Veterinary Medicine - August 2007 - (Page 518)

OPEER-REVIEWED Diagnostic imaging for linear foreign bodies in cats These clinicians focus on their diagnostic evaluation of a cat with vomiting and abdominal pain due to a linear foreign body. Find out which imaging techniques will best help you identify these common gastrointestinal foreign bodies in your patients. Luis M. Gonzalez, DVM, MS David S. Biller, DVM, DACVR Laura J. Armbrust, DVM, DACVR L inear foreign bodies are a wellrecognized problem in smallanimal practice. In cats, the most common linear foreign bodies are string, carpet, and plastic.1 Clinical signs of a foreign body include vomiting, regurgitation, ptyalism, inappetence, anorexia, depression, diarrhea, abdominal pain, and dehydration. Early diagnosis helps prevent complications such as peritonitis due to gastric or intestinal perforation.2 Since the clinical signs are nonspecific, imaging is almost always necessary to diagnose linear foreign bodies. In our teaching hospital, we use several imaging techniques including survey abdominal radiography, upper gastrointestinal (GI) series with barium or iodinated contrast material, survey or contrast abdominal compression radiLuis M. Gonzalez, DVM, MS* David S. Biller, DVM, DACVR Laura J. Armbrust, DVM, DACVR Department of Clinical Sciences College of Veterinary Medicine Kansas State University Manhattan, KS 66506 *Dr. Gonzalez’s current address is Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061. ography, and abdominal ultrasonography. The advantages and disadvantages of these techniques are discussed below, including a case report in which three of these imaging studies were used to definitively diagnose a linear foreign body in a cat. marked lymphopenia (800/µl; reference range = 2,000 to 7,000/µl). These results were consistent with dehydration and inflammation. Intravenous fluid therapy with a crystalloid solution was given to correct dehydration. Survey radiography CASE REPORT A 1-year-old spayed female domestic longhaired cat was presented to the Veterinary Teaching Hospital at Kansas State University with a 24-hour history of coughing, vomiting, polydipsia, anorexia, lethargy, and abdominal pain. Abnormal findings on ventrodorsal and right lateral survey abdominal radiographs were a plicated small intestine, fluid opacity within the pylorus, and a heterogeneous mix of gas and soft tissue opacity in the fundic region of the stomach (Figures 1A & 1B). A left lateral view was also obtained to complete the evaluation of the stomach and pylorus. All views revealed normal serosal detail. Examinations and diagnostic tests On physical examination, the cat appeared depressed and had dry, tacky mucous membranes. The cat’s abdomen was tense on palpation. Oral examination findings were unremarkable. Based on the history and physical examination results, the differential diagnoses included a GI foreign body, pancreatitis, and gastroenteritis of unknown cause. A complete blood count revealed polycythemia (packed cell volume = 60%; reference range = 30% to 45%), increased plasma protein (9.1 g/dl; reference range = 6 to 8 g/dl), leukopenia (total white blood cell count = 3,600/µl; reference range = 5,500 to 19,500/µl) with slight neutropenia (2,400/µl; reference range = 2,500 to 12,500/µl), and Survey compression radiography Because this case allowed an additional opportunity for instructing students, abdominal compression radiography with a compression paddle applied gently and uniformly to the left ventrolateral abdomen was performed to isolate the small intestine and enhance the visibility of its shape and contour. This view demonstrated bunching of the small intestine and plication without gas segmentation of the intestine (Figure 2). Because plication was identified on the survey and abdominal compression radiographs, a positive contrast GI 518 August 2007 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - August 2007

Contents A Veterinary Medicine Interview Veterinary Voices Idea Exchange Diagnosis and Treatment of Solar Dermatitis in Dogs Diagnostic Imaging for Linear Foreign Bodies in Cats Overcoming the Diagnostic and Therapeutic Challenges of Canine Immune-Mediated Thrombocytopenia Ophthalmic drugs: What’s new? CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - August 2007

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