Case Study

RAD – Functional gastrointestinal ileum with intestinal dilation and maldigestion pattern in a 15 year old FS DSH cat

This 15 year old FS DSH cat has a history of kidney disease and urinary stones, has been newly diagnosed diabetic.

Physical Exam: distended tender abdomen. No palpable masses. Excess gas on ultrasound today.

CBC: neutrophilia and lymphocytosis

Chem: glucose 243

This 15 year old FS DSH cat has a history of kidney disease and urinary stones, has been newly diagnosed diabetic.

Physical Exam: distended tender abdomen. No palpable masses. Excess gas on ultrasound today.

CBC: neutrophilia and lymphocytosis

Chem: glucose 243

Image Interpretation

Rads of the thorax and abdomen – There is moderate generalized osteopenia. Moderate degenerative changes are noted
throughout the axial skeleton including spondylosis and spondyloarthropathy.
Thorax:
There is a moderate generalized bronchial lung pattern.
The cardiac silhouette is normal for size and shape. The caudal vena cava is thin. The
pulmonary vessels are thin.
Abdomen:
The serosal detail is normal. There is abdominal distention. The stomach contains a
moderate amount of gas. There is moderate and even distention of the small intestinal
loops with gas. The small intestine appears to reduced in tone. The colon is distended
as well and contains mainly gas next to a mild amount of fecal matter. The fecal
matter is of increased opacity indicating a high degree of inspissation.
Multiple urinary bladder stones are noted. The urinary bladder is moderately distended.
The assessment of the kidneys is limited owing to the superimposition of the intestinal
gas. The liver is within normal limits. The spleen is not seen.

DX

The radiographic findings are compatible with a functional gastrointestinal ileus with moderate intestinal dilation and a maldigestion pattern.

Outcome

There are multiple radiopaque urinary bladder stones.
The functional ileus is likely a secondary gastrointestinal disorder. Given the history,
the most likely underlying causes are delayed gastrointestinal transit and maldigestion
as a function of the diabetes mellitus with hyperglycemia crisis or electrolyte
imbalances. Chronic renal disease and electrolyte imbalances, as well as disturbance
of the homoeostasis gastrointestinal motility, and absorption disorders have been
described in cats.
The findings do not suggest an obstructive gastrointestinal disorder here.
The changes of the lung parenchyma are compatible with normal geriatric findings.
Chronic feline lower airway disease cannot be ruled out, but since there is no air
trapping there is no evidence of expiratory obstructive disease at this point and the
significance of the findings is questionable.
There are signs of hypovolemia with underperfusion of the lung. The presence of
inspissated fecal matter may be a consequence of electrolyte imbalances as well as
hypovolemia.

Patient Information

Patient Name : Mama Hallihan/ACCFlanders

Gender : Female, Spayed

Species : Feline

Type of Imaging : Ultrasound

Status : Complete

Liz Wuz Here : Yes

History

Diabetes, uncontrolled
Renal Failure
Struvite Stones

Exam Finding

Abdominal Distension
Abdominal Pain

Images

Blood Chemistry

Glucose, High

CBC

Lymphocytes, High
Neutrophils, High