Skip to content
Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.

Early lymphoma and hepatic lipidosis in a 10 year old FS DSH cat

Case Study

Early lymphoma and hepatic lipidosis in a 10 year old FS DSH cat

A 10-year-old FS DSH cat was presented for weight loss, vomiting, and anorexia. On physical examination, the patient was quiet and cachexic. The patient had lost 5-pounds over seven months, was tachycardic, and had thickened intestines and small kidneys. CBC showed lymphopenia, polycythemia, and thrombocytopenia. On blood chemistry, there was elevated ALP, ALT, and hyperbilirubinemia. The serum was icteric. The patient was treated with intravenous fluids containing 5% dextrose, antibiotics, liver protectants, appetite stimulants, gastroprotectants, pain medication, and lactulose.

A 10-year-old FS DSH cat was presented for weight loss, vomiting, and anorexia. On physical examination, the patient was quiet and cachexic. The patient had lost 5-pounds over seven months, was tachycardic, and had thickened intestines and small kidneys. CBC showed lymphopenia, polycythemia, and thrombocytopenia. On blood chemistry, there was elevated ALP, ALT, and hyperbilirubinemia. The serum was icteric. The patient was treated with intravenous fluids containing 5% dextrose, antibiotics, liver protectants, appetite stimulants, gastroprotectants, pain medication, and lactulose. Radiographs did not demonstrate any significant findings. After two days on fluid therapy, the patient was showing no menace, could not see, was head pressing, and was icteric.

Sonographic Differential Diagnosis

Gastric wall thickening, potential lymphoma. Probable hepatic lipidosis. Possible hepatic lymphoma.

Image Interpretation

The esophageal stomach revealed 1.3 x 1.5cm thickening that was aspirated by fine needle aspirate. The liver was diffusely hyperechoic compared to falciform fat in the near field most consistent with lipidosis.

DX

Stomach: early lymphoma. Liver: hepatic lipidosis

Outcome

The initial therapy was continued and a feeding tube was placed. The follow day the head pressing had resolved, menace had improved, but there was still ongoing anorexia and icterus. The owners declined any surgical intervention, decided to continue treating the cat for hepatic lipidosis, and would pursue an oncology consult for possible chemotherapy. Recheck blood work showed some improvement in the liver enzyme activity and bilirubin. The patient was tolerating tube feedings well but was still not eating on her own. The patient was started on the Madison-Wisconsin chemotherapeutic protocol. She starting eating on her own, however, after the second dose of chemotherapy, her appetite waned. The owner decided to cease any further chemotherapy and instead treat the patient with steroids and appetite stimulants. At last communication, the patient was stable.

Clinical Differential Diagnosis

Liver disease – lipidosis, cholangiohepatitis, infectious, neoplasia. GI disease: IBD, intestinal neoplasia, lymphoma.

Sampling

US-guided FNA cytology from the stomach wall was suggestive of early lymphoma; whereas the liver aspirates were consistent with hepatic lipidosis. (PT and APTT were done prior to obtaining the aspirates).

Patient Information

Patient Name : Jessie D
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 04_00151

Clinical Signs

  • Anorexia
  • Vomiting
  • Weight loss

History

  • Anorexia
  • Vomiting
  • Weight Loss

Exam Finding

  • Cachexia
  • Icterus
  • Small Kidneys
  • Tachycardia
  • Thickened Intestines

Images

0400151jessedo1_090820110957450400151jessedo1a_090820110952370400151jessedoliverfna_090820110952510400151jessedo2pylorus_09082011095800

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • Total Bilirubin, High

CBC

  • Lymphocytes, Low
  • Platelet Count, Low

Clinical Signs

  • Anorexia
  • Vomiting
  • Weight loss