- 8 year old FS DSH with a history of chronic vomiting and weight loss (16lbs to 11 lbs in the last 3 months).
- Chemistry profile and T4 performed in June were both normal.
- Abdominal ultrasound showed focal thickening (6.8mm) of the gastric wall with loss of layering detail.
- This patient was not fasted for this exam and had a moderate amount of ingesta in the stomach at the time of the scan. Should I rescan this patient with an empty stomach or are these images sufficient? No other abnormalities were seen.
- 8 year old FS DSH with a history of chronic vomiting and weight loss (16lbs to 11 lbs in the last 3 months).
- Chemistry profile and T4 performed in June were both normal.
- Abdominal ultrasound showed focal thickening (6.8mm) of the gastric wall with loss of layering detail.
- This patient was not fasted for this exam and had a moderate amount of ingesta in the stomach at the time of the scan. Should I rescan this patient with an empty stomach or are these images sufficient? No other abnormalities were seen.
- I have recommended endoscopy but am not sure if that will happen as this cat’s medical expenses are paid for by an animal shelter.
- Thank you for your input!
Comments
Possiblities are neoplasia
Possiblities are neoplasia (lymphoma, carcinoma) and granulomatous lesion/reaction. Try and FNA the wall as it may give you a diagnosis. Endoscopy may help but if there is no perforation /involment of the mucosal layer it may not be diagnostic.
Thanks Remo. I just don’t
Thanks Remo. I just don’t know whether to say yes, this is the cause of the vomiting and weight loss or if they should continue to look for other causes. Since no abnormalities were seen on bloodwork, it makes sense that some kind of GI biopsy is in order.
If labs are normal and
If labs are normal and pancreatitis is not an issue then it has to be a primary GI issue.
I have aspirated the gastric wall before and lymphoma did not exfoliate very well. I posted the cat with the owners OK and you could see my needle marks right in the area of the thickening (I did not miss). Histopath confirmed Lymphoma.
If possible an exploratory with full thickness biopsy would be the way to go- then they can run the bowel.
Thanks Randy. I agree. The
Thanks Randy. I agree. The situation is a slightly complicated in that even though the cat was adopted out, the rescue group pays for the medical care since the cat is FeLV+. As such, exploratory may not be an acceptable option for them. I am hoping to be able to scan the cat again with an empty stomach just to make sure there isn’t some kind of food artifact. If it is still there, I will try to aspirate. I have successfully aspirated gastric wall lymphoma before, but the wall was thicker (>1.0cm).
I surely dont like that wall
I surely dont like that wall with hypertrophy and loss of mural detail. LSA or carcinoma are my best guesses maybe dry fip. Sx bx and liberation of the stomach material (hair or similar) is an option as well.