Gastric submucosal fat in cats

A previous study showed that a gastric intramural radiolucent band seen on radiographs and a gastric intramural hypoattenuating layer seen on computed tomography were due to the presence of gastric submucosal fat in a cat. There is no known prevalence and distribution pattern of this gastric submucosal fat in cats. This study was carried out to determine the prevalence and distribution pattern of submucosal fat in cat stomachs. Histologic examination of 41 cat stomachs was performed after scheduled killing of cats, obtained from animal shelters. The results revealed that submucosal fat was present in all stomachs. However, thickness and distribution pattern of the submucosal fat varied.     

ULTRASONOGRAPHIC APPEARANCE OF FELINE ALIMENTARY LYMPHOMA

Abdominal ultrasonography was performed in seven cats with intestinal lymphoma and four cats with gastric lymphoma. Ultrasonographic abnormalities included the presence of a hypoechoic mass associated with the gastrointestinal tract, focal or diffuse thickening of the gastric wall, symmetric thickening of the bowel wall, loss of the normal layered appearance of the gastrointestinal wall, and abdominal lymphadenopathy. The thickness of the stomach wall ranged from 8 to 22 mm in cats with gastric lymphoma, and the thickness of the bowel wall ranged from 5 to 20 mm in cats with intestinal lymphoma. Fine needle aspiration of a gastrointestinal lesion was performed without complication in six cats, and was diagnostic for lymphoma in five out of six. Results of this study indicate that ultrasonography is an effective noninvasive means of identifying lesions consistent with alimentary lymphoma in cats.     

ULTRASONOGRAPHY OF ALIMENTARY LYMPHOSARCOMA IN THE CAT

Clinical, radiological and ultrasonographic findings from 22 cats with gastrointestinal lymphosarcoma were reviewed. The most common clinical findings were anorexia, weight loss, vomiting, lethargy, depression, fever, anemia and a palpable abdominal mass. Abdominal radiographs of 12 cats revealed a mass associated with the gastrointestinal tract and/or mesentery, and decreased serosal detail, suggestive of peritoneal effusion. The most common ultrasonographic finding was transmural gastric or intestinal thickening associated with loss of normal wall layering, reduced wall echogenicity and localized hypomotility. As is noted in people, other patterns such as transmural-segmental, transmural-nodular, transmural-bulky and mucosal infiltration were represented. In 3 cats, mesenteric lymph-adenopathy was responsible for most of the mass-effect. Fine-needle aspiration biopsy, automated microcore biopsy, endoscopic biopsy or necropsy confirmed the diagnosis of lymphosarcoma in all cats. Chemotherapy was instituted in 19 cats. Only 6 cats had a complete response to treatment. The results of this study indicate that ultrasonography is a valuable tool for the diagnosis of feline alimentary lymphosarcoma and that biopsies can be obtained under ultrasonographic guidance.     

Stomach wall evaluation using helical hydro-computed tomography

In helical hydro-computed tomography (helical hydro-CT), water is used as a neutral luminal contrast medium together with intravenous iodine contrast medium for the diagnosis and staging of human gastric neoplasia. We evaluated the feasibility of helical hydro-CT in 11 healthy animals (nine dogs and two cats). Adequate uniform gastric distension was obtained with 30 ml water/kg body weight. Fourteen client-owned dogs and four cats with suspected or diagnosed gastric neoplasia then underwent helical hydro-CT followed by intravenous contrast medium administration. Focal thickening with moderate contrast enhancement was found in 10 dogs and 3 cats. The extent of the lesion was assessed easily in all these patients. Three dogs and one cat had a normal stomach wall. One dog had multifocal thickening of the antrum but no histopathologic diagnosis was made. Helical hydro-CT, followed by intravenous contrast medium administration, is a simple technique for assessing the stomach wall.     

