I have a 3.5 year old male cat who I got from the SPCA with what was claimed to be IBD just about a year ago and he has recorded issues going back about a year before this. He has been doing fairly well all things considered and has had a few flare ups but has seemed to be doing well for the most part. Last month he had his second flareup since he has been with me and has had issues with throwing up, appetite, and stools and it has been lingering in one form or another since then. I took him in for an ultrasound and the report is below but the vet is concerned it is cancer and thinks we should cut him up to do a biopsy and see what is there. I am no expert but would be surprised if cancer would just hang around for a few years without just destroying him. Given this condition has been around for 1.5 - 2 years would you guess IBD or cancer? I really have the idea of cutting him up but I am not sure there is a choice.
Thanks for any incite.
Ultrasound report
Sonographic findings:
- The small intestinal wall is diffusely moderately increased in thickness, measuring up to 0.41 cm (ileum) with marked
altered wall layering, the muscularis and mucosal layers being thicker than normal. In the ileum, there is an asymmetric
thickening of the mucosa over approximately 3 cm. The right colic and jejunal lymph nodes are mildly irregular and
heterogeneous however remains within normal limits for thickness, measuring up to 0.36 cm. The colon contains a small
volume of fecal material. The colonic wall is within normal limits for layering and thickness, measuring 0.1 cm. The
gastric wall is at upper limit of normal for thickness, measuring 0.31 cm, however the stomach is empty potentially mildly
overestimating this finding. The gastric wall layering is considered normal.
- The left and right kidneys are mildly irregular with mild hyperechoic renal cortices. The rest of the renal architecture is
considered within normal limits bilaterally. The left and right kidneys are within normal limits for size, respectively
measuring 3.93 and 4.37 cm in length.
- The liver is within normal limits for size, echogenicity, echotexture and contour. There is no evidence of hepatic
lymphadenopathy. The gallbladder is within normal limits for size and content. The gallbladder wall is circumferentially
within normal limits for thickness (0.1 cm). The visible portion of the common bile duct is unremarkable
.
- The spleen is within normal limits for size, echogenicity, echotexture and contour.
- The left and right adrenal glands are within normal limits for thickness, respectively measuring 0.35 and 0.36 cm.
- The urinary bladder contains a small volume of anechoic urine. The wall of the urinary bladder is circumferentially within
normal limits for thickness, measuring 0.16 cm. The visible portion of the urethra is unremarkable. There is no evidence
of medial iliac lymphadenopathy
.
- The rest of the visible abdominal lymph nodes are within normal limits for thickness, echogenicity, echotexture and
contour.
Conclusion:
- The small intestinal wall changes are suggestive of inflammatory bowel disease or round cell neoplasia. The jejunal and
right colic lymph node changes are most likely compatible with reactive lymphadenopathy. Early dissemination of a
round cell neoplasia to the jejunal lymph nodes and right colic lymph nodes cannot be excluded.
- Despite the normal appearance of the pancreas, a chronic active/inactive pancreatitis cannot be ruled out.
- The renal changes are considered non-specific. Incidental fat infiltration may explain the hyperechogenicity of the renal
cortices.
Recommendations/procedures:
- A consultation with an internal medicine specialist and/or full thickness biopsies/endoscopic biopsies of the intestines +/-
biopsies of the jejunal lymph nodes should be considered.
Thanks for any incite.
Ultrasound report
Sonographic findings:
- The small intestinal wall is diffusely moderately increased in thickness, measuring up to 0.41 cm (ileum) with marked
altered wall layering, the muscularis and mucosal layers being thicker than normal. In the ileum, there is an asymmetric
thickening of the mucosa over approximately 3 cm. The right colic and jejunal lymph nodes are mildly irregular and
heterogeneous however remains within normal limits for thickness, measuring up to 0.36 cm. The colon contains a small
volume of fecal material. The colonic wall is within normal limits for layering and thickness, measuring 0.1 cm. The
gastric wall is at upper limit of normal for thickness, measuring 0.31 cm, however the stomach is empty potentially mildly
overestimating this finding. The gastric wall layering is considered normal.
- The left and right kidneys are mildly irregular with mild hyperechoic renal cortices. The rest of the renal architecture is
considered within normal limits bilaterally. The left and right kidneys are within normal limits for size, respectively
measuring 3.93 and 4.37 cm in length.
- The liver is within normal limits for size, echogenicity, echotexture and contour. There is no evidence of hepatic
lymphadenopathy. The gallbladder is within normal limits for size and content. The gallbladder wall is circumferentially
within normal limits for thickness (0.1 cm). The visible portion of the common bile duct is unremarkable
.
- The spleen is within normal limits for size, echogenicity, echotexture and contour.
- The left and right adrenal glands are within normal limits for thickness, respectively measuring 0.35 and 0.36 cm.
- The urinary bladder contains a small volume of anechoic urine. The wall of the urinary bladder is circumferentially within
normal limits for thickness, measuring 0.16 cm. The visible portion of the urethra is unremarkable. There is no evidence
of medial iliac lymphadenopathy
.
- The rest of the visible abdominal lymph nodes are within normal limits for thickness, echogenicity, echotexture and
contour.
Conclusion:
- The small intestinal wall changes are suggestive of inflammatory bowel disease or round cell neoplasia. The jejunal and
right colic lymph node changes are most likely compatible with reactive lymphadenopathy. Early dissemination of a
round cell neoplasia to the jejunal lymph nodes and right colic lymph nodes cannot be excluded.
- Despite the normal appearance of the pancreas, a chronic active/inactive pancreatitis cannot be ruled out.
- The renal changes are considered non-specific. Incidental fat infiltration may explain the hyperechogenicity of the renal
cortices.
Recommendations/procedures:
- A consultation with an internal medicine specialist and/or full thickness biopsies/endoscopic biopsies of the intestines +/-
biopsies of the jejunal lymph nodes should be considered.