Case Study

Ileocecocolic adenocarcinoma in a 14 year old Pug

This 14-year-old Pug dog was presented for persistent, non-responsive diarrhea. Blood analysis revealed moderate leukocytosis with a left shift and 4% bands, mild anemia, and mild hypoalbuminemia.

This 14-year-old Pug dog was presented for persistent, non-responsive diarrhea. Blood analysis revealed moderate leukocytosis with a left shift and 4% bands, mild anemia, and mild hypoalbuminemia.

Sonographic Differential Diagnosis

Ileal/ileocolic wall mass consistent with neoplasia. Granulomatous disease or an equivocal inflammatory process/abscess is considered less likely.

Image Interpretation

Marked, circumferential distal ileal wall thickening is noted. The affected ileum lacks normal wall layering and the thickening is slightly asymmetrical (greater in the far field). The echogenic gas curtain adjacent to the mass represents a continuation of the gastrointestinal tract as the ascending colon, and involvement of the structure cannot definitively be ruled out. Video demonstrates an 18ga automated core biopsy of the intestinal mass to ensure that structure is represented as opposed to FNA which would reveal only cytology and potentially not be diagnostic for granulomatous disease.

DX

Ileocecocolic adenocarcinoma

Outcome

Partial remission was achieved with a Gemzar protocol for 2 months until local recurrence prompted persistent similar signs. The owner opted for euthanasia at this time.

Clinical Differential Diagnosis

Gastroenteritis with protein-losing enteropathy, neoplasia, pancreatitis, foreign body, or chronic intussusception.

Sampling

Ultrasound-guided 18ga intestinal biopsy revealed papillary epithelial proliferation. Surgical ileocecocolic resection was analyzed as intestinal adenocarcinoma with multiple lymphatic emboli.