- 9 year old mn feline indoor-only DSH presented with 5 day history of vomiting and anorexia
- This cat belongs to a vet tech who lives at home with her family, 2 other cats, and a dog.
- PE showed abdominal pain and a small bruise on the lower left abdomen and SQ dermal masses
- FNA’s of the masses showed MCT, this cat has had previous dermal MCT’s removed.
- CBC shows a moderate anemia with a small number of spherocytes, leukopenia (2.3 X 10^6), mild thrombocytopenia (150,000)
- 9 year old mn feline indoor-only DSH presented with 5 day history of vomiting and anorexia
- This cat belongs to a vet tech who lives at home with her family, 2 other cats, and a dog.
- PE showed abdominal pain and a small bruise on the lower left abdomen and SQ dermal masses
- FNA’s of the masses showed MCT, this cat has had previous dermal MCT’s removed.
- CBC shows a moderate anemia with a small number of spherocytes, leukopenia (2.3 X 10^6), mild thrombocytopenia (150,000)
- Chemistry profile shows an increased amylase and slightly increased ALT
- Radiographs showed splenomegaly
- Abdominal ultrasound shows a large pocket of anechoic fluid in association with the caudal spleen, smaller pockets of free anechoic fluid by the liver and the caudal right abdomen, and an increased small intestinal muscularis to mucosal ratio. No splenic masses or nodules are seen.
- PT/PTT were both increased at 35sec and 200sec respectively.
- My problem list includes moderate anemia, leukopenia, mild thrombocytopenia, coagulopathy, vomiting/anorexia, abdominal effusion, and dermal MCT.
- A retic count and recheck CBC are pending
- My differential diagnoses list includes coagulopathy (rodenticide, rickettsial, immune mediated), severe hemorrhage (no known trauma), neoplasia (disseminated MCT, LSA) and FIP.
- Just wanted to get some thoughts on the tail of the spleen. The largest pocket of effusion is closely associated with the tail of the spleen and I am trying to determine if the spleen is truly intact or if there has been trauma or perhaps hemorrhage associated with splenic MCT.
- What do you think?
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Comments
About 2/3 the way through the
About 2/3 the way through the cine there is an abnormal area that is very irregular. I am not certain if it is spleen. I wonder if this could be the source of the effusion. Did you tap the effusion?
I am including a screenshot I took of this suspicious area. Sorry the play arrow is there. Pathology is to the left of the arrow. I will let others weigh in here.
About 2/3 the way through the
About 2/3 the way through the cine there is an abnormal area that is very irregular. I am not certain if it is spleen. I wonder if this could be the source of the effusion. Did you tap the effusion?
I am including a screenshot I took of this suspicious area. Sorry the play arrow is there. Pathology is to the left of the arrow. I will let others weigh in here.
Quite honestly, I think that
Quite honestly, I think that is just fat. There were no intra-abdominal masses. There was no lymphadenopathy. The clip is from the caudal left abdomen. I did not tap the effusion because of the moderate to severe anemia and the markedly prolonged PT and PTT. I also wanted to get the cat on Vit K and determine if this effusion is intracapsular or not (splenic) before sticking a needle into it, especially since systemic MCT is on the list.
Quite honestly, I think that
Quite honestly, I think that is just fat. There were no intra-abdominal masses. There was no lymphadenopathy. The clip is from the caudal left abdomen. I did not tap the effusion because of the moderate to severe anemia and the markedly prolonged PT and PTT. I also wanted to get the cat on Vit K and determine if this effusion is intracapsular or not (splenic) before sticking a needle into it, especially since systemic MCT is on the list.
One thing about MCT as
One thing about MCT as opposed to other round cell neoplasia as you need very little pathology volume to cause bad disease. The spleen is non descript other than eyeballing about 1.2 cm in width (> 1 cm is abnormal) but with that hx I would tap the fluid and spin it down looking for mast cells… my bet is that you will find them….mastocytosis… similar to lymphocytosis or carcinomatosis… no overt mass but effusive disease form lymphatic infiltration obstruction but tap and cytospin to rule in or rule out the potential. Another good rule of thumb regarding localized effusions: they usually beong to the organ adjacent so stick the spleen with 25 g fna as long as coag is decent and platelets are > 60k. Otherwise try to get there with just the abdominocentesis and cytospin.
One thing about MCT as
One thing about MCT as opposed to other round cell neoplasia as you need very little pathology volume to cause bad disease. The spleen is non descript other than eyeballing about 1.2 cm in width (> 1 cm is abnormal) but with that hx I would tap the fluid and spin it down looking for mast cells… my bet is that you will find them….mastocytosis… similar to lymphocytosis or carcinomatosis… no overt mass but effusive disease form lymphatic infiltration obstruction but tap and cytospin to rule in or rule out the potential. Another good rule of thumb regarding localized effusions: they usually beong to the organ adjacent so stick the spleen with 25 g fna as long as coag is decent and platelets are > 60k. Otherwise try to get there with just the abdominocentesis and cytospin.