This 12-year-old FS DSH cat was presented with a short history of eating plants, vomiting hairballs, and anorexia that was non-responsive to hospitalization and intravenous medical treatment. Clinical exam revealed a doughy abdomen, and mild hypothermia. Blood analysis revealed mild neutropenia and hypoalbuminemia.
This 12-year-old FS DSH cat was presented with a short history of eating plants, vomiting hairballs, and anorexia that was non-responsive to hospitalization and intravenous medical treatment. Clinical exam revealed a doughy abdomen, and mild hypothermia. Blood analysis revealed mild neutropenia and hypoalbuminemia.
Case Study
Small Intestinal Pseudo-Obstruction in a 12 year old FS DSH cat
Sonographic Differential Diagnosis
Obstructive or partial obstructive pattern (due to focal functional or neurologic ileus, foreign body, infiltrative disease not evident on ultrasound).
Image Interpretation
This is an example of an obstructive pattern. There is a hyperechoic sound absorbing structure within the lumen and dilation of the small intestine proximal to the object and empty small intestine distal to the object.
DX
Small intestinal pseudo-obstruction
Outcome
The patient expired due to cardiac arrest at surgical laparotomy with no visible obstruction. Variable areas of hypoxic intestine were noted during surgery.
Comments
This is an example where there was an obstructive pattern created on ultrasound that was not due to an actual physical object as suspected from the images. Thus the labeling of this case is as a pseudo-obstruction. This type of ultrasound pattern can be caused by focal non functional portions of bowel with resultant areas of dilated small intestine and empty small or large intestines. Luminal ingesta can often be mistaken as a sound absorbing foreign body. Regardless, given the clinical presentation the choice to perform an exploratory laparotomy was justified due to lack of response to medical therapy.
Clinical Differential Diagnosis
GI pathology – Plant toxicosis, trichobezoar, protein losing enteropathy, IBD, gastric ulceration, dietary indiscretion, neoplasia; pancreatic pathology – pancreatitis
Sampling
No biopsies were performed. (See outcome notes.)
Video
Patient Information
Patient Name :
Firecracker L
Gender :
Female, Spayed
Species :
Feline
Type of Imaging : Ultrasound
Status :
Complete
Liz Wuz Here :
Yes
Code :
04_00086
Clinical Signs
- Anorexia
- Vomiting
Exam Finding
- Doughy Abdomen
- Hypothermia
Images
Blood Chemistry
- Albumin, Low
CBC
- Neutrophils, Low
Clinical Signs
- Anorexia
- Vomiting