History & Signalment
'Dinky' is an 8yr Male Domestic Short-Haired Cat with a 3 month history of intermittent vomiting and retching. Vomitus generally contained brown liquid. Weight loss was also noted during this time period and appetite was reduced. Occasional diarrhoea was also reported but was much less frequent than vomiting.
Physical Examination Findings
On clinical examination Dinky was bright and alert and had obvious muscle wasting over the lumbar spine. He was in acceptable body condition at 7.7kg. Mucous membranes were pale and a grade I/VI systolic murmur was auscultated. A mid abdominal mass was palpable which did not appear to cause discomfort.
Bloods were collected. Haematology was unremarkable except for a marginal eosinophilia. SNAP fPL was normal. On biochemistry, azotaemia was present and a mild non-specific hepatopathy was also noted. Dinky was negative for both FeLV and FIV.
Imaging Examination Findings
Abdominal ultrasound was initiated and a large volume of pleural effusion was imaged via the diaphragm (See figure).
The scan was abandoned until thoracocentesis had been performed. A total of 138mls of straw coloured fluid was retrieved from the pleural space and samples were examined cytologically.
Post-drainage radiographs were obtained (see Figure)
The abdominal scan revealed a small volume of free abdominal fluid. Several hypoechoic masses (the largest of which was 3.19 x 3.99cm) corresponding to enlarged lymph nodes, were identified in the mid abdomen in close proximity to an intestinal mass (focal thickening of the intestinal wall >1.24cm). The focal mass had indistinct wall layering. The video clip shows a more normal piece of intestine attached to the intestinal mass. Ultrasound guided aspirates of the lymph nodes were performed.
The right kidney was small with a hyperechoic cortex and a dilated renal pelvis (see Figure).
Thoracic fluid fluid contained medium to large lymphoid cells with open chromatin.
Cytology from the abdominal lymph nodes revealed medium to large lymphoid cells with open chromatin and small amounts of pale basophilic cytoplasm and an indistinct nucleolus.