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.     

Nocardial peritonitis in a cat

Objective To illustrate a successfully managed case of nocardial peritonitis in a cat.
Design Case report.
Animal An 8 year old neutered male Burmese cat presented for nonspecific signs of depression, anorexia, pallor and mild dehydration. Pyrexia, loss of weight and abdominal distension developed despite treatment with amoxycillin-clavulanate and supportive therapy.
Procedure Various medical and surgical procedures were used.
Results Haematology revealed severe inflammatory left shift. Biochemistry showed mild prerenal azotemia. A "ground glass" appearance to the abdomen was seen on radiographs. Fluid collected by abdominocentesis contained "sulphur granules" and had characteristics of a septic exudate. Laparotomy allowed drainage of peritoneal fluid and extensive lavage of the peritoneal cavity. Culture of the fluid revealed Nocardia sp. Sensitivity testing resulted in a change of antimicrobial therapy to trimethoprim-sulphadiazine.
Conclusion Response to surgical drainage and change in antibacterial therapy was excellent. No toxic side effects were encountered during the 3 months course of trimethoprim-sulphonamide. The cat made a complete recovery.     

Mesenteric vascular thrombosis associated with disseminated abdominal visceral hemangiosarcoma in a cat

An adult castrated male cat was evaluated because of a 4 day history of lethargy and partial anorexia. Physical examination revealed abdominal pain with a palpable fluid wave. Cytologic and biochemical analyses of peritoneal effusion were suggestive of septic peritonitis. On surgical exploration of the abdomen, the mesenteric vessels had no palpable pulses and they contained gross thromboses. The intestines were white with no visible peristalsis. Necropsy findings included disseminated, poorly differentiated hemangiosarcoma throughout the abdomen. Mesenteric arterioles contained fibrin thrombi. To the author's knowledge, no previous reports exist of complete mesenteric vascular thrombosis associated with disseminated abdominal visceral hemangiosarcoma in a cat.     

ULTRASONOGRAPHIC FEATURES OF PERITONEAL CESTODIASIS CAUSED BY MESOCESTOIDES SP. IN A DOG AND IN A CAT

Peritoneal infections caused by Mesocestoides spp. are rare in dogs and cats. Little data exist on the role of abdominal ultrasonography for diagnosis and therapy management of the disease. We describe the ultrasonographic features of peritoneal cestodiasis in a dog and in a cat. In the dog, abdominal ultrasound allowed both a presumptive diagnosis and the collection of tissue samples to confirm peritoneal larval infection. Ultrasound was also very useful for therapy management. In the second patient the ultrasonographic features of tetrathyridial infection in a cat in which the parasite was observed as an incidental finding during ovariohysterectomy are described.     

Peritoneal effusion in cats: 65 cases (1981-1997)

OBJECTIVE: To determine signalment, diagnoses, presence of effusions in multiple sites, and outcome in cats with peritoneal effusion. DESIGN: Retrospective case series. ANIMALS: 65 cats. PROCEDURE: Medical records from 1981 to 1997 were reviewed to obtain information on cats with peritoneal effusion identified on physical examination, radiographs, abdominal ultrasonograms, or at necropsy. RESULTS: Conditions most commonly associated with peritoneal effusion in cats, in order of frequency, were cardiovascular disease, neoplasia, hepatic disease, renal disease, feline infectious peritonitis, peritonitis attributable to other causes, and urinary tract trauma. Dilated cardiomyopathy (DCM) was the most common disease associated with peritoneal effusion; however, DCM was diagnosed in most of these cats before taurine deficiency was found to be a primary cause of this form of cardiomyopathy in cats. Neoplasia was the most common cause after 1987. Right-sided congestive heart failure was the most commonly associated disorder in cats < 1 year old, whereas neoplastic disease was more common with increasing age. Most effusions were detected during the initial physical examination and were modified transudates. Peritoneal effusion was commonly accompanied by fluid accumulation elsewhere, particularly pleural effusion. The prognosis for a cat with abdominal effusion in this study was poor (mean survival time, 21 days; range, 1 to 350 days; median, 2.5 days). CLINICAL IMPLICATIONS: The primary differential diagnosis for peritoneal effusion in cats is neoplastic disease in older cats and right-sided heart failure in kittens. Diseases associated with peritoneal effusion generally have poor prognoses.     

