Clostridium perfringens type C–associated emphysematous gastritis in a dog with pancreatic disease

Emphysematous gastritis is a rare, serious infection with very few reported cases in veterinary species. Gas-producing bacteria are most often implicated in both animals and humans. Here, we describe a case of emphysematous gastritis in a 7-y-old dog that was diagnosed with ileus of 12 d, chronic pancreatitis, and exocrine pancreatic insufficiency. Histologically, the gastric submucosa was markedly expanded by emphysema, and the mucosa had multifocal necrosis, hemorrhage, and gram-positive bacilli. Anaerobic culture of the stomach wall yielded 3+ growth of Clostridium perfringens, Enterococcus faecalis, and Escherichia coli. PCR typing identified the C. perfringens isolate as type C, further characterized as a beta2 toxin-producing strain. Fluorescence in situ hybridization using a C. perfringens probe identified bacilli within the gastric mucosa and submucosa. C. perfringens type C causes enteritis necroticans in humans and necrohemorrhagic enteritis in livestock when levels of endogenous trypsin are low or dietary levels of trypsin inhibitors are high. The exocrine pancreatic insufficiency in our case likely allowed C. perfringens type C to exert cytotoxic effects on the gastric mucosa and contributed to the unique emphysematous gastritis.