Case Study

Pseudo-Obstructive Pattern in a 16 year old FS DSH cat

This 16-year-old FS DSH was presented for acute, persistent vomiting and anorexia that was non-responsive to medical treatment. Clinical exam revealed poor body condition but was otherwise unremarkable. The blood analysis only revealed mild hyperglobulinemia.

This 16-year-old FS DSH was presented for acute, persistent vomiting and anorexia that was non-responsive to medical treatment. Clinical exam revealed poor body condition but was otherwise unremarkable. The blood analysis only revealed mild hyperglobulinemia.

DX

Pseudo-obstructive pattern

Sonographic Differential Diagnosis

Acute inflammatory disease. Differentials include gastroenteritis possibly secondary to dietary indiscretion, bowel wall ischemia or infarction and less likely, neoplasia.

Image Interpretation

The stomach and several loops of small bowel are mildly to moderately fluid and gas distended with suspect hyper-segmentation.. Wall thickness and layering of the effected bowel are within normal limits. Normal ileocolic region. (Note the abrupt change in ileal and colonic wall thickness and lack of ileal distention.)

Outcome

The patient expired 36 hours postoperative due to complications. This is an example of a pseudo-obstructive pattern and the lack of recognition of the ileocecal transition from empty small intestine to colonic stool. Upper GI stasis and hyperperistalsis was present which were simply due to inflammation or irritation.

Clinical Differential Diagnosis

GI pathology – Foreign body, trichobezoar, gastroenteritis, pancreatitis, intussusception, neoplasia, IBD.

Sampling

Exploratory surgery was performed based on obstructive criteria and need for intestinal biopsies. Histopathological analysis revealed normal stomach and moderate lymphoplasmacytic duodenal and jejunal inflammation. No obstruction was found during the exploratory surgery.