Case Study

Colonic mass in a 15 year old MN DSH cat

A 15-year-old MN DSH cat was presented for inappropriate urination over a 2 month period, intermittent vomiting, and possibly straining to defecate. On physical examination the patient was BAR, slightly dehydrated, and had a non-compressible mass in the caudal abdomen. Proteinuria (1+) and glycosuria (3+) was present on urinalysis. Abnormalities on CBC and blood chemistry were thrombocytopenia, hyperglycemia, and hyperamylasemia. T-4 was within normal range.

A 15-year-old MN DSH cat was presented for inappropriate urination over a 2 month period, intermittent vomiting, and possibly straining to defecate. On physical examination the patient was BAR, slightly dehydrated, and had a non-compressible mass in the caudal abdomen. Proteinuria (1+) and glycosuria (3+) was present on urinalysis. Abnormalities on CBC and blood chemistry were thrombocytopenia, hyperglycemia, and hyperamylasemia. T-4 was within normal range. Survey radiographs showed some stool in the colon, a narrow lumen of gas in the rectum, increased gas pattern in the mid-abdomen, and a suspicious radiopaque area in the right lung field.

Sonographic Differential Diagnosis

Colonic mass effect: inflammatory, infiltrative (neoplastic) or focal stricture

Image Interpretation

A 2.17 cm wide focal hypoechoic wall thickening is in the colon with visible bowel contents both cranial and caudal to affected area.

DX

Colonic mass

Outcome

The patient was euthanized.

Comments

The owner opted for symptomatic treatment with Baytril and amoxicillin but within 2 days was presented at an emergency center for not urinating, vomiting, and not defecating. A mass in the descending colon measuring 2.2cm was seen. Although the mass was largely obstructive it appeared resectable. A subtotal colectomy and pancreatic biopsy were advised for the patient. While attending the subtotal colectomy surgery, the patient’s owner accidentally overdosed the cat with insulin causing him to enter into a hypoglycemic coma, and he was subsequently euthanized.

Clinical Differential Diagnosis

Glycosuria/hyperglycemia – Diabetes mellitus. Abdominal mass – neoplasia/granuloma/abscess of colon, bladder, peritoneal cavity. Vomiting – GI tract pathology (neoplasia, IBD, foreign body); Pancreatic pathology (neoplasia), Liver pathology (neoplasia); Lung pathology (neoplasia, infectious pneumonia, aspiration)