of lateral palatine processes
‡ Etiology unknown
9Genetic factors (Charolais cattle)
9Maternal ingestion of drugs (ie. griseofulvin in
queens and mares; steroid administration during
pregnancy in primates)
9Teratogenic plants (ie. lupines, hemlock in ewes
and sows)

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 Pallate does not fuse

Palatoschisis completely.

Aspiration pneumonia may arise from

palatoschisis because pallate not
present to block food/liquid from being
aspirated into lungs. Animal/human may
also not have negative pressure in their
oral cavity due to palatoschisis and may
starve to death in nature if not fixed.

Palatoschisis in a sheep

Palatoschisis in a calf
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Cheiloschisis
Multifactorial (as is
palatoschisis).

“Hare lip” in calves

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 Stomatitis and Gingivitis
„ Vesicular stomatitides
9Characterized by the formation of vesicles
(accumulation of serous fluid within the
epithelium or between the epithelium and
lamina propria)
9Infectious or non-infectious
Most common vesicular
stomatitis disease is foot and
mouth disease.

Feline calicivirus- Oral vesicles

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Feline calicivirus -vesicles in the tongue
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Vesicular stomatitides
Foot and Mouth Disease Picornavirus Ruminants, pigs
(FMD) (Aphtovirus)

Vesicular Stomatitis (VS) Rhabdovirus Cattle, pigs,

Reportable disease. (Vesiculovirus) horses

Vesicular Exanthema of Swine Calicivirus Pigs

(VES)

Swine Vesicular Disease Picornavirus Pigs

(SVD) (Enterovirus)

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¾All virally induced
¾Very similar clinical, gross and histologic appearance
¾Fluid-filled vesicles on lips, buccal mucosa, margins of
tongue Æ coalesce to form bullae Æ bullae rupture Æ
ulcers

V = vesicle.

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• Lesions may arise on coronary bands, interdigital skin,
teats, vulva

• Histologically Æ start as intracellular edema Æ

ballooning degeneration of stratum spinosum Æ
necrosis Æ intercellular edema

FMD, VES and SVD are exotic to the US and

thus are reportable to state and federal
authorities
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 Foot and Mouth Disease
„ One of the most contagious animal diseases; important
economic losses
„ Low mortality rate in adults, often high mortality in young
due to myocarditis
„ Vesicles or blisters on the tongue, dental pad, gums, cheek,
hard and soft palate, lips, nostrils, muzzle, coronary bands,
teats, udder, snout of pigs, and interdigital spaces

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 Foot and Mouth Disease

‡ Post-mortem lesions on rumen pillars, and in the

myocardium particularly of young animals Æ “tiger
heart”

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 Foot and Mouth Disease

„ Lesions can be more severe in

pigs than in cattle

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 Vesicular Stomatitis
„ Rhabdovirus (vesiculovirus)
„ Common in calves, does not affect goats, sheep;
affects horses and pigs
„ Insects may act as vectors
„ Lesions limited to the epithelial tissues of the
mouth, teats and feet
Reportable!!!!

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Vesicular Exanthema
„ Calicivirus
„ Disease of pigs; clinically and
pathologically indistinguishable
from FMD
„ Closely related to San Miguel
sea lion virus

Swine Vesicular Disease

„ Picornavirus (Enterovirus)
„ Indistinguishable from other
swine vesicular diseases

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Non-infectious vesicular diseases
¾ Pemphigus vulgaris
¾Autoimmune disease mediated by autoantibodies to
the desmosome protein Ædesmoglein 3
¾Characterized by acantholysis
¾ Bullous pemphigoid
¾Autoimmune disease characterized by subepithelial
clefting and no acantholysis

Pemphigus vulgaris
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Erosive/Ulcerative Stomatitides
Mechanisms

„ Viral damage to the epithelium

„ Compromised circulation to subepithelial connective
tissue resulting in infarction of the epithelium
„ May reflect ulceration of vesicular stomatitides