Lactate as a diagnostic test for septic peritoneal effusions in dogs and cats

Lactate concentration in peritoneal fluid was evaluated and compared to blood lactate concentration in dogs and cats with septic and nonseptic abdominal effusions. All dogs with septic effusions had a peritoneal fluid lactate concentration >2.5 mmol/L and a peritoneal fluid lactate concentration higher than blood lactate, resulting in a negative blood to fluid lactate difference. In dogs, the diagnostic accuracy of the peritoneal fluid lactate concentration and the blood to fluid lactate difference in differentiating septic peritoneal effusion was 95% and 90%, respectively. Peritoneal fluid lactate concentration and blood to fluid lactate difference were not accurate tests for detecting septic peritoneal effusions in cats.     

Physical and clinical pathological findings associated with experimentally induced rupture of the equine urinary bladder

Two mature horses were examined for changes in laboratory and physical findings after experimentally induced bladder rupture. The postrupture laboratory diagnostic changes, which provide valuable information for a correct diagnosis are described. Hematology, serum and peritoneal fluid sodium, potassium, calcium, phosphorous, creatinine, urea nitrogen, albumin and peritoneal fluid components were measured and evaluated versus time. Hyponatremia and hyperkalemia occurred, as well as increased concentrations of peritoneal fluid potassium and inorganic phosphorus. In addition, peritoneal fluid creatinine:serum creatinine and peritoneal fluid urea nitrogen:serum urea nitrogen ratios were followed with time. Hematology and cytology of the peritoneal fluid showed an inflammatory response to urine contamination of the abdominal cavity. Physical findings of tachypnea and tachycardia as well as a mild colic were absent until nearly 50 hours postrupture. Based on these findings, it was concluded that the peritoneal fluid creatinine:serum creatinine ratio was the most useful antemortem laboratory diagnostic aid.     

Pneumoperitoneum secondary to a perforated gastric ulcer in a cat

A 7-year-old domestic cat was examined because of a history of weight loss, intermittent diarrhea, and anorexia of 6 months' duration. Results of physical examination were normal except for marked abdominal tension. Results of a CBC and serum biochemistry profile were unremarkable. Severe pneumoperitoneum was noted radiographically, and abdominocentesis yielded 640 mL of air. Abdominal distension recurred 1 day after abdominocentesis. Exploratory laparotomy was performed 3 days after recurrence of abdominal distension and revealed a gastric perforation along the greater curvature of the stomach with omental and pancreatic adhesions at the site of perforation. Mild local peritoneal inflammation was also noted. A partial gastrectomy was performed to resect the lesion, and histologic examination confirmed a severe perforating ulcer. The gastric wall adjacent to the ulcer was histologically normal. Aerobic and anaerobic bacteriologic cultures of abdominal swab specimens were negative for bacterial growth. The cat was discharged 4 days after surgery and clinically normal at suture removal.     

Myelofibrosis in a cat (abstract)

A 2-year-old female domestic shorthair cat was presented with ill-health and marked ascites. Clinically, there was marked pallor of mucous membranes. Two haematological examinations and transudate-exudate analyses of peritoneal fluid were conducted 1 week apart, as well as a coagulation screen and routine serum biochemistry. The haematological examinations revealed a severe persistent non-regenerative anaemia. There were no abnormalities within the neutrophil and lymphocyte cell lines. Very occasional nucleated red blood cells (RBCs) in peripheral circulation and some RBC agglutination were seen. Analysis of peritoneal fluid disclosed a modified transudate, and small numbers of erythroid and myeloid precursors were observed on the second occasion. The cat was FIV/FeLV-negative, and there were no coagulation abnormalities. Following necropsy and histopathological examination, myelofibrosis and extramedullary haematopoiesis were seen. Thoracic masses were hyperplastic lymph nodes in which there was evidence of extramedullary haematopoiesis. The exact cause of the myelofibrosis was not obvious but it may have been a case of myeloid metaplasia, however not all the characteristics of this entity were present.     

Suspected idiopathic intestinal lymphangiectasia in two foals with chylous peritoneal effusion

Two foals were examined for signs of abdominal discomfort. Transabdominal ultrasonography revealed an increased amount of free peritoneal fluid and thickened small intestine walls. Abdominocentesis yielded an odourless, white‐to‐yellow, opaque, homogeneous peritoneal fluid with elevated triglyceride levels. Based on the findings, diagnosis of chylous ascites was made. Idiopathic intestinal lymphangiectasia was suspected to be the cause for the condition. Both foals responded well and the condition resolved.     

