June's Case of the Month
Patient Information:
Age: 2 years
Gender: Spayed Female
Species: Feline
History
Patient presented for a 1-2 month history of progressive weight loss and mild lethargy. Owners reported no known vomiting at home and a good appetite. Indoor only.
Physical Exam
Rectal temp. - 104.4F, HR 180, RR - 36.
Body weight 6.7 lb (8.6 lb when last weighed in Oct, 2017).
Thin, mild generalized muscle mass loss. Heart and lung auscultation WNL, patient eupneic and mildly tachypneic. Mucous membranes show mild pallor.
Right cranial abdominal palpation - firmer, linear palpating region (~2x3 cm) just ventral and caudal to right caudal kidney pole.
Laboratory & Radiographic Findings
CBC- HCT 19.3%, non-regenerative. Normocytic, normochromic. Autoagglutination strong positive.
Chem - TP 10.4, Glob 8.9. Alb 2.3. TBil 0.5.
FeLV/FIV SNAP - neg/neg
Abdominal ultrasound was recommended for further evaluation.
Image Interpretation
1. Marked mesenteric lymphadenopathy with mottled hepatomegaly is highly suspicious for multicentric neoplasia (ie. lymphoma, mast cell tumor, other round cell) vs. less likely granulomatous disease (feline infectious peritonitis).
2. Scant peritoneal effusion represent inflammatory or neoplastic effusion.
3. Chronic degenerative changes to the kidneys.
4. Ileal muscularis layer thickening may represent enteritis vs. multicentric round cell neoplasia vs. inflammatory bowel disease.
Additional Diagnostics
Fine-needle biopsies of an enlarged mesenteric lymph node were performed and revealed moderate to marked pyoranulomatous lymphadenitis.
Slides were submitted to Auburn University for coronaviral PCR and revealed FIP Virus mRNA POSITIVE.
Case outcome
Owners elected to monitor and maintain quality of life. Patient did well spanning ~ 5 months and was eventually euthanized due to severe weakness, anorexia, and lethargy.
Sonographer: Connie Shang, DVM
Special thanks to:
Matt Benedick DVM - Woodley Gardens Veterinary Care
Matt Paek DVM DACVR – Synergy VIP
Casey J. Leblanc DVM, PhD, Diplomate, ACVP (Clinical Pathology) – Eastern VetPath