Severe, diffuse, eosinophilic enteritis 6 Year Old MN DSH cat

Case Study

Severe, diffuse, eosinophilic enteritis 6 Year Old MN DSH cat

A 6 year old MN DSH cat was presented for vomiting.

A 6 year old MN DSH cat was presented for vomiting.

Sonographic Differential Diagnosis

IBD type gastrointestinal type pattern with portion of necrotic bowel. Potential emerging neoplasia. Potential for spontaneous perforation. Reactive omentum. Recommend intraoperative ultrasound in this patient with delineation of an infiltrative pattern with any section of bowel that is approximately 1.5 cm in width. This extends to approximately 15-20 cm. However, it turns into a more prominent low grade muscularis thickening, which is likely inflammatory bowel. Full thickness biopsies would be ideal. Recommend referring to intraoperative ultrasound abstract on www.sonopath.com from ECVIM 2009. In the meantime, broad spectrum antibiotics would be recommended. If surgery is not an option in this patient then Prednisolone can be considered. Fine-needle aspirates of the affected bowel in the muscularis region may prove fruitful. However, regardless of the underlying pathology this portion of thickened bowel is precarious and suspicious for spontaneous perforation such as bowel infarction.

Image Interpretation

The gastrointestinal tract in this patient presented some minor retained ingesta noted in the stomach. There was diffuse hypoechoic thickening of the muscularis and associated mesenteric root lymphadenopathy. A particular area of jejunum revealed some loss of detail and excessive thickening. This was approximately twice the width of any other areas of intestine and measured 1.2 cm in width. This portion of the intestine presented omental adhesion attached to the serosa. The width of serosa to mucosa measured 0.72 cm with a total width of 1.4 cm. This could be isolated surgically or further defined by intraoperative ultrasound. This intestinal presentation is most consistent with emerging lymphoma with inflammatory bowel elsewhere with the possibility of complicated inflammatory bowel disease, bowel infarction, dry form FIP or mast cell disease. Resection of the more dramatic portion of bowel is recommended. However, intraoperative delineation of the extent of the bowel is highly recommended. The mesenteric root lymph nodes measured 2.3 x 1.0 cm.

DX

Severe, diffuse eosinophilic enteritis of jejunum. Lymph node: eosinophilia infiltrate

Outcome

No further outcome provided.

Clinical Differential Diagnosis

GI tract – neoplasia, IBD, obstruction, ulceration, infectious (bacterial, protozoal, helminths), dietary, toxins Pancreatitis Metabolic – liver, renal, diabetes

Sampling

Biopsy of the jejunum revealed severe, diffuse, eosinophilic enteritis. Biopsy of lymph node revealed eosinophilia infiltrate.

Patient Information

Patient Name : Poseidon B
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Book : yes
Status : Complete
Liz Wuz Here : Yes
Code : 04_00285

Clinical Signs

  • Vomiting

Clinical Signs

  • Vomiting