“What’s Your Diagnosis?” Challenge Winners & Answer: Oct-Dec 2011

Thank you to Del Mar Heights Veterinary Hospital for referring this case to us!

The patient is a 44-pound,  7-year-old, female Labrador mix presenting for anorexia, lethargy, +/- vomiting for one day. Pain and soft-tissue mass on mid-abdominal palpation. Two views of the abdomen were obtained one hour after presentation.

Images: (Click on each to view a larger version.)

WYD Answer

Findings: Two views of the abdomen are available for interpretation. On the lateral view there is a tubular soft tissue structure in the mid-ventral abdomen. No gas is noted within this structure. On the V/D projection this structure resides along midline. Several loops of small bowel are noted in the cranila abdomen, which have a normal appearance. Abdominal detail is normal. No skeletal lesions are noted. The nipples are prominent.

Conclusion: 1) Tubular soft-tissue structure in the mid-ventral abdomen. Given the lack of gas within this structure and the prominent nipples, a fluid-filