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Chronic Hypertrophic Pylorus Gastropathy, CHPG (Narrowing of the Gastric Outlet) in cats

Occurrence: very rare
Location of illness: Abdomen/pelvis

Chronic Hypertrophic Pylorus Gastropathy (CHPG) in cats is a condition in which the muscle layer in the area of the pylorus, the exit of the stomach, thickens, leading to a narrowing and impairing the normal passage of food into the intestine.

The most important facts at a glance

Chronic Hypertrophic Pylorus Gastropathy (CHPG) in cats is a condition in which the muscle layer around the pylorus, the transition from the stomach to the small intestine, thickens and narrows, hindering the flow of food. This thickening can be caused by chronic inflammatory conditions or fibrous tissue changes. Factors such as genetic predispositions, chronic gastrointestinal diseases, and certain dietary habits can increase the risk for CHPG. Symptoms include frequent vomiting, loss of appetite, and weight loss. Diagnosis is made through clinical examinations, blood tests, and imaging procedures such as ultrasound or endoscopy to detect the thickening of the pyloric region and to take biopsies for examination.

Treatment focuses on alleviating the symptoms and facilitating food passage. Dietary adjustments and medications such as proton pump inhibitors can be used. In severe cases, surgical intervention may be necessary. The prognosis depends on the severity of the disease and the treatment, with early diagnosis and treatment increasing the chances of improvement. Preventive measures such as a balanced diet and regular veterinary examinations can help reduce the risk. Current research approaches are investigating genetic predispositions, non-invasive diagnostic methods, and new treatment approaches to better understand and treat the disease.

Causes

The pylorus is the part of the stomach that forms the transition to the small intestine. In a healthy cat, the pylorus opens and closes to regulate the flow of food. In CHPG, the muscle layer around the pylorus thickens, narrowing the opening. This thickening can be caused by inflammatory conditions or by a fibrous tissue change. The exact mechanisms that lead to the thickening are not yet fully understood, but it is believed that chronic stimuli or inflammatory conditions may play a role.

Possible causes for the development of CHPG include genetic predispositions, as some cat breeds may be more susceptible to this condition. Chronic gastrointestinal diseases that lead to recurrent inflammatory conditions could also play a role as triggering factors. In addition, certain dietary habits or food allergies can promote the development of CHPG.

Another factor could be the age of the cat. Older cats are more likely to show structural changes in the digestive tract, which could increase the risk of developing pyloric stenosis. Hormonal changes or metabolic diseases could also contribute to the thickening by disrupting the normal function of the gastrointestinal tract.

Symptoms

Very common symptoms:

Common symptoms:

Weight Loss

The symptoms of CHPG are often subtle and can easily be confused with other gastrointestinal problems. One of the most common symptoms is chronic vomiting, which can occur either directly after eating or several hours later. The vomit may contain undigested food and is often accompanied by mucus.

Other symptoms include weight loss despite normal or increased appetite. This is because food is not efficiently transported from the stomach to the intestine, resulting in reduced nutrient absorption. In addition, affected cats may show signs of abdominal pain, which can be noticeable through restlessness, increased meowing, or altered behavior.

In some cases, there may also be changes in bowel movements, with cats suffering from either constipation or diarrhea. This results from the disturbed digestion and absorption of food in the gastrointestinal tract.

Diagnosis

The diagnosis of CHPG in cats usually begins with a thorough clinical examination and medical history to rule out other possible causes for the symptoms. Typically, blood tests are performed to assess the cat’s general health and rule out other systemic diseases.

An important diagnostic step is imaging diagnostics, especially abdominal ultrasound. An experienced veterinarian can detect a thickening of the pyloric region. In some cases, an X-ray with contrast medium can also be used to visualize the passage of food through the stomach.

An endoscopic examination can also be helpful to directly view the lining of the stomach and the pylorus. Biopsies can also be taken to perform a histopathological examination, which can provide information about the type of tissue change.

Therapy

The treatment of CHPG focuses on alleviating the symptoms and facilitating the passage of food. In mild cases, dietary adjustments, such as feeding smaller, more frequent meals with easily digestible food, can be helpful. Special dietary supplements that promote digestion can also be used.

Proton pump inhibitors or H2 receptor antagonists can be used medicinally to reduce gastric acid production and protect the lining of the stomach. Motility-promoting drugs can also be used to improve gastric emptying.

In more severe cases, where there is significant anatomical narrowing, surgery may be required. A procedure that is often used is pyloromyotomy or pyloroplasty, in which the narrowed muscle layer is cut or reshaped to widen the opening and facilitate the passage of food.

Prognosis and follow-up care

The prognosis for cats with CHPG depends heavily on the severity of the condition and the treatment method chosen. With early diagnosis and appropriate treatment, especially if surgical correction is performed, the prognosis is often favorable. Most cats show a significant improvement in their symptoms after treatment and can lead a normal life.

