Sonopath Forum

Chronic vomiting and inappetence in a 17 year old FS DMH with a history of stage 2 renal disease, possible IBD,and elevated fPLI

This is a 17 year old FS DMH with a history of crf Iris stage 2, high fPLI, anorexia, and chronic intermittent vomiting. The cat is currently being treated with Miralax, ALOH, prednisone, and mirtazapine. CBC shows nsf, fPLI=4.4, BUN=53, Creat=2.6, Chol=309, SDMA=16.

Ultrasound findings done on 9-29-16 showed: a small intestine-increased muscularis to mucosal ratio, ileocecal-colic region-adjacent, echogenic, reactive fat, right kidney-reduced size, caudal pole infarct, left pancreas-normal, pancreatic body-slightly decreased echogenicity with echogenic fat seen between the pancreas and the stomach.

The owner has declined additional diagnostics (endoscopy, surgical biopsy) and the cat continues to do poorly. The owner subsequently discontinued the pred as he felt it made the cat initially better than worse.

I have suggested anti-ulcer medication, anti-emetics, cobalamin supplementation, antibiotics and other immunusuppressive therapy. Any other thoughts?

Comments

October 29, 2016 at 10:02 pm -

This muscularis hypertrophy

This muscularis hypertrophy is very very common in cats especially older ones and really tough to say much about it without bx but since no loss of detail and ratio is not over the top its likely a minimal player and just ibd that may or may not be active. The right panc base is a bit hypoechoic though. I would focus more on combating hydration, any hypertension or uti and ensurign a renal canned diet.