A 14-year old female spayed American Domestic Shorthair Cat is presented
to your clinic with a 2 day history of anorexia, bloody vomiting and
loose stools. The cat had a chronic history of weight loss, lethargy and
occasional vomiting. She had been diagnosed with lymphocytic-plasmacytic
enteritis and Helicobacter infection on endoscopic biopsy, 2 weeks prior
to presentation. Since than she had been treated with amoxicillin (22.0
mg/kg, PO, Q8h), omeprazole (1 mg/kg, PO, Q24h) and prednisone (1 mg/kg,
PO, Q12h). There is no history of sneezing, coughing or straining to
defecate. At presentation, the patient is underweight (5.1 lbs; 2.4 kg)
and has an unkept hair coat. On physical examination, the cat is
dehydrated (5 – 7%) and does not show pain on palpation of the abdomen.
Further physical examination is not possible due to lack of patient
cooperation. The CBC is within normal reference ranges and plasma
biochemical panel shows a mild increase in BUN, creatinine, K+ and
glucose. Serum T4 is within normal limits and serologic tests for FIP/FeLV/FIV
are negative. Initial abdominal radiographs and ultrasound are
unremarkable with the exception of bilaterally small kidneys. The cat is
admitted to the hospital for supportive care and food is withheld due to
the vomiting and IV fluids (Normosol + KCl) are administered. Sucralfate
is added to the medication. The following day the cat appears to be more
alert than at the time of admission, however a 1x2 cm firm, irregular
mass is palpated in the right cranial abdomen, and the cat vomits after
palpation. Right lateral (Image A) and ventrodorsal (Image B) abdominal
radiographs are repeated.
- What’s your diagnosis?
- What other diagnostic tests would be helpful in determining the
diagnosis?
- What treatment(s) would be appropriate?