Computed tomographic findings of the gastrointestinal tract in rabbits

BackgroundGastrointestinal (GI) diseases are common in rabbits. Although diagnostic imaging studies can assist clinicians in selecting therapeutic approaches, there are few reports of advanced imaging findings in normal rabbits. Computed tomography (CT) is recognized as a useful tool in dogs and cats, but there are few reports of normal findings on multidetector computed tomography (MDTC) in rabbits. The goals of this study are to describe the CT anatomic imaging appearance of the GI tract and their normal variation in healthy pet rabbits and to obtain the normal wall thickness measurements of normal GI tract structures.MethodsTwenty-three rabbits were scanned under general anesthesia and the CT abdominal images were analyzed by two experienced radiologists. Location and size of the major GI organs and structures were determined, and wall thickness of the stomach, small and large intestines were measured, including the interobserver agreement. Statistical analysis of quantitative and qualitative variables was performed.ResultsWall thickness values were established for the different parts of the stomach (cardia: 3.4 ± 0.4mm; fundus: 1.4 ± 0.2mm; body: 1.4 ± 0.1mm; pylorus: 2.9 ± 0.5mm), small intestines (duodenum: 1.4 ± 0.1mm; jejunum: 1.2 ± 0.1mm; ileum: 1.4 ± 0.1mm), and large intestines (cecum: 1.2 ± 0.1mm; colon ascending: 1.4 ± 0.3 mm and descending: 1.3 ± 0.3mm). When distended the stomach did not extend beyond the caudal limits of the L2 vertebra. The cecum occupied the ventral abdominal region from T12/T13 to L7/S1, the sacculus rotundus was identified in 11 of the 23 rabbits. The sacculus rotundus and vermiform cecal appendix were identified only in rabbits with mild large intestinal distension.Conclusions and clinical relevanceIt was possible to use CT to evaluate the different portions of the GI tract that are not normally readily visible on radiographs and ultrasound (US). Normal wall thickness values of the different portion of the GI tract were stablished. These results provide new and important reference values for CT studies in normal pet rabbits and provide data for further studies in rabbits with GI diseases.     

THE SONOGRAPHIC APPEARANCE OF INTESTINAL MUCOSAL FIBROSIS IN CATS

The medical records of 11 cats with full‐thickness intestinal biopsies and histopathologic confirmation of segmental mucosal fibrosis were reviewed. All cats received an abdominal ultrasonographic evaluation. The sonographic feature of a small intestinal mucosal hyperechoic band paralleling the submucosa was present in all cats. Other intestinal sonographic findings included wall thickening, and altered wall layering (increased mucosal echogenicity, thickened submucosa, and/or muscularis layer). None of the cats had complete loss of wall stratification. All cats had clinical signs related to the gastrointestinal (GI) tract at the time of presentation. Three of the 11 cats had palpably thickened small intestinal loops, 3/11 abdominal pain, and 2/11 abdominal fluid. Histopathologically, mucosal fibrosis was associated with inflammatory cell infiltrates in all cats. In those cats with histopathologic evidence of mural fibrosis, all cats had a visible hyperechoic band through several intestinal segments. We speculate that the hyperechoic mucosal band represents the zone of mucosal fibrosis. Independently and prospectively, we reviewed the clinical presentation of 35 cats having this visible hyperechoic mucosal band on ultrasound. Twenty‐four of these 35 cats had clinical signs related to the digestive system at the time of record. Our study suggests that the hyperechoic mucosal band represents fibrosis, and in presence of concurrent GI signs, further diagnostic tests may be warranted.     

Gastric dilatation-volvulus associated with diaphragmatic hernia in three cats: clinical presentation, surgical treatment and presumptive aetiology

Three cats were examined because of acute dyspnoea and sudden abdominal enlargement. In all cats, radiographs revealed gastric dilatation-volvulus (GDV) and diaphragmatic hernia. Cardiovascular shock and dyspnoea were treated by intravenous fluid-therapy, oxygen administration and relief of diaphragmatic pressure by means of stomach decompression and in one case placing the patient in an inclined position. Gastric decompression was performed by needle gastrocentesis, placement of a rhino-gastric tube, or a combination of these. Diaphragmatic herniorrhaphy was performed in either case; one cat also underwent gastropexy. The immediate postoperative period resolved uneventfully and the cats were doing well at follow-up. Feline GDV is a rare event in which diaphragmatic hernia may be a predisposing factor.     

