hello and welcome to this case from first opinion vinary ultrasound I'm Dr Camila Edwards so this was an 11-year-old male newed domestic short-haired cat with a history of collapse two weeks ago had improved on fluids and still not eating right and had soft feces ultrasound of the abdomen had revealed a large mass in the mid abdomen and wanted further clarification of what that was okay so let's have a look at some images from this case so first of all we found um the liver here um so we've got the diaphragm down here we've got the liver and then we've got the gallbladder with its irregular wall here um there's also some evidence of possible uh torturous bile ducts down here we' need to put Doppler on to be sure that they are B ducts Fanning through the liver um we can really see that irregular G BL add a wall there moving into further into the abdomen we found this Mass um and found that it was associated with um Loops of junim so Fanning through that area and we can see this abnormal junim here so this abnormal junim with reaction around it um leading into this Mass following the J jum round and we come to this large mass here so this mass is uh heterogenous um it has a large hypo aoic area but also um some possibly some reactive fat around it um um we're assessing its vascularity thinking about taking a sample um and we don't want to stick a um a needle into a large blood blood vessel it's essential to try and follow where the the MK goes and to view it in um a few planes so at least two planes um and trying to follow what organ It's associated with so continuing to investigate following in a couple of planes um to see from a few different View points um how this mass is associated with the gunum turning the cat over we now can see the gallbladder from the right hand side and we can assess these um ducts we're applying color Doppler to see whether there's any flow in these and which there isn't so that does appear to be uh torturous bile ducts there that can be normal in cats um but combined with this irregular galbladder wall uh makes us a little bit more suspicious of Chio cystitis so just seeing that gallbladder with these grape like structures below it showing this torturous bile duct now assessing the mass for um fine needle aspirate I like to measure from this point down to the lesion so that I can know what needle length I need and here we're taking a fine needle aspirate we can see the needle entering here the mass here I'm following that down can see the needle tip and just a little woodpecker movement to get some cells before withdrawing the needle I repeat this here we can really see that mass um moving all by itself so we can see that this this uh hyperic area is actually part of the mass um so that's really useful um so sticking the needle into the mass and then uh woodpecker movement and withdrawing the needle the more samples we get the more likely we'll get a diagnosis so taking a good sort of four or five samples from a lesion is is very worthwhile so in this case we had a large G bladder with a thick regular wall we saw torturous B ducts with no evidence of obstruction a small amount of free fluid in the region and we decided there was cystitis with no evidence of obstruction there was also a focal junal Mass with a loss of wall layering which was associated with a larger heterogeneous mass and we followed that up by taking a fine needle aspirate of the junal mass which came back as a m Cel tumor