Evaluation of postceliotomy peritoneal drain fluid volume, cytology, and blood-to-peritoneal fluid lactate and glucose differences in normal dogs

Objective: To describe peritoneal drain fluid volume, fluid cytology, and blood‐to‐peritoneal fluid lactate and glucose concentration differences after exploratory celiotomy in normal dogs. Study Design: Prospective study. Animals: Healthy Beagle dogs (n=10). Methods: After exploratory celiotomy, a peritoneal drain was placed, and peritoneal fluid was recorded every 6 hours for 7 days. Fluid was submitted for cytologic examination, and fluid and blood glucose and lactate concentrations were recorded every 12 hours. On day 7, drains were removed and drain tips submitted for aerobic bacterial culture. Results: Mean peritoneal fluid volume decreased from 2.8 mL/kg/day (day 1) to 0.6 mL/kg/day (day 7). All dogs had degenerate neutrophils in peritoneal fluid throughout the 7 days. Four dogs developed contaminated drains. Blood‐to‐peritoneal glucose concentration differences>20 mg/dL occurred after day 4. By day 7, 5 of 7 dogs with patent drains had blood‐to‐peritoneal lactate concentration differences70% of dogs had differences consistent with septic peritonitis each day. Postoperative blood‐to‐peritoneal fluid glucose and lactate difference may not be reliable indicators of septic peritonitis when evaluating abdominal fluid collected with closed suction drains.     

Ascites in a 13‐year‐old miniature horse mare with an ovarian granulosa theca‐cell tumour: A manifestation of Meigs' syndrome?

A 13‐year‐old miniature horse mare presented for evaluation of ascites. Abdominal ultrasound showed severe free peritoneal fluid accumulation as well as a caudal abdominal mass. The peritoneal fluid was characterised as a transudate with no evidence of sepsis. Surgical exploration of the abdomen was performed; copious free peritoneal fluid and a large right ovarian mass were discovered. The abnormal ovary was removed, and the mass was determined histologically to be a benign granulosa theca‐cell tumour. Although there was mild peritoneal fluid accumulation in the immediate post operative period, the ascites effectively resolved with removal of the tumour, and the mare returned to a normal lifestyle. This is similar to reports of Meigs' syndrome in human women, in which a benign ovarian mass of significant size causes ascites that resolves once the mass is removed.     

Septic peritonitis associated with caudal myotomy in a Tennessee walking horse.

A 2-year-old Tennessee Walking Horse colt was admitted for evaluation of signs of abdominal pain, inappetence, and constipation of 5 days' duration. Two days prior to the onset of signs, the owner had cut the sacrococcygeal muscles as part of a tail-setting procedure. On examination, the horse was febrile and lethargic, and intestinal sounds were not heard on auscultation. Results of peritoneal fluid analysis were indicative of peritonitis. The horse continued to deteriorate and died despite treatment with antimicrobials, flunixin meglumine, and balanced electrolyte solution. At necropsy, the peritoneal cavity contained approximately 20 L of serosanguineous fluid. One of the myotomy wounds was filled with yellow-green material that extended from the base of the tail along the ventrolateral aspect of the rectum and into the peritoneal cavity. Escherichia coli was isolated from the myotomy site and peritoneal fluid.     

Neospora caninum associated with septic peritonitis in an adult dog

A 7-year-old, male neutered Rhodesian Ridgeback dog was referred to the University of California-Davis Veterinary Medical Teaching Hospital with a 4-month history of peritonitis and episodic abdominal discomfort, lethargy, and weakness. Marked abdominal distension with a prominent fluid wave was noted on physical examination. Cytologic analysis of the abdominal fluid indicated a septic exudate with mixed bacteria and many protozoal zoites. Differentials for the identity of the protozoal zoites included Toxoplasma gondii, Sarcocystis neurona, and Neospora caninum. Indirect latex agglutination antigen testing, standard indirect fluorescent antibody testing, and PCR analysis were performed to identify the zoites. The dog's serum antibody titer for N caninum tachyzoites was 1:20,480, known polysera to N caninum reacted against zoites in the abdominal fluid, and PCR analysis of the abdominal fluid was positive for the presence of a known gene of N caninum. Based on the morphologic, immunologic, and molecular findings, the zoites were identified as N caninum. It remains unclear how the tachyzoites gained access to the peritoneal cavity. To the authors' knowledge, there are no reports of free N caninum in abdominal fluid of any species.     

Open Intestinal Anastomosis with Surgical Stapling Equipment in 24 Dogs and Cats

Surgical stapling equipment was used to perform open antiperistaltic side-to-side ("functional end-to-end") entero-anastomoses in 20 dogs and 4 cats. Twenty-one anastomoses healed uneventfully. Seven animals with severe bacterial peritonitis required open peritoneal drainage and delayed abdominal closure. There was postoperative leakage at the anastomotic site in two dogs and a localized abscess at the staple line in one cat. No long-term complications occurred in follow-up periods of 3 to 29 months.     

