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  • acetylcholine inhibitors In addition to narrowing a wide kno


    In addition to narrowing a wide knowledge gap in Hh developmental biology research, improved understanding of Disp structure and function is likely to also be relevant to cancer. A growing body of evidence supports that Shh facilitates tumor–stroma communication in a range of cancers to influence tumor growth (reviewed in [56]). The ability of Disp to modulate cytoneme dynamics or deployment-route selection might therefore be exploited by tumors to enhance such communication. Thus, delineation of the molecular mechanisms by which Disp facilitates Hh family ligand transport during tissue morphogenesis may reveal novel opportunities for therapeutic intervention against Shh-secreting tumors.
    Acknowledgments This work was supported by National Institutes of Health Grant R35GM122546 (S.K.O.) and by ALSAC of St. Jude Children's Research Hospital. We thank members of the Ogden laboratory for comments on the manuscript.
    CASE REPORT A 2-month-old intact female African pygmy hedgehog (Atelerix albiventris) presented with a 1-week history of intermittent vomiting. The patient was presented 2 weeks prior for a wellness exam, and no abnormalities were found at the time. The hedgehog was housed alone and fed dried insects and a commercial cat food, which was switched to a commercial hedgehog pellet (Exotic Nutrition Hedgehog Complete, Newport News, VA, USA) 5 days prior to presentation. The owner had previously noticed carpet chewing and was concerned about a possible foreign body. Physical examination was unremarkable at the time of presentation, and the hedgehog weighed 310 g. Whole-body radiographs and ultrasound were performed under general anesthesia using isoflurane to effect in 100% oxygen. Radiographs showed mild gastric distention with soft tissue opaque amorphous to granular material. Similar material was also found in the intestines. A gas filled intestinal loop was present in the cranial abdomen. On ultrasound, the acetylcholine inhibitors was mild to moderately dilated with air and echogenic material with no obvious foreign material in the pylorus. There was a mild to moderately fluid-dilated loop of intestine in the mid to right abdomen. Radiographs and ultrasound could not confirm or rule-out foreign material or obstruction, so the patient was sent home with famotidine (0.5 mg/kg to be given orally every 12 hours) on the presumptive diagnosis of a gastritis of unknown origin, possibly secondary to the recent diet change. Histopathology of gastric and intestinal biopsy samples revealed a moderate eosinophilic gastroenteritis with globule leukocytes (Fig. 1). The lamina propria was diffusely expanded by moderate numbers of eosinophils, neutrophils, lymphocytes, and globule leukocytes. Intraepithelial lymphocytes were present. There was minimal epithelial injury and no evidence of villous stunting. No infectious etiology was detected. The patient was started on fenbendazole (20 mg/kg orally once every 24 hours for 3 days and repeated in 14 days) to treat a possible parasitic infection. On the last day of fenbendazole treatment, the patient presented with no clinical improvement. Prednisolone (0.36 mg/kg orally every 12 hours) with food was initiated for its anti-inflammatory effects. Four weeks later there was no clinical improvement from the prednisolone and a complete blood count and plasma biochemistry panel were performed via jugular venipuncture. Complete blood count revealed a relative eosinophilia (1.2 × 103; 12%, reference interval 0% to 5.1%). Plasma biochemistry values were unremarkable. A 1-month diet trial was initiated and the patient was transitioned from a commercial hedgehog diet to a feline hypoallergenic diet (Hill's Prescription Diet z/d feline, Topeka, KS, USA).
    DISCUSSION This case describes the diagnosis and long-term clinical management of eosinophilic gastroenteritis in a pet hedgehog. We believe the clinical signs of hematemesis, ileus, diarrhea, and dysbiosis seen in this patient can be explained by this chronic inflammatory disease. Eosinophilic gastroenteritis, a form of inflammatory bowel disease (IBD), has not previously been reported in pet hedgehogs. IBD has been reported in many other species including horses, dogs, cats,2, 3, 4 and exotic animal species including the ferret. In ferrets, IBD is primarily characterized by lymphoplasmacytic inflammation while primary eosinophilic inflammation is rare. Inciting factors for IBD in ferrets may include food hypersensitivity, gastric foreign body, bacterial overgrowth, carbohydrate overload, bacterial or viral infection, parasites, aberrant immune response, or toxins. Clinical signs of IBD in ferrets may be subtle in the early course acetylcholine inhibitors of disease, while signs of progression include weight loss, melena, vomiting, and loss of musculature. Acute diarrhea may occur due to secondary bacterial overgrowth.