Case Study

Colonic neoplasia in a 15 year old FS DSH cat

A 15-year-old FS DSH cat was presented for vomiting for the past week with mucousy stools and tenesmus. Current diet was C/D. Abnormalities on CBC and serum biochemistry was leukocytosis, neutrophilia, thrombocytopenia, and elevated AST and ALT activity. T4 was 1.6 ug/dL.

A 15-year-old FS DSH cat was presented for vomiting for the past week with mucousy stools and tenesmus. Current diet was C/D. Abnormalities on CBC and serum biochemistry was leukocytosis, neutrophilia, thrombocytopenia, and elevated AST and ALT activity. T4 was 1.6 ug/dL.

Sonographic Differential Diagnosis

Colonic neoplasia (LSA, MCT, Carcinoma) or granulomatous colitis. Possible concurrent pancreatic neoplasia or nodular hyperplasia. Potential hairball accumulation within the stomach.

Image Interpretation

The upper gastrointestinal tract was structurally uneventful. However, the transverse and descending colon appeared to be thickened and infiltrated with hypoechoic mural changes and omental reactivity with adhesions. A hair density was noted in the stomach. The pancreas was hypoechoic and slightly irregular.

DX

Colonic neoplasia vs granulomatous colitis. Possible pancreatic neoplasia. Tricobezoar.

Outcome

The patient has not returned for follow up ultrasound. No further outcome was available.

Comments

The colonic adhesions appear resectable if the surgeon is to resect the colon at the level of the apex of the urinary bladder back to the proximal colon just after the cecum in a subtotal colectomy fashion. Biopsies and wall cultures would be recommended. The hair density in the stomach should be evacuated at the time of surgery. A pancreatic biopsy would be recommended at the time of surgery. However, fine-needle aspirates could be performed.

Clinical Differential Diagnosis

Vomiting – GI tract pathology (neoplasia, IBD, idiopathic colitis, infectious -bacteria, fungal, helminths, protozoa), dietary; Liver pathology (cholangitis-cholangiohepatitis, neoplasia, infectious); Pancreatic pathology (pancreatitis, neoplasia)