By Dr Phoebe Nunn, Soundiagnosis. December 2024
History:
A 9-year old male desexed Domestic Short Hair cat was presented to a Melbourne Veterinary Clinic for chronic intermittent vomiting and more acute hyporexia. Blood work performed in November 2024 was largely unremarkable. The patient was started on maropitant and mirtazapine.
Soundiagnosis Abdominal Ultrasound Findings:
The ultrasound showed a very dilated stomach lumen, which was filled with hyperechoic content. This was less suggestive of foreign body material.
It also revealed a severe focal thickening in the mid-body region of the ventral gastric wall causing a mass effect. This thickened gastric wall was hypoechoic in appearance, vascularised and showed complete loss of normal gastrointestinal wall layering.
There was also a hypoechoic nodule noted in the region of the pylorus, which was most likely an enlarged pancreaticoduodenal lymph node.
Images:
Diagnosis:
Gastric mass effect with secondary functional ileus of the stomach and inflammation/infiltration of local lymph nodes.
Comments and Outcome:
Given the gastric mass effect was on the ventral aspect of the gastric wall, we were able to safely perform a fine needle aspirate. Unfortunately, cytology results were consistent with large cell lymphoma.
Although other conditions such as chronic enteropathies, chronic pancreatitis or gastric foreign bodies can be common causes of chronic vomiting, this case highlights the importance of ultrasound in excluding gastric neoplasia.
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