Case Study

Distal small intestinal mass, gastric foreign body and bladder stones in a 11 year old MN Norwich Terrier

This 11 year old MN Norwich Terrier has a history of urate crystals and presented with gastroenteritis and inappetance.

DX

Distal small intestinal mass with obstructive pattern. Concurrent bladder calculi embedded in the proximal urethra.

Image Interpretation

The urinary bladder presented multiple calculi that were non obstructive. Calculi appeared to be embedded within the pelvic urethra as well. The stomach in this patient presented shadowing pyloric structure with an obstructive pattern and fluid accumulation, which continued into the small intestine. Mural thickening in a focal mass measuring 3.01 x 1.9cm was noted in the mid abdomen. This appeared to be jejunum with an obstructive pattern. Focal areas of mineralization were noted. Given the focal mineralization this is suggestive for carcinoma. Obstructive and inflammatory pattern was noted. The mass appeared to be positioned between the spleen and urinary bladder. This appears to be small intestinal in nature and superimposes on the colon. Slight areas of free fluid were noted.

Outcome

Focal mineralization, suggestive for carcinoma.
Shadowing material noted in the stomach as well.
Concurrent foreign matter is suspected.
Recommend laparotomy with expectations towards aggressive resection and
anastomosis as well as evacuation of the stomach and expression of the gallbladder. At
that time cystotomy with normal and retrograde flushing would be recommended as
the calculi appeared to be embedded within the pelvic urethra. Guarded prognosis. No
overt evidence of metastatic disease was noted. However, concurrent liver biopsy
would be ideal given the heterogenous changes.