Gastritis: helicobacter

Introduction

• Still controversy as to whether Helicobacter causes disease in domestic carnivores.
• Cause : spiral bacteria in the genus Helicobacter - Helicobacter felis , Helicobacter bizzozeronii, Helicobacter salomonis; Helicobacter heilmannii believed to be non-pathogenic form.
• Signs : chronic vomiting, abdominal pain, pica, anorexia - even asymptomatic (most infected animals).
• Diagnosis : brush cytology, histological examination, urease test.
• Treatment : antibiotics with or without H2 blocker or proton pump inhibitor.
• Prognosis : reasonable with appropriate therapy - may relapse.

Diagnosis

Clinical signs

• Often appear normal on clinical examination.

• Abdominal discomfort.

Diagnosis

Differential diagnosis

• Other causes of chronic vomiting including:
  • Chronic gastritis .
  • Hypoadrenocorticism .
  • Gastric neoplasia .
  • Foreign body .
  • Gastric ulceration .
  • Dietary hypersensitivites/food intolerance .
  • Inflammatory bowel disease .

Sequelae

Prognosis

• Reasonable if appropriate therapy instituted - may relapse as reinfection recrudescence is common.
• Triple therapy has 90% cure rate.

Expected response to treatment

• Resolution of vomiting within a few days of starting therapy.
• If no response to therapy, re-investigate other potential causes of vomiting.

Reasons for treatment failure

• Incorrect diagnosis - spiral bacteria incidental finding on biopsy.
• Resistance to selected antibiotics.

Sources

Publications

Refereed papers

• Recent references from PubMed.
• Harbour S, Sutton P (2008) Immunogenicity and pathogenicity of Helicobacter infections of veterinary animals. Vet Immunol Immunopathol 122 , 191-203 PubMed.
• Leib M S, Duncan R B, Ward D L (2007) Triple antimicrobial therapy and acid suppression in dogs with chronic vomiting and gastric Helicobacter spp. JVIM 21 , 1185-1192 PubMed.
• Simpson J (2005) Helicobacterinfection in dogs and cats: to treat or not to treat? In Practice 27 , 204-207.
• Simpson K W et al(1999) Gastric function in dogs with naturally acquired gastric Helicobacter spp. infection. J Vet Int Med 13 (6), 507.
• Jenkins C & Bassett J R (1997) Helicobacter infection. Comp Cont Ed Prac Vet 19 , 267-279.
• Lecoindre P, Chevallier M, Peyrol S, Boude M, Ferrero R L & Labigne A (1997) Pathogenic role of gastric Helicobacter sp in domestic carnivores. Vet Res 28 , 201-215.
• Happonen I, Saari S, Castren L, Tyni O, Hanninen M L & Westermarck E (1996) Comparison of diagnostic methods for detecting gastric Helicobacter-like organisms in dogs and cats. J Comp Path 115 , 117-127.
• Beyer et al(1993) Occurrence of spiral-shaped bacteria in gastric biopsy in dogs and cats. Vet Rec 133 , 18-19.
• Hills B A (1993) Evidence for Helicobacter pylori infesting gastric surfactant and deriving protection from it. Gut 34 , 588.
• Eaton et al(1992) Gastritis associated with gastric bacteria in asymptomatic - random source of dogs. Vet Pathol 29 , 454.
• Lee A, Krakowka S, Fox J G et al (1992) Role of Helicobacter felis in chronic canine gastritis. Vet Pathol 29 , 487-491.

Other sources of information

• Tennant B (1996) Scientific information document on Helicobacter pylori. JSAP 37 , 609-610.
• Fox J G (1995) Helicobacter-associated gastric disease in ferrets, dogs and cats. In: Current Veterinary Therapy XPhiladelphia: W B Saunders. pp 720-723.