Time to play! [12]

13-year-old toy Poodle is presented for a routine blood glucose curve and a neurological evaluation for ataxia.

What do you think about the video clip of his stomach?

Notice the patient’s position…how is it impacting your findings?

I cannot wait to read your replies and I will give you my thoughts in a couple of days.

This entry was posted by Dominique.

13 thoughts on “Time to play! [12]

  1. My guess: gastric polyp; pyloric antrum. They are typically in this location too. On US, they give the appearance of a squishy (compliant) mass. I find this most often incidentally: no vomiting reported. This one too seems to go with the motility and gastric wall changes/contractions. Some are pedunculated but in my experience, not all. The echogenicity as well would lend support to an incidental polyp. I did have one dog with multiple polyps and chronic vomiting so I addressed that one as pyloric outflow obstruction. This dog has fluid in its stomach and some residual dependent ingesta. Not sure I would actually do anything beyond focusing on the DM unless chronic vomiting is part of the history or the owner reports the dog has fasted for a decent amount of time (thereby making the amount of liquid in the stomach not normal). But I would bet he has free access to water. If any question whether symptoms or not, I may re-ultrasound again at a later date.

  2. It has the appearance of an instussusception of the duodenum into the stomach, but without the typical concentric circles. I would wonder if the right lateral position was causing this, so would also scan with patient in dorsal and left lateral.

  3. The stomach is moderately distended with liquid digesta and gas bubbles. Wall layering pattern is normal and subjectively thickness is normal. There are strong antral contractions. In the pyloric antrum there is an echogenic mass with a heterogenous echotexture that shows positive blood flow on colour Doppler. The mucosal layer of the stomach is preserved over the mass. Differentials would be a benign gastric polyp or emerging neoplastic lesion. Gastroscopy and biopsy could be considered however surgical excision would be more efficient and possibly curative. By scanning in this position, the fluid falls to the dependent part of the stomach, and gas rises, allowing for visualization of the lesion in the pyloric outflow.

  4. Stomach is filled with fluid and little gas with too much peristaltic movement, on the right side ie. pyloric/duodenal area you can see an intestine in the lumen of the stomach, I can only think of intussesception of the duodenum to the stomach but I don’t know if it’s even possible 😉

  5. a neoproliferative lesion or a neoplasm should be ruled out … a gastroscopic evaluation and sampling is indicated
    thanks a lot

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