hello and welcome to this first opinion veter ultrasound case I'm Dr Camila Edwards this case was a 17-year-old male entire domestic Shad cat with a history of mild regenerative anemia moderate hypo album anemia marked neutrophilia an increased alt and a moderately increased alkp so here we're looking at um intestines um it's quite a skinny cat so we can see quite a lot of the abdomen a lot of the time so there was this focal um um swelling on the on the um intestines here that was spotted just a small thickening in the um wall layer there with a slight loss of wall layering also but very quickly followed to normal gut as well we also noted multiple um quite prominent lymph nodes although they weren't enlarged they were quite hypo eoic um and and lots of them here we're just seeing a mirror image artifact because the cat is so skinny we're actually hitting the table and then this is a mirror image artifact again more lymph nodes seen in the abdomen more here and measuring them they're under the half centimeter that we worry about um as a thickness guide in cats but um important to be aware as there were so many so Fanning through um the abdomen we're seeing um lots of these lymph nodes also see the kidneys and how close they are in a um skinny cat and we can see the liver here cranial in the abdomen here we're starting to be concerned there just appears to be a lot more um anaco tubes in the liver than we'd expect and we need to understand whether those are bile ducts or whether they are um um vessels so again this large lymph node two kidneys and these uh anaco tubes in the G in the bladder in the liver sorry more Fanning through the abdomen and we can see that swelling on that bit of intestine it's a focal thickening in that wall of the intestine there measuring that um thickened wall it's coming up at uh 7 cm Which is far thicker than um intestinal wo should be in the cat here we've got the liver um and the g bladder there and we're just investigating these um anaco tubes for flow um we can see some of these don't have flow in them and are probably bile ducts so there we could see uh an aoic tube um which doesn't have flow in it um is likely a thickened bow duct so this B duct is measuring at. 22 cm it's also they appear quite torturous it may also be a bit of free fluid around here as well um so these bile ducts are are are certainly torturous and and enlarged and we can really see from the gallbladder here how this B common bile duct um is very tortuous um down here following these torturous bow ducts just checking that there's no flow and that what we are actually seeing following is the ball duct we can follow it up towards the duodenum so focal masses in the small intestine in cats can be due to near play a or inflammatory bow disease this area was currently too small to feel confident about taking a fine needle aspirate from was also concerned about the multiple lymph nodes which although they weren't enlarged they were very prominent and hypo aoic there was also evidence of chronic colangitis with tortous B ducts and some reactive fats surrounding the tissue we didn't find an obstruction so working diagnosis of chronic colangitis and IBD uh was consistent with the ultrasound scan we hadn't ruled neoplasia out and biopsies would be the next course of action