In cats that are only treated with medication, the prognosis may be more variable because the condition is chronic and requires a lifelong management strategy. Regular monitoring and adjustment of therapy are crucial in such cases to prevent recurrence of symptoms.

Prevention

Preventing Chronic Hypertrophic Pylorus Gastropathy (CHPG) in cats can be challenging because the exact causes of this condition are not fully understood. Nevertheless, there are some measures that could reduce the risk. A balanced diet plays an essential role. It is important to provide your cat with high-quality, easily digestible food that is specifically tailored to their needs. Avoid giving your cat fatty or difficult-to-digest foods, as these can strain the gastrointestinal tract.

Regular veterinary examinations are also crucial to identify and treat health problems early. Make sure your cat maintains a healthy weight, as overweight can increase the risk of various health problems. A low-stress environment can also help promote your cat’s overall well-being, which may reduce the risk of gastrointestinal diseases.

In addition, regularly monitoring your cat’s behavior and eating habits can help you become aware of potential problems early on. If you notice changes in your cat’s appetite or behavior, do not hesitate to consult a veterinarian. Early interventions can help maintain your cat’s health in the long term.

Outlook on current research

In recent years, research into Chronic Hypertrophic Pylorus Gastropathy (CHPG) in cats has made progress by focusing on the genetic and environmental factors that contribute to the development of this disease. Researchers are working to identify the genetic predispositions that could make certain cat breeds more susceptible to this condition. These genetic studies could lead to more targeted treatments in the future that are specifically tailored to the affected breeds.

Another important area of research relates to the development of non-invasive diagnostic methods. Currently, diagnosis often requires imaging procedures and endoscopic examinations, which can be stressful for the animal. Researchers are investigating the possibility of identifying specific biomarkers in the blood or urine that could indicate CHPG early on. This could enable faster and gentler diagnosis.

In addition, the effectiveness of various drug treatment approaches is being explored. While surgical procedures such as pyloroplasty are often used to correct the narrowing, there is interest in developing drugs that could reduce the hypertrophy of the pyloric tissue. Research is investigating whether certain anti-inflammatory drugs or hormone therapies could be an effective alternative to surgery.

Another aspect of current research is the investigation of nutritional factors that could influence CHPG. Researchers are working to develop special diets that could reduce the risk of developing or worsening the disease. These diets often focus on easily digestible ingredients and an adapted fiber composition to relieve the gastrointestinal tract.

Finally, researchers are striving to better understand the underlying mechanisms of tissue hypertrophy. By studying cell proliferation and the role of growth factors, scientists hope to develop targeted therapies that directly address the abnormal tissue proliferation. This basic research is crucial to establishing long-term treatment strategies that combat not only the symptoms but also the causes of CHPG.

Frequently asked questions (FAQs)

What is Chronic Hypertrophic Pylorus Gastropathy in Cats? CHPG is a condition in which the gastric outlet (pylorus) narrows due to a thickening of the tissue. This narrowing can impede the normal flow of food from the stomach to the intestine, leading to a variety of digestive problems.
What symptoms occur with CHPG? The most common symptoms include vomiting, weight loss, loss of appetite, and occasionally abdominal pain. Some cats may also show signs of dehydration or weakness as the condition progresses.
How is CHPG diagnosed? Diagnosis usually requires a combination of imaging procedures such as ultrasound or X-ray and endoscopic examinations. Sometimes blood tests are also necessary to rule out other diseases.
What treatment options are available for CHPG? Treatment can be surgical or medical. In severe cases, surgery is often recommended to correct the narrowing. In less severe cases, medications and special diets can help relieve the symptoms.
Is CHPG curable? While the symptoms can often be well controlled with treatment, CHPG is not considered completely curable. The treatment aims to improve the cat’s quality of life and avoid complications.
Which cats are most at risk of developing CHPG? Certain breeds, such as Persian cats, appear to be more susceptible to CHPG. Older cats are also at higher risk of developing this condition.
Can diet influence the development of CHPG? Yes, diet can play a role. A diet that contains easily digestible ingredients and a balanced fiber composition can help reduce the strain on the stomach and alleviate symptoms.
Are there long-term complications with untreated CHPG? Untreated CHPG can lead to serious complications such as chronic vomiting, severe weight loss, and dehydration. These can severely impair the cat’s quality of life and even become life-threatening.
How can I support my veterinarian in the treatment of CHPG? Close cooperation with your veterinarian is important. Adhere to recommended diets and medication plans, and closely observe your cat’s behavior and symptoms to provide accurate information to the veterinarian.
Are there preventive measures against CHPG? While there are no specific preventive measures, a healthy diet and regular veterinary check-ups can help reduce the risk and detect early signs of the disease.