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- When Obstruction Isn’t the Obstruction: CT Uncovers Intestinal Leiomyositis in a Young Labrador
When Obstruction Isn’t the Obstruction: CT Uncovers Intestinal Leiomyositis in a Young Labrador
VRU 2025
Obi Veterinary Education
December 17, 2025
Mercedes Cantu; Eric T. Hostnik; Rebecca Urion
Background
Intestinal pseudo-obstruction is a rare syndrome in veterinary medicine characterized by impaired gastrointestinal motility without a mechanical blockage. Leiomyositis, an inflammatory disease of intestinal smooth muscle, represents an uncommon cause of this condition in dogs and is poorly documented, particularly with advanced imaging. This report aimed to describe the radiographic and computed tomographic features of intestinal leiomyositis in a young canine patient and to highlight the diagnostic value of CT angiography in cases of severe ileus .
Methods
A 3-year-old male neutered Labrador Retriever with several weeks of hyporexia, acute anorexia, and vomiting underwent abdominal radiography, point-of-care ultrasound, and triple-phase contrast-enhanced CT angiography. Due to severe generalized gastrointestinal dilation without evidence of obstruction, exploratory laparotomy with full-thickness biopsies of multiple gastrointestinal segments and a jejunal lymph node was performed to establish a definitive diagnosis .
Results
Radiographs and CT demonstrated severe, diffuse dilation of the stomach and small intestine with gas–fluid interfaces and reduced to absent peristalsis, but no mechanical obstruction, mural thickening, abnormal contrast enhancement, vascular compromise, or peritoneal disease. Surgical exploration confirmed functional ileus without obstruction. Histopathology revealed mild to moderate lymphoplasmacytic gastroenteritis with leiomyositis, multifocal neutrophilic infiltrates, and smooth muscle vacuolation, establishing a diagnosis of intestinal leiomyositis. Despite supportive medical management, the patient failed to improve and was euthanized three days postoperatively .
Limitations
This report describes a single clinical case, limiting generalizability. The pathogenic significance of concurrent gastric organisms identified histologically was uncertain. Additionally, although CT effectively excluded many differential diagnoses, definitive diagnosis still required invasive full-thickness biopsies .
Conclusions
This case documents the CT imaging characteristics of canine intestinal leiomyositis and demonstrates the utility of CT angiography in differentiating functional ileus from mechanical, vascular, or peritoneal causes of gastrointestinal dilation. While histopathology remains essential for definitive diagnosis, CT provided critical guidance for clinical decision-making and expands the limited imaging literature on this rare condition in dogs .
Post-contrast venous phase CT images in mid-sagittal (A), left parasagittal (B), and dorsal (C) planes with the patient in sternal recumbency. Cranial is to the left in (A) and (B) and to the top in (C). The majority of the small intestine is moderately diffusely dilated with a mixture of homogeneous soft tissue and gas, resulting in gravity-dependent gas–fluid interfaces (white arrowheads). A small amount of heterogeneous soft tissue, mineral, and gas attenuating content is within several small intestinal segments, although incompletely filling the lumens (white arrows). In (A), there is normal contrast-filling of the celiac and cranial mesenteric arteries (white asterisks).
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