Domestic Shorthair Samson, 7 years

Weight loss

Images courtesy of Tierklinik Hofheim. Dres Kessler, Kosfeld, Tassani-Prell, Bessmann, Rupp, Delfs, Schmohl, von Klopmann

Diagnosis

Description

Thin body condition.

Collapse of the intervertebral disc space L7/S1 with sclerosis of the adjacent vertebral endplates and associated ventral spondylosis. Moderate ventral spondylosis is also present at L5 to L7. The last rib on the right side shows at its mid portion circular smooth and solid periostal new bone formation, the opacity is slightly reduced compared to the rib. The rib appears sclerotic centrally.

The diaphragm is intact. The visible part of the thorax is unremarkable.

The abdominal serosal detail is reduced centrally.

The liver is visible within the rib cage and is of homogenous soft tissue opacity. The stomach is moderately dilated and contains gas. Two populations of small intestinal loops are present. In the central abdomen a C-shaped, gas containing small intestinal loop is visible. It extends from caudo-dorsally from level L6 to L4, curves ventrally at L4 and terminates caudo-ventrally level with L5. It is approximately 3 times the height of the vertebral body of L5. At close inspection a second dilated intestinal loop is evident parallel to the ventral body wall and immediately caudal to the loop described above. It contains fluid and small gas bubbles. Caudal to the caudo-dorsal end of the gas containing dilated intestinal loop the gas containing descending colon is visible. The colon can be traced cranially, where it contains formed faecal material and is superimposed onto the described dilated intestinal loop. The remaining small intestinal loops are unremarkable containing small amounts of gas and fluid.

The dilated, gas filled intestinal loop is visible as a ring like structure in the central left abdomen. The spleen is visible along the left lateral abdominal wall. Kidneys and urinary bladder are unremarkable.

Radiographic diagnoses

  • Two populations of small intestinal loops are present, one of which shows a focal, severely dilated gas- and fluid content
  • Reduced abdominal serosal detail
  • Solid, smooth periostal reaction 13th rib right side
  • Collapsed intervertebral disc space L7/S1 with sclerosis of the end plates and ventral spondylosis

Discussion

The changes are compatible with a mechanical ileus.
This can be due to an intraluminal foreign body, mural changes, e.g. neoplasia, or extramural changes, e.g. stricture. Differentiation between the different aetiologies is not possible radiographically. The reduced abdominal serosal detail is most likely due to the reduced body condition. A perforation with peritonitis and a mild amount of ascites cannot be excluded though no free abdominal gas is evident.

Changes affecting the last rib are compatible with an old, healed rib fracture.

The collapsed intervertebral disc space L7/S1 with sclerosis of the end plates and ventral spondylosis is most likely related to chronic disc degeneration and herniation.

Outcome

In surgery an intestinal mass was found, which lead to the mechanical ileus. The mass was removed. On patho-histology the mass was confirmed as an intestinal adenocarcinoma. The cat recovered uneventfully and was discharged a couple of days later.