RADIOGRAPHIC HEART-VOLUME ESTIMATION IN NORMAL CATS

Heart volume mensuration was evaluated on conventional radiographs from eight normal cats in different body positions using computed tomography (CT). Heart volumes were calculated from orthogonal thoracic radiographs in ventral and dorsal recumbency and from radiographs exposed with a vertical X-ray beam in dorsal and lateral recumbency using the formula for an ellipsoid body. Heart volumes were also estimated with CT in ventral, dorsal, right lateral and left lateral recumbency. No differences between heart volumes from CT in ventral recumbency and those from CT in right and left lateral recumbency were seen. In dorsal recumbency, however, significantly lower heart volumes were obtained. Heart volumes from CT in ventral recumbency were similar to those from radiographs in ventral and dorsal recumbency and dorsal/left lateral recumbency. Close correlation was also demonstrated between heart volumes from radiographs in dorsal/ left lateral recumbency and body weights of the eight cats.     

IMAGING DIAGNOSIS—GASTRIC PNEUMATOSIS IN A CAT

Gastrointestinal foreign bodies were removed surgically from a 9‐year‐old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.     

Intrinsic Innervation of the Stomach of the Fetal Pig: an Immunohistochemical Study of VIP-Immunoreactive Nerve Fibres and Cell Bodies

Using an immunohistochemical technique, the presence and distribution of vasoactive intestinal polypeptide (VIP) was investigated in cryostat sections, both tangential and transverse, of the fetal pig's stomach. In all fetuses and in all gastric segments investigated, VIP-like immunoreactive (IR) nerve-cell bodies were seen in all intramural ganglia, and VIP-IR nerve fibres were found in all layers of the gastric wall except the tunica serosa. Consequently, VIP-IR nerve fibres were found to form a periglandular network, to accompany arterioles, to interconnect the intramural ganglia, to encircle both VIP-IR-negative and -positive neurons, and were found in all muscle layers. Despite the fact that VIP-IR seems to be restricted to the intramural nervous elements, some nonspecific-reacting VIP-IR glandular cells were noticed in the basal parts of the fundic, antral and pyloric gastric glands. The distribution pattern of VIP in the fetal pig resembles that of the adult pig. This suggests a possible functional role for VIP during fetal life and/or puts forward the suggestion that the stomach of a fetal pig from the second half of the gestation period is prepared, from then on, for postnatal function. High similarities with regard to the general distribution pattern of VIP in the stomach have also been noted between the fetal pig and humans, proving once more that the fetal pig can serve as a good animal model in several research areas. Finally, the morphological data provided here may, combined with the physiological significance of VIP, contribute to a better insight into the physiopathology of economically important gastro-intestinal disorders in the pig, such as gastric ulceration.     

Presumptive Intramural Gastric Hemorrhage Secondary to Rodenticide Intoxication in a Dog

A dog being treated for demodicosis with ivermectin was presented for intermittent vomiting. The vomiting progressed to hematemesis and an underlying coagulopathy was diagnosed. The etiology of the coagulopathy was determined to be ingested brodifacoum. Ultrasound evaluation of the abdomen revealed thickened gastric wall that was suspected to be intramural hemorrhage. Most likely, the intramural hemorrhage and resulting thickening of the stomach wall led to the clinical signs and metabolic alkalosis. This case represents an typical presentation of hemorrhage secondary to rodenticide intoxication. (J Vet Emerg Crit Care 2001; 11(1):27–31, 2001).     

SONOGRAPHY OF THE NORMAL FELINE GASTROINTESTINAL TRACT

The normal sonographic appearance of the stomach in various degrees of distension, the duodenum, the small intestine, and the large intestine was determined in awake and sedated cats. The mean stomach rugal fold thickness was 4.38 mm, and the interrugal thickness was 2.03 mm. No significant difference in stomach wall thickness was seen when the stomach was empty, half full, or full. The duodenal wall thickness was significantly greater than other parts of the small intestine, and this difference was accentuated by sedation (awake mean 2.4 mm; sedated mean 2.71 mm). The mean small intestinal wall thickness was 2.1 mm, and the mean colonic wall thickness was 1.67 mm. The five characteristic sonographic layers similar to that seen in the gastrointestinal tract of other species were routinely identified at all regions of the feline gastrointestinal tract.     

Transient post-traumatic hemidiaphragmatic paralysis in two cats

A diagnosis of post-traumatic hemidiaphragmatic paralysis was made in two cats. Both cats had a history of trauma and paradoxical inward movement of the abdominal wall at inspiration. Thoracic radiographs were taken at inspiration and expiration. Although the images were suggestive of hemidiaphragmatic paralysis, definitive diagnosis was reached by fluoroscopy in one cat and by ultrasonography in the second. Both cases resolved spontaneously and diaphragmatic function was normal at follow-up.     

