What is the cause of chronic vomiting in this cat?

Lymphadenopaty And tickness of muscular layer compatible with Lymphoma

Small intestine obstruction, mildly enlarged LNs, echogenic mesenteric fat and trace free fluid. Area of obstruction shows thick irregular intestinal muscularis and submucosa narrowing the lumen but almost a placated appearance. Some contents seen distal to obstruction. Not typical for neoplasia. ? Long-standing partial obstruction or perforationby foreign object causing scarring, and narrowing. X-ray may show FB. Recommend surgery to remove damaged bowel.

Linfoma

Snow day here in Ontario and lots of cancelled appointments so I'll give it a go! The small intestines show diffuse pattern of a thickened muscularis layer. In some loops there is a thin echogenic line parallel to the mucosa indicating fibrosis from chronic disease or past intestinal disease. Wall layering pattern is otherwise maintained, Some loops show mild corrugation and there is a trace effusion. There is no to mild luminal distension with echogenic liquid digesta. The ileum at the ileocecocolic junction has a thickened muscularis layer that is thicker and sightly eccentric compared to the rest of the small intestinal tract. The submucosal layer is also thickened, but layering pattern is otherwise maintained. The colon at the ICCJ is severely distended with moderately echogenic but uniform fecal material. There are several enlargedI ICCJ lymph nodes with a short/long axis ratio suggesting malignancy. Wall layering pattern is maintained but altered with mild wall thickening and a thickened muscularis layer. Moving distally, the wall transitions into an irregular shaped intraluminal mass with a possible plication pattern that is hypoechoic with a mildly heterogeneous appearance and complete loss of layering pattern. The surrounding fat in this region is ill-defined and hyperechoic with small pockets of fluid. Gas artifact within the lesion suggests ulceration. Distal to the lesion, there is transition to normal colon wall with mild luminal distension with uniform fecal material. No free abdominal gas is appreciated

On radiographs there may be loss of abdominal detail with segmental distension of the colon at the ICCJ.

Differentials: SI wall thickened muscularis layer: IBD, lymphoma
Colon wall muscularis wall thickening: colitis, lymphoma
Enlarged ICCJ LN's: neoplastic, reactive
Colon mass: neoplasia (carcinoma, lymphoma, granulomatous)
Local echogenic fat and fluid: steatitis with possible perforation (or emerging) and local peritonitis
Conclusion: Partial upper colon obstruction due to an ulcerated mass in the descendiing colon, local effusion and possible peritonitis with concurrent IBD,colitis or diffuse neoplasia pattern in the rest if the GI tract.

Test to confirm: because of concern of peritonitis, I would not wait on FNA;s or colonoscopy, but would take the patient to surgery for possible resection and biopsy. An attempt to aspirate the fluid could be made to look for evidence of peritonitis but this may be challenging due to the low volume present. Three view chest rads pre-op.

Hello, thanks for the clips! I see the jejunum muscular layer enlarged but the layerbstructure is preserved. There is ileocecal linphadenopathy. In what i thinks is colon i see a hipoecoic structure, irregular and with loss of the normal layer structure, which seems to be causing a semiobstruction.
i think in the rx we would spect to see a semiobstructive pattern, perhaps with gravel sign. I wood recommend fine needle aspirate of the intestinal mass, and depending on results and overall health condition consider surgery.
my first differential would be neoplasm (lymphoma) but i wouldn't rule out severe inflammation.

Bezoar

There are areas of ileus in the SI with food particles and gas. Several areas of the SI the muscularis region is very thickened and in the later views the layering is disrupted or absent in the more severely affected regions. There is a large area that appears to be a large mass effect in the wall of the intestine. In some of the dilated loops of bowel the mucosal region takes on a very hyperechoic appearance which may be food material but seems suspect for soft tissue changes. There are structures in the scan that are suspect for enlarged lymphnodes. With the signalment, malignancy is the top of my differential with Lymphoma at the top of that list (especially with the muscularis thickening). A FNA of the large mass lesion may be very helpful, otherwise surgical biopsy. Xrays would probably show enlarged bowl and gas with a mass lesion at that one area.

Thikened muscular wall of the pylorous,Stomach with content,loose of stomack walls architecture with desorganisation of the wall layers compatible with neoplasia.In the xrays will expect a mass with possible organs displacement,will need an Fna/biopsy to confirm.

propably ileus due to linear foreign body..

Ileo colic obstruction

wow, is this the ileocaecal region with a mass? age would fit alimentary lymphoma. FNA and go from there?

In the first clips I thought the mucosal layer was a bit thickened, but I'm not sure if this is actually the case or that it's the duodenum, which is supposed to have a thicker mucosa. In the later clips there appears to be a mass originating from the muscularis layer of the colon. I think that there are also enlarged lymph nodes in the abdomen.

Mildly thickened jejunal segments , muscular layer is thicker, and regional lymphadenopathy
Stomach with focal loss of normal wall layering (inhomogeneous mass), suggestive of Feline Lymphoma
Fine needle aspiration cytology is recommended

neoplastic ileocecocolic valves

Stomachache tumor?

Bonne apres midi !
Il me semble que vous parlez français, donc je tente d'envoyer ma réponse en français :
Il me semble voir un épaississement de la paroi stomacale avec alteration de la structure en couches, ainsi qu'une hypertrophie des NL gatsriques, et un épanchement abdominal tres modéré en regard des anses du duodénum ?
A la radiographie peut etre rien de spécifique, et pour aller plus loin dans le diagnostic cytoponction de la paroi et des NL, ou fibroscopie paroi stomacale
Merci pour ces vidéos tres instructives !
Caroline Tardieu

Muscularis layer thickened. Lymphadneopathy. Large, mixed echogenic, mass in the colon, dilated colon

Enlarged hypoechoic lnn. Mild thickened muscularis layer in jejunum and even in colon. Heavy thickening of muscularis låter in ileum and a masslike heterogenous lesion in ileocecalis area. FIP?

It’s a mass from muscular layer of the gastric wall. Three are several hypoechoic lymph nodes.
In rx we would can view caudal displacement of transvers colon.
I would make a PAAF of the lesion.
Thanks

lymphoma with metastasis to the mucous membrane of the stomach, associated mesenteric lymphadenopathy....

The cat has enlarged intestinal muscular layer more pronounced at the ileocecocolic valve. Need to perform a full thickness biopsy. Dd - IBD, intestinal lymphoma.

The tunica muscularis is a little big in one segment of the intestine and the linfnodes there are hypo to anechoic and seem a little round (linfadenopathy). Another part oft the small intestine is quite dilated and there seems to be a linear foreign body (hyperechoic line with shadow) in it which causes the dublication oft the distal intestine. I would do an laparotomy.

Irregular and thickened intestinal wall, loss of normal layering, enlarged mesenterial lln. Suspected intestinal lymfoma of sarcoma.

Interstinal obstruction , susp. linear foreign body , pancreatitis ? enlarged reactive lymph nodes .

Thank you - very interesting!

Thank you!

👏🏼👏🏼👏🏼 Very interesting and great images!!!

Thanks.

Perfect timing for these videos, I’m just doing my ultrasound module on GIT. Very helpful!