HISTIOCYTIC ULCERATIVE COLITIS - A SPECIAL FORM OF COLITIS y y y y Chronic, debilitating inflammation of the colon occurring predominantly in young Boxer

dogs Affected dogs have chronic hemorrhagic diarrhea with tenesmus, and occasionally vomiting, inappetence and weight loss Colonic mucosa is thickened, friable and ulcerated Macrophage containing PAS-positive granules are found in the mucosa and submucosa

Pathogenesis y Thickening of the lamina propria and infiltration of the mucosa and submucosa with histiocytes, lymphocytes, and plasma cells; ulceration with neutrophil infiltration in some animals. It causes inflammation and sores (ulcers) in the lining of the large intestine.

Differential diagnosis y y y y y y y Parasitic/infectious colitis Irritable bowel syndrome/ Stress colitis Eosinophilic colitis Regional enteritis Colonic cancer Colitis secondary to chronic pancreatitis Blood clotting disorders ("coagulopathies")

Note: All of these can cause symptoms similar to those that occur in colitis such as fresh (bright red) blood in the stool, mucus in the stool, straining to defecate, increased frequency of defecation and painful defecation. Pathognomonic lesion y The pathognomonic lesion of HUC in Boxer dogs is mucosal infiltration with large numbers of macrophages staining positively with periodic acid-Schiff (PAS), and is usually accompanied by mucosal ulceration and loss of goblet cells.

HUC is a chronic, severe gastrointestinal disease of typically seen in young Boxer dogs. Affected dogs usually present with signs of large bowel disease, initially frequent bloody mucoid stools, often progressing to chronic debilitation, weight loss, anemia, and hypoalbuminemia. Clinical signs are usually unresponsive to immunosuppressive therapy, and recent work strongly suggests a breedspecific defect in host defense is linked to invasion and persistence of E. coli within the colonic mucosa The colon of the dog becomes swollen with ulcers all along the lining of the dogs large intestine. The swelling actually destroys cells in the colons lining and this is where the ulcers develop. This condition is also called "Boxer Colitis" because the Boxer breed seems predisposed. This form of colitis is particularly ulcerative and involves infiltration of the tender colon lining with cells called "histiocytes." These cells are the cells that are normally called into the scene of inflammation relatively late so that they can absorb the dead cells and debris that have been created by the inflammatory event. Dogs with this condition typically show symptoms at an early age (less than 2 years) and become more debilitated by their symptoms than the usual colitis patients do. It is currently believed that this condition results from an inappropriate immune response against the common bacteria of the colon. Dogs with this form of colitis do not respond well to the usual remedies listed above but instead seem to show an excellent response to the antibiotic enrofloxacin. This antibiotic is particularly effective against gram negative bacteria (so classified because their cell wall's staining properties when tested). It has thus been inferred that these bacteria are at the root of the problem. Histiocytic ulcerative colitis can be confirmed by biopsy though signs of colitis in a young Boxer are highly suggestive of this condition. How Colitis Affects Dogs When the colon become inflamed for whatever reason, substances called inflammatory cytokines begin to accumulate there, disrupting the normal cellular structure and junctions of colonic tissues. This stimulates secretion of mucus and other substances from the large intestinal lining and adversely affects normal gut motility. As a result, the colons ability to properly absorb water and process feces is compromised, causing profuse diarrhea that often is mixed with mucus and/or frank (fresh) red blood.