Open Peritoneal Drainage in Experimental Peritonitis in Dogs

Peritonitis was induced In 12 dogs by creation of an avascular jejunal loop. After 24 hours, the avascular jejunal loop was removed, and purulent material was removed by aspiration. The abdominal incision in six experimental dogs was left open under a bandage, while the incision was closed in six control dogs. All six open abdomen, and four control, dogs survived the 8 days of the study. The number of bacteria in the peritoneal exudate in experimental animals was less than in control animals. At the end of the 8 day study, experimental animals were more active, had better appetites, and were less likely to have fever, vomition, diarrhea, and dehydration. Experimental animals weighed significantly less than control animals. There were no differences between groups with respect to biochemical and hematologic parameters. At necropsy, experimental animals had fewer adhesions and less peritoneal fluid accumulation than control animals. Complications of open peritoneal drainage included persistent fluid loss, weight loss, adhesions of abdominal viscera to the bandage, and contamination of the peritoneal cavity with cutaneous organisms.     

Severe abdominal dog bite wounds in a pregnant cat

Bite wounds are one of the most common reasons for admission of cats to veterinary clinics. Appropriate wound management seems to be more important in the successful outcome of bite wound injuries than antibiotic therapy alone. This report describes a heavily pregnant cat that suffered severe abdominal bite wounds necessitating treatment with extensive surgery. A necrotic herniated kidney, abdominal wall hernias, internal peritoneal ruptures and fracture of the thirteenth rib, gravid cornu rupture, an extrauterine dead foetus and its free kidney were all observed at laparotomy. At surgery the extrauterine dead foetus was removed, and two live foetuses were retrieved by en bloc ovariohysterectomy. A right nephrectomy and partial costectomy were also performed. Two weeks postoperatively, the cat had fully recovered without a problem. Bite wounds encountered in cats, though severe and invasive, can be tolerated and extensive surgical management can result in successful outcomes even under suboptimal conditions.     

Immunoglobulin A myeloma in a cat with pleural effusion and serum hyperviscosity

Immunoglobulin A myeloma, serum hyperviscosity, and septic pleuritis were diagnosed in a cat with pleural and peritoneal effusions. Serum hyperviscosity was determined by use of a WBC pipette, and clinical manifestations included retinopathy and cardiac changes. The presence of Salmonella typhimurium in the pleural fluid may have resulted from increased susceptibility to infection. Postmortem examination revealed plasma cell infiltration of the pleura, mesenteric lymph nodes, and the serosa of the intestine, liver, and spleen. This case represents an unusual form of myeloma in the cat.     

Skin fragility syndrome in a cat with feline infectious peritonitis and hepatic lipidosis

A 6-year-old spayed female domestic shorthair cat with a 3-week history of inappetence, weight loss, and hiding was examined. A palpable abdominal fluid wave, dehydration, and a small tear on the left flank were noted during initial examination. When the cat was gently restrained for blood sampling, the skin on the dorsal neck tore, leaving a 15 cm x 7 cm flap of skin. Clinicopathological abnormalities included nonregenerative anaemia, hypoalbuminaemia, increased globulin concentration, and mildly elevated aspartate aminotransferase and alkaline phosphatase activities. Abdominal fluid was viscous and had a total protein of 5.3 g dL(-1) with 316 cells microL(-1), consistent with a modified transudate. Cytology of the abdominal fluid revealed 86% nondegenerate neutrophils, 13% macrophages, and 1% small lymphocytes. Histopathological evaluation and indirect immunohistochemistry confirmed a diagnosis of feline infectious peritonitis, hepatic lipidosis and feline skin fragility syndrome. Feline skin fragility syndrome has not previously been reported in association with feline infectious peritonitis (FIP). Its inclusion as a clinical sign associated with FIP may facilitate a diagnosis.     

Urinoma (para-ureteral pseudocyst) as a consequence of trauma in a cat

A two-year-old cat was involved in a road traffic accident. Survey abdominal radiographs and urinary function were considered unremarkable. Six weeks later the cat presented with a palpable dorsal abdominal mass. Radiography revealed a soft tissue opacity mass caudal to the right kidney. Ultrasonography revealed a cyst-like structure with moderately echogenic contents, and right-sided hydronephrosis. There was no excretion of contrast medium from the right kidney after intravenous urography. Surgery revealed a disrupted right ureter adherent to the retroperitoneal mass. The mass contained serosanguineous fluid consistent with extravasated urine. Ureteronephrectomy was performed. The majority of the mass was excised and the cavity ablated. Histopathology of the excised tissue revealed a thick fibrous wall with no epithelial lining, consistent with a urinoma, which is thought to have developed as a consequence of ureteral trauma. The cat was clinically well three months postoperatively.