Case Study

Jejunal mass in a 9-year-old MN Rottlweiler mixed dog

A 9-year-old MN Rottweiler mixed dog presented at an emergency referral facility for vomiting. Abnormalities on CBC and serum chemistry were thrombocytopenia and hypoalbuminemia. Abdominal radiographs showed a small liver, some ingesta in the stomach, some gas in the GI tract but with no obstructive patterns, thickening of the intestinal walls and corrugation of the colon. The patient was treated with SQ fluids, Cerenia, famotidine, and tramadol with the recommendation that the patient be reevaluated by their regular veterinarian if vomiting persists.

A 9-year-old MN Rottweiler mixed dog presented at an emergency referral facility for vomiting. Abnormalities on CBC and serum chemistry were thrombocytopenia and hypoalbuminemia. Abdominal radiographs showed a small liver, some ingesta in the stomach, some gas in the GI tract but with no obstructive patterns, thickening of the intestinal walls and corrugation of the colon. The patient was treated with SQ fluids, Cerenia, famotidine, and tramadol with the recommendation that the patient be reevaluated by their regular veterinarian if vomiting persists. Ten days after the initial exam the owner had the pet reevaluated as there was ongoing vomiting and the development of PU/PD.

Sonographic Differential Diagnosis

Infiltrative jejunal mass. This is most consistent with complicated inflammatory bowel disease. However, lymphoma and intestinal carcinoma are of primary concern as well.

Image Interpretation

Visibility was difficult in this patient owing to body confirmation. A large amount of gastrointestinal gas was present. Prominent mucosa was noted throughout the gastrointestinal tract. However, a 7 cm long x 4 cm wide jejunal mass was noted. This created a partial obstructive pattern. Omental adhesions were also noted associated with the serosa. The jejunal mass appeared to be in the left caudal abdomen adjacent and cranial to the urinary bladder.

DX

Jejunal mass

Outcome

It was recommended that the pet have surgery. The owner elected to have the pet humanely euthanized.

Comments

Fine needle aspirate or biopsy following coagulation panel would be ideal. The mass appears resectable, yet aggressive resection 5 cm proximal to and distal from any wall thickening and omental reactivity would be warranted given that a progressive prominent bowel and IBD presentation is also noted. Therefore, intraoperative ultrasound would be ideal in this case.

Clinical Differential Diagnosis

GI tract pathology (neoplasia, foreign body, intussusception, IBD, partial torsion); Pancreatic pathology (pancreatitis, neoplasia); Liver pathology (cirrhosis, chronic liver failure)