Gastrointestinal pythiosis causing vomiting and weight loss in 10

Abstract

BACKGROUND: Pythium insidiosum is an aquatic oomycete that causes severe segmental thickening of the canine gastrointestinal (GI) tract, resulting in weight loss, vomiting, diarrhea, and death. Infection in dogs previously has been observed primarily in the southeastern United States. OBJECTIVE: To describe the clinicopathologic and epidemiologic findings associated with GI pythiosis in 10 dogs from California. METHODS: Dogs were initially identified on the basis of supportive clinical findings and routine histology. Pythiosis was confirmed in each dog with at least one of the following: immunoblot serology, enzyme-linked immunosorbent assay serology, immunohistochemistry, and culture followed by species-specific polymerase chain reaction, rRNA gene sequencing, or both. RESULTS: Between September 2003 and December 2006, GI pythiosis was confirmed in 1 dog from central California and 9 dogs that lived within a 30-mile radius of Davis, CA. Seven of 8 dogs for which environmental data were available had frequent access to flooded rice fields or other water sources. Esophageal lesions were present in 2 of 10 dogs. Common laboratory findings included eosinophilia (7/9), hypoalbuminemia (9/9), and hyperglobulinemia (8/9). Median survival time was 26.5 days (range, 0-122 days), and the disease was ultimately fatal in all 10 dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: The geographic distribution of pythiosis has widened in recent years to include the western United States. Factors that may have contributed to this change include altered rice-farming practices and landscape irrigation. Veterinarians in California should be familiar with the clinicopathologic features associated with GI pythiosis to aid in early diagnosis and effective treatment.