Strongly shadowing gastric luminal material

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Strongly shadowing gastric luminal material

  • 6 year old 5.2lb mn Morkie on prednisone for PLE.
  • Recently developed diabetes mellitus.
  • Primary vet palpated a mass…turns out he is palpating the stomach.
  • Radiographs show moderate to marked gastric distension
    • 6 year old 5.2lb mn Morkie on prednisone for PLE.
    • Recently developed diabetes mellitus.
    • Primary vet palpated a mass…turns out he is palpating the stomach.
    • Radiographs show moderate to marked gastric distension
    • Abdominal ultrasound shows moderate gastric distension (patient was not fasted).  Some of the intraluminal content shadows quite strongly.  The pylorus appears unobstructed.  The small intestines show mucosal fogging and mucosal striations.  There is one very small pocket of free anechoic fluid adjacent to the bladder apex. The gallbladder is moderately distended. The pancreas shows mildly increased size and echogenicity.  Last ALB check was wnl.  A recheck ALB is pending.
    • Rule outs for the moderate gastric distension include recent meal, gastric stasis secondary to unregulated DM and PLE, or FB/obstruction.
    • The patient has a good appetite and is not vomiting but has a BCS of about 3/9.
    • I don’t like the strong intenisty of the gastric lumen shadow, but the patient is not showing any clinical signs of a FB other than weight loss which is most likely due to his DM and PLE.
    • What are your thoughts on the stomach?  

Comments

DrMac

I think this is most likely

I think this is most likely post prandial presentation as sometimes even normal ingesta can shadow somewhat. Minor potential for GI foreign material, but I think its food without clinical signs at this point and with recent meal ingestion.

I would recheck the stomach in 12-24 hours with ultrasound following a documented fast. This may be a little challenging with the DM so watch the BG. 

If there is some degree of food bloat, supportive IV fluids +/- electrolyte supplementation may help with GI motility.

Electrocute

Thank you for your input, Dr.

Thank you for your input, Dr. Mac.

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