Case Study

Chronic enteritis in a 14 year old FS DSH cat

This 14-year-old FS DSH presented for anorexia, occasional vomiting, and weight loss. CBC and blood chemistry analysis were normal.

This 14-year-old FS DSH presented for anorexia, occasional vomiting, and weight loss. CBC and blood chemistry analysis were normal.

DX

Moderate, chronic, fibrosing, lymphoplasmacytic, eosinophilic enteritis

Sonographic Differential Diagnosis

Severe inflammatory bowel disease with possible malignant transformation to lymphosarcoma is suspected. Persistent, however moderately less severe, inflammatory changes are present on the follow-up study.

Image Interpretation

The small intestines are diffusely, moderately to markedly thick walled and abnormally layered, represented by a severely thickened muscularis layer (arrow). Subtle loss of wall layering is also noted. The long axis view of the ileocecal region further demonstrates muscularis thickening and loss of mural detail (arrow.) Mild to moderate bowel wall thickening persisted after 2 months of therapy. On recheck ultrasound, the muscularis layer is persistently prominent (wide arrow); however, discrete wall layering is now visualized (thin arrow).

Comments

The patient responded well to anti-parasitic therapy, novel protein diet, and a tapering immune-suppressive dosing regimen of prednisone. The patient is currently managed at 2.5 mg prednisone every other day. The patient becomes symptomatic again if tapered off of this steroid regimen. No video is available on this patient.