Feline gastric pneumatosis

Medical management of feline emphysematous hepatitis-A case report

Case report summary: A 9-year-old male castrated domestic shorthair feline was presented to the emergency department with a chief complaint of constipation of 3-day duration, decreased urination of 1-day duration, vomiting, and hind limb weakness. Physical examination abnormalities included hypothermia, dehydration, and generalized paresis with inability to stand for a prolonged period of time. Abdominal ultrasonography showed pinpoint hyperechoic foci throughout the hepatic parenchyma, small gas foci circulating within the portal vasculature consistent with emphysematous hepatitis, and mild volume of ascites. Cytology of the ascites was consistent with inflammatory effusion. Hepatic cytology was consistent with mixed inflammation/hepatitis with no apparent cause for inflammation noted. Urine culture yielded a negative result. Surgical liver biopsy and culture were declined by the patient's family. Ultrasound changes were presumed to be most likely secondary to an ascending infection.

Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract

PRACTICAL RELEVANCE

Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction.

CLINICAL CHALLENGES

Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease.

AIM

This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material.

EQUIPMENT

Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience.

EVIDENCE BASE

Information provided in this article is drawn from the published literature and the author's own clinical experience.