June's Case of the Month

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Dianosing Dry FIP in a 2 year old Domestic Shorthair

Sonographer: Connie Shang, DVM

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

 Enlarged hypoechoic lymph node at the portal vein.

Enlarged hypoechoic lymph node at the portal vein.

 Rounded hypoechoic lymph node near spleen.

Rounded hypoechoic lymph node near spleen.

 Enlarged hypoechoic lymph node near the ICCJ.

Enlarged hypoechoic lymph node near the ICCJ.

 Numerous neutrophils and macrophages surrounding several small lymphocytes and few plasma cells.

Numerous neutrophils and macrophages surrounding several small lymphocytes and few plasma cells.

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