Case Study

Ileal Mass and Foreign Body in an 11-year-old MN Labrador Retriever dog

An 11-year-old MN Labrador retriever dog was presented with a history of vomiting and hematuria. Recent CBC had revealed eosinopenia and neutrophilia. T4 was low. Prior urine culture a few months prior had been positive for E. coli but a more recent urine culture was negative. The cystitis had been treated with Baytril. There was progressive vomiting and more recent loss of appetite. The patient was treated with Cerenia, Pepcid, Purina EN, and Carafate but continued with the vomiting and poor appetite. Diarrhea was now present. It was noted that abdominal radiographs contained irregularities.

An 11-year-old MN Labrador retriever dog was presented with a history of vomiting and hematuria. Recent CBC had revealed eosinopenia and neutrophilia. T4 was low. Prior urine culture a few months prior had been positive for E. coli but a more recent urine culture was negative. The cystitis had been treated with Baytril. There was progressive vomiting and more recent loss of appetite. The patient was treated with Cerenia, Pepcid, Purina EN, and Carafate but continued with the vomiting and poor appetite. Diarrhea was now present. It was noted that abdominal radiographs contained irregularities. Thoracic radiographs were within normal limits.

DX

Ileal mass and foreign body

Sonographic Differential Diagnosis

Distal small intestinal obstruction, complicated IBD. Potential concurrent intestinal neoplasia.

Image Interpretation

The gastrointestinal tract presented distal small intestinal, embedded, tubular foreign body with translucent properties and a V shaped tubular structure with surrounding loss of structural detail of the intestinal wall and reactive, hyperechoic omentum. A minor amount of free fluid was noted.

Outcome

An abdominal exploratory surgery was performed. A mid ileum mass was found. The mass was resected and samples were submitted to a pathologist for review. A foreign body was found inside of the mass. The microscopic interpretation of the samples from the intestines revealed slight plasmacytic, lymphocytic, eosinophilic enteritis, and the sample of the mass revealed intestine with transmural perforation and chronic ongoing peritonitis with fibrosis. After recovering from surgery the pet was released from the hospital with tramadol and previcox, and metronidazole. One week after the surgery the owner reported that the pet was having diarrhea, had a poor appetite, and had become lethargic. The owner returned the pet to the hospital and elected to humanely euthanize the pet.

Comments

Intestinal wall resection and biopsies would be recommended with abdominal lavage.

Clinical Differential Diagnosis

Gastrointestinal pathology – foreign body, neoplasia, IBD, ulceration, granulomatous disease; Pancreatic pathology – pancreatitis, neoplasia; Focal peritonitis

Sampling

A mid ileum mass was found. The mass was resected and samples were submitted to a pathologist for review. A foreign body was found inside of the mass.