Hello,
Hello,
This is a pro bono case which sems pretty complicated. This is a 10 months old feline M/N fully vaccinated indoor that likes to play with feathers.According to owner feathers are missing He is still eating well but after 4-6 hours he vomits a green/brown intestinal content.BM are dry and rare ( every 3-4 days). Now he is emaciated, dehydrated and on US I see a distended GB, Cystic duct, CBD, pancreas hypoechoic, minor abdominal fluid and I see this shadows that I’m not convinced that are in SI but they look like a foreign body to me. Negative for FIV/Leuk/PanleukopHis bloodwork is pending. previouslly from 2 weeks ago mild anemia, leukopenia.
DDX : Triaditis/ Partial obstruction- feathers/ FIP -colon dry
I’m recommending fluids for 12-24h rescanning and if the same exploratory. Is that SI or colon?
Thank you,
Comments
Cool case. the Gb Cd will
Cool case. the Gb Cd will dilate in anorexia in this fashion and the walls are not edematous or thick so i dont think they are players. The stomach content has echogenicity of feathers or a thin hairball which would look like this but the pylorus-duodenum almost looks like the lumen has the feather stalk bending through it but that coule be material as well tough to say. If its still there in 24 hours I would explore and evacuate the stomach and get a shopping spree of bx to be sure no underlying disease as well.
When distended abd shadowing
When distended abd shadowing I have difficulties recognizing SI from Colon. If it s chronic process you can see the submucosa layer didtincly in large as well, wich is the confusing part for me….
Thank you
this was actually a stricture
this was actually a stricture of the ileum. I will update once a I Have the path report and pictures
The “stricture” was due to a
The “stricture” was due to a chronic intussusception ( histopath report) that was never diagnosed. This cat was treated for many days at a different clinic and no U/S was done…..
To distinguish colon form SI
To distinguish colon form SI follow the descending colon from the pelvic inlet cranially then transverse til you reach the ICJ. The SI uis never in the pelvis only the colon lives there so follow it cranially. Then you know what the colon looks like. Moving proximally from the icj obstructions will have empty SI preceded by dilated SI and the obstructive pathology… stricture, FB, dysfunctional mural disease, tumor….. same thing with gastric obstruction … full stomach with empty SI and usually something in the pylorus or the pylorus itself obstructing like Hypertrophic pyloric gastropathy or gastric neoplasia.
Take a look at ECVIM 2009 GI obstruction criteria that we established an still have to publish!! we are such slackers lol.
http://sonopath.com/resources/research-publications