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Erosive/Ulcerative Stomatitides
„ Agents responsible include:
„ Viruses Æ Bovine viral diarrhea virus (BVD), Rinderpest,
Malignant catarrhal fever (MCF), Feline Calicivirus,
Equine Viral Rhinopneumonitis, Bluetongue

„ Other causes:
9 Uremia
9 Feline Eosinophilic Granuloma Complex
9 Vitamin C deficiency in primates and Guinea Pigs

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Bovine viral diarrhea

Ulcerative gingivitis BVD

Number 1 differential diagnosis with
these type of lesions.

Ulcerative stomatitis BVD

(mucosal disease)
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Rinderpest

Malignant catarrhal fever

Blue tongue

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Non-infectious causes

„ Uremia

„ Feline eosinophilic granuloma

(rodent ulcer)

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Uremic stomatitis
Pathogenesis
„ High blood and salivary urea Ÿ oral bacteria transforms
salivary urea into ammonia Ÿ caustic injury
„ Vascular damage Ÿ thrombosis Ÿ ischemia Ÿ infarction
„ Increased urea Ÿ decreased immune response

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 Papular/Proliferative Stomatitides
„ Caused by Parapoxviruses (both zoonotic)
„ Viral infection of epithelial cells results in cell swelling
and hyperplasia

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Bovine papular stomatitis
„ Papules on nares, muzzle, gingiva, buccal cavity, palate,
tongue, esophagus, rumen and omasum

„ Characterized by ballooning degeneration of the stratum

spinosum Æ epithelial cells may contain eosinophilic
intracytoplasmic parapoxvirus inclusions

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Contagious ecthyma "Scabby Mouth"

ƒ Affects sheep and goats

ƒ Macules, papules, vesicles, pustules, scabs, scars,
in areas of skin abrasions Æ corners of mouth,
mouth, udder, teats, coronary bands, anus,
esophagus, rumen
ƒ Epithelial cells may contain eosinophilic
intracytoplasmic viral inclusions

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 Necrotizing/Deep Stomatitides
„ Occur in cattle, sheep, pigs
„ Epithelial trauma permits invasion of opportunistically
pathogenic normal flora into deeper tissues of the oral
cavity (muscle, fascia, bone, and/or regional lymph
nodes)

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Calf diphtheria (Oral necrobacillosis)
ƒ Usually end-stage of any form of stomatitis complicated
by infection with Fusobacterium necrophorum (Gram-
negative anaerobe) Æ produces necrotizing toxins
ƒ Clinical signs Æ swollen cheeks, anorexia, fever, fetid
breath

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Other stomatitides
1. Oral eosinophilic granuloma
„ Presence of a focal granuloma or ulcer within the oral
cavity of cats, less commonly young dogs
„ Cats Æ upper lips (near commissure); may develop in
gingiva, palate, pharynx, tongue, regional lymph nodes
„ Canine eosinophilic granuloma Æ young male Siberian
Huskies, Cavalier King Charles Spaniel

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Oral eosinophilic granuloma
„ Affected animals can have peripheral eosinophilia
„ Cause unknown; suspected immune-mediated
mechanismÆ hypersensitivity reaction ?
„ Histologically, characterized by the presence of
multiple eosinophilic granulomas around a central
foci of collagenolysis

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2. Lymphoplasmacytic stomatitis

„ Chronic idiopathic condition of cats characterized by

inflamed gingiva, inappetence, fetid breath
„ Associated with other infectious diseases (feline leukemia
virus, feline immunodeficiency virus)
Painful condition. Inflammed gingiva --> why
the animal may not be eating.

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3. Chronic ulcerative paradental stomatitis

„ Condition of dogs also known as ulcerative stomatitis and

lymphocytic-plasmacytic stomatitis
„ More common in older dogs and in Malteses and Cavalier
King Charles Spaniels

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