Case Study

Splenic mast cell disease in a 13 year old FS DSH cat

A 13-year-old spayed female DSH was presented for evaluation of intermittent chronic vomiting. Abnormalities on physical examination were pale mucus membranes, grade I/VI murmur, and ascites.

Sonographic Differential Diagnosis

Splenomegaly: inflammation (splenitis, splenic torsion), infection (penetrating abdominal wound, migrating foreign body, endocarditis, sepsis, infection secondary to splenic torsion), necrosis (anaerobic infection, Salmonella secondary to torsion or neoplasia), eosinophilic gastroenteritis, lymphoplasmacytic disease (subacute or chronic infectious disorder, infectious canine hepatitis, ehrlichiosis), granulomatous or pyogranulomatous disease (histoplasmosis, mycobacteriosis, blastomycosis), hyperplasia (infection, immune-mediated, congestion), infiltration (neoplasia, extramedullary hematopoiesis secondary to IMHA or ITP), amyloidosis. Ascites: transudate (increased intravascular pressure, right heart failure, portal hypertension secondary to portal vein thrombus, hypoalbuminemia, cirrhosis, lymphatic obstruction, noncirrhotic portal hypertension), exudate (septic, non-septic such as pancreatitis or chylous effusion), neoplastic effusion.

Image Interpretation

Spleen is nearly twice normal size measuring 18.5mm (N<10mm); it is mildly rounded in shape with irregular jagged margins, and has a heterogenous hyperechoic echogenicity. No focal lesions are appreciated. A mild amount of anechoic fluid is noted between the liver lobes. A moderate amount of anechoic fluid is seen within the abdomen.

DX

Splenic mast cell disease

Outcome

None

Comments

Case courtesy of Marty Henderson, DVM. SonoVet, Inc.

Clinical Differential Diagnosis

Ascites: hypoalbuminemia, portal hypertension (liver disease, thromboembolic disease, cardiac disease), neoplasia, hemorrhage, FIP, septic peritonitis; Cardiac disease: dilated/hypertrophic cardiomyopathy; Hyperthyroidism.