A RETROSPECTIVE STUDY ON THE SONOGRAPHIC FINDINGS OF ABDOMINAL CARCINOMATOSIS IN 14 CATS

A retrospective review was performed on 14 cats with histology- or cytology-proven carcinomatosis. The mean age was 12.7 years with a median of 11 years. The diagnosis of carcinomatosis was made by histology in 11 cats and cytology in three cats. Twelve cats had cytologic examination of the peritoneal free fluid and seven cats (58.3%) had evidence of malignant cells. The primary tumor site was determined in 13 cats. The most common organ locations for the primary tumor were the liver (n = 5), pancreas (n = 3), and small intestine (n = 3). Other sites were stomach and spleen in one cat each. Epithelial cell neoplasia was the primary tumor type in 11 cats. Two cats had abdominal lymphomatosis and one cat had abdominal sarcomatosis secondary to metastatic hemangiosarcoma. Free peritoneal fluid and masses in the connecting peritoneum were found in all cats (100%). Additional findings included primary or metastatic masses in abdominal organs in 10 cats (71.4%), lymph node enlargement in five cats (35.7%), pleural effusion in three cats (21.4%), parietal peritoneal masses in two cats (14.3%), and visceral peritoneal masses in one cat (7.1%). Masses in the connecting peritoneal may be a very specific finding for carcinomatosis in cats, especially with a concurrent abdominal neoplastic mass. Parietal and visceral peritoneal masses, while uncommon in this series of cats, have not been reported for other diseases and seem to strongly support a diagnosis of carcinomatosis.     

ULTRASONOGRAPHIC FINDINGS IN DOGS AND CATS WITH GASTROINTESTINAL PERFORATION

A retrospective study was performed to evaluate the sonographic features of gastrointestinal (GI) perforation in dogs and cats. Sonographic findings in 19 animals (14 dogs and 5 cats) included regional bright mesenteric fat (19), peritoneal effusion (16), fluid-filled stomach or intestines (12), GI wall thickening (11), presence of free air (9), loss of GI wall layering (9), regional lymphadenopathy (8), reduced GI motility (7), pancreatic changes (4), corrugated intestines (4), presence of a mass (3), presence of a foreign body (3), and mineralization of the gastric wall (1). In 14 patients, "perforation" was listed as a differential diagnosis by the sonographer. Abdominal radiographs and radiographic reports were available for 14 patients. Radiographic findings were decreased serosal detail (12), free air (8), peritoneal contrast medium (1), and suspected foreign body (1). GI perforation was listed as radiographic diagnosis in eight patients, seven of which had evidence of pneumoperitoneum, and one had leakage of contrast material on an upper GI study. In 9/14 patients with radiography, "GI perforation" was listed as a sonographic diagnosis. In three patients in which free air was diagnosed sonographically, radiographs were either not available (2) or the presence of free air was not detected at presentation (1). Peritoneal fluid analysis was performed in nine patients, five of which were identified as septic inflammation, and the remaining four were classified as neutrophilic inflammation with no etiologic agent identified. The histologic or surgical diagnoses were as follows: three intestinal surgical dehiscence; one percutaneous endoscopic gastrostomy tube site leakage; one duodenal adenocarcinoma; one ileocolic lymphoma; one trichobezoar; one ascarid impaction; and one bobby pin foreign body. In the remaining 10 patients, a focal area of gastric/intestinal ulceration or transmural necrosis with perforation was identified without evidence of an underlying cause.     

Chronic myocardial infarction due to arteriosclerosis of coronary arteries followed by acute thromboembolism of caudal abdominal aorta in a cat

A 10-year-old cat with the paresis of hind limbs was initially diagnosed as a hypertrophic cardiomyopathy followed by acute thromboembolism of caudal abdominal aorta from the findings of the medical examinations. However, this case was proved to be an chronic myocardial infarction due to arteriosclerosis of coronary arteries by the pathologic diagnosis. In the left ventricular, the hypertrophy and the narrowing were slight, and a coagulative infarction was seen obviously. The intramural coronary arteriosclerosis showed thickening of the wall due to medial hyperplasia by fibrosis, and arterial stenosis. Myocardial infarction and arteriosclerosis are scarcely any reports of these lesions in cats. This case is valuable for an extremely rare case of myocardial infarction in the cat.     

USE OF RADIOGRAPHY IN COMBINATION WITH COMPUTED TOMOGRAPHY FOR THE ASSESSMENT OF NONCARDIAC THORACIC DISEASE IN THE DOG AND CAT

Computed tomography (CT) of the thorax was performed in 28 dogs and five cats and findings were compared with previous thoracic radiographs. The sample population included all animals that had thoracic radiographs and a CT study within 5 days of each other, where the complete imaging studies were available for review. Thoracic radiographs were considered indeterminate in 31 patients and CT examinations were done to acquire additional information. The presence of additional information from CT relating to presence of pathology, location of pathology, extent of pathology, and involvement of mediastinal structures was recorded. Whether there was a change in diagnosis based on the CT findings was also recorded. In only 4/33 animals (all dogs) did CT fail to provide any new information for the parameters evaluated when compared with survey thoracic radiographs. Additional information about the pathology that was present was gained by CT in 5/5 cats and 21/ 28 dogs. New information on compartmental location of pathology was seen in 4/5 cats and 19/28 dogs. New information on pathology extent was noted in 5/5 cats and 20/28 dogs. Additional information regarding involvement of mediastinal structures was obtained in 2/5 cats and 10/28 dogs. A change in diagnosis was made in 3/5 cats and 13/28 dogs. In conclusion, CT is a valuable tool for evaluating intrathoracic disease. CT provides additional cross-sectional anatomic information that can aid in anatomic localization and evaluation of the extent of the pathology in question.     

IMPROVING CONSPICUITY OF THE CANINE GASTROINTESTINAL WALL USING DUAL PHASE CONTRAST‐ENHANCED COMPUTED TOMOGRAPHY: A RETROSPECTIVE CROSS‐SECTIONAL STUDY

Gastrointestinal (GI) disease is a common clinical complaint in small animal patients; computed tomography (CT) examinations enable a global overview of the GI tract and associated structures. Previously, the GI wall has been reportedly identified from serosa to mucosa in 77% of standard postcontrast CT studies and wall layers seen in ultrasound have not been distinguished. Inconsistent strong contrast enhancement of the inner layer of the GI mucosal surface was noted on dual phase CT studies acquired in our institution, which increased the visibility of the GI tract and disease processes. The aim of this retrospective, observational, cross‐sectional study was to determine the optimal portal vein attenuation for maximizing GI wall conspicuity using dual phase contrast‐enhanced CT. Patients with abdominal CT for a non‐GI related disease were included. In a pilot study, 175 GI segments from 35 CT studies were graded for presence of mucosal surface enhancement (MSE). The strongest mucosal surface enhancement grade correlated with portal vein attenuation of 43–150 HU; this value was used as inclusion criterion in the main study. A total of 441 GI segments were evaluated in 42 CT studies postcontrast for GI wall conspicuity. The GI wall was conspicuous in 56.7% precontrast, 84.5% at 30s, and 77.3% late postcontrast; 4.7% of segments were removed due to motion blur. At 30 s distinct mucosal surface enhancement was seen in the small intestine and gastric mucosal surface enhancement was poor. Findings supported the use of dual phase contrast‐enhanced CT for improving conspicuity of the GI wall.     

THE UPPER GASTROINTESTINAL EXAMINATION IN THE CAT: NORMAL RADIOGRAPHIC APPEARANCE USING POSITIVE CONTRAST MEDIUM

The normal radiographic appearance of the feline upper gastrointestinal (UGI) examination following oral administration of barium sulfate suspensions was described. Important findings included the minimal gastric air and small bowel gas present on survey abdominal radiographs. Gastric appearance was nearly constant. A normal duodenal pattern, referred to as a "string of pearls", was described. Small bowel lumen size was consistently less than 12 mm. Small bowel mucosal patterns varied widely. The most commonly identified normal radiographic UGI patterns in this study were found consistently in a group of 26 cats thought to be without gastrointestinal disease. Because of the consistency of observation of many radiographic patterns, rapid gastric emptying, and a short small bowel transit time, normal UGI examinations in the cat present a more constant appearance than in the dog, thus making them more valuable as well as easier to conduct.