– 13 year old DSH MN with history of severely decreased appetite; no v/d
– CBC, biochem, fPLI unremarkable
– 3 view chest rads show one questionable area of increased radio-opacity (alveolar pattern)
– a focal region of eccentric, hypoechoic wall thickening with loss of wall layering found (approx 1cm diameter) in the intestine
– cystic jejnunal LN seen
– trace pericardial effusion with normal LA
– u/s guided FNA’s of intestinal lesion performed but not holding my breathe as I often get inconclusive results with these
– 13 year old DSH MN with history of severely decreased appetite; no v/d
– CBC, biochem, fPLI unremarkable
– 3 view chest rads show one questionable area of increased radio-opacity (alveolar pattern)
– a focal region of eccentric, hypoechoic wall thickening with loss of wall layering found (approx 1cm diameter) in the intestine
– cystic jejnunal LN seen
– trace pericardial effusion with normal LA
– u/s guided FNA’s of intestinal lesion performed but not holding my breathe as I often get inconclusive results with these
DDx: lymphoma, FIP thoughts?
This would be a good case for intra-operative ultrasound
Comments
Biochem does not really fit
Biochem does not really fit FIP unless it is focal granulomatous enteritis. Other possiblities would be adenocarcinoma and focal perforation. Not sure of the significance of the pericardial effusion. As you say candidate for laparotomy and intra-operative ultrasound.
pc effusion is not
pc effusion is not cardiogenic in this case but you can see this in cats with cachexia, spreading neoplasia, infectious disease… its a sign but not a functional player.
Diffs on this focal loss of detail and thickening are focal lsa, mct, dry fip, focal complicated ibd not in that order necessaily.
IOP US and R&A is what I would do if chest rads are clear.
Try corkscrew technique 20 or even 18 gauge on these lesions and try pining it up against the body wall with your probe hand so it doesnt bounce.