GENERAL CONSIDERATIONS

Biologic Behaviour

•intestinal LSA is the most common intestinal tumor

•majority are multifocal and involve the small intestine

CLINICAL FEATURES

Clinical Signs

•anorexia, weight loss, intermittent vomiting, and diarrhea

•severe, persistent vomiting is occasionally observed if proximal small intestinal tumor causes obstruction

Diagnosis

Physical Examination

•palpable abdominal mass and cachexia are common

•other findings include dehydration and abdominal pain

Laboratory Tests

•mesenchymal tumors are associated with microcytic hypochromic anemia, hypoproteinemia, and mild leukocytosis

Abdominal Radiographs

•abdominal mass, obstruction, or persistent irregularity of bowel appearance are identified in 25% of small intestinal tumors and nearly 50% of non-lymphoid intestinal tumors

•abdominal mass is detected in 60% of canine mesenchymal small intestinal tumors

Contrast Radiography

•contrast radiographs: mural lesions include luminal filling defect, intestinal wall thickening, mucosal ulceration, abnormal positioning of intestinal loops, and constricting annular lesions

Ultrasonography

•intestinal mass identified in 87% (13/15) dogs with non-lymphoid small intestinal tumors

•loss of wall layering is an excellent predictive factor for differentiating intestinal neoplasia from enteritis in dogs (99% v 12%) with intestinal tumors 50.9-times more likely to have loss of wall layering

•intestinal tumors also have significant increases intestinal wall thickness (15 mm v 6 mm) and are significantly less likely to have diffuse intestinal involvement (2% v 72%)

Exploratory Celiotomy

•definitive diagnosis with exploratory celiotomy and biopsy

TREATMENT

Surgery

•debilitation and hypoproteinemia may complicate treatment

•exploratory celiotomy with resection and end-to-end anastomosis with 4-8 cm margins and serosal patching

•mesenteric and regional lymph nodes should be assessed ± aspirated

Chemotherapy

•multiagent protocols recommended for LSA as either adjuvant therapy or sole treatment for diffuse disease