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A 2-year-old MN DLH cat presented for lethargy. CBC/Chem/UA showed BUN of 41, urine specific gravity 1.041, 2+ proteinuria, urine culture (+) for Staphylococcus. Generalized cardiomegaly was noted on radiographs in addition to subnormal renal size.
A 2-year-old MN DLH cat presented for lethargy. CBC/Chem/UA showed BUN of 41, urine specific gravity 1.041, 2+ proteinuria, urine culture (+) for Staphylococcus. Generalized cardiomegaly was noted on radiographs in addition to subnormal renal size.
If respiratory distress under exercise is an issue then this is likely owing to pericardial diaphragmatic hernia and lack of adequate oxygenation of the lung fields owing to the herniation. However, many patients live normally with this type of hernia over a number of years. Therefore, other source of lethargy such as infectious disease, orthopedic disease, general inflammation or possible splenic related disease should be considered. The splenic enlargement is not explainable. Given the size of 1.4 cm, ultrasound-guided FNA would be indicated especially if any weight loss is present. Surgical consultation could be considered. However, it is debatable on whether surgery is absolutely necessary in this patient.
Currently, the patient is stable and treatment options are being explored.
The spleen was slightly enlarged and mildly irregular measuring 1.44 cm with minor, heterogenous parenchymal changes and scalloping contour. The liver and falciform fat in this patent were displaced cranially as was the stomach. Portions of the liver and falciform fat were herniated through the diaphragm. It appears that mainly fat has entered into the pericardium. However, herniated liver appears to occupy the caudal thorax. The abdominal fat herniated into the pericardium and occupied the heart base. However, it did not enter circumferentially around the pericardium. The herniated tissue appears to measure 5.0 x 4.0 cm. Diaphragmatic hernia was present and measured 2.0 cm. The stomach was displaced. Normal cardiac function.
