Case Study

Jejunal suppurative inflammation in a 13 year old MN cat

A 13 year old male neutered DSH was presented for a decreased appetite. On physical examination, thickened intestines were present on palpation. Urinalysis was within normal limits. CBC showed neutrophilia, lymphopenia, and thrombocytopenia. On survey radiographs, gas in the colon, food in the stomach, and mineral densities in the kidneys was evident.

A 13 year old male neutered DSH was presented for a decreased appetite. On physical examination, thickened intestines were present on palpation. Urinalysis was within normal limits. CBC showed neutrophilia, lymphopenia, and thrombocytopenia. On survey radiographs, gas in the colon, food in the stomach, and mineral densities in the kidneys was evident.

DX

Suppurative inflammation of a section of jejunum

Sonographic Differential Diagnosis

Intestinal necrosis, enteritis or IBD with transmural penetration, intestinal neoplasia emerging (LSA, MCT), or dry form feline infectious peritonitis are all possibilities. The lesion appears resectable ideally with intraoperative ultrasound to define the margins.

Image Interpretation

The small intestine reveals diffuse muscularis thickening, but the thin hyperechoic submucosa remains intact. Echogenic surrounding fat is attached to the serosal layer of the intestine suggestive for transmural inflammation or emerging neoplasia.

Outcome

Full thickness intestinal biopsies were recommended but declined. The patient was treated with antibiotics and then steroids and was stabilized.

Comments

Follow-up exam would have been ideal as this could have represented neoplasia that did not exfoliate on the cytology examination.

Clinical Differential Diagnosis

Intestinal thickening (IBD, neoplasia, granulomatous disease, infection (bacterial/fungal), renal mineralization (calculi, calcification).

Sampling

Fine needle aspirate cytology from the jejunum revealed mixed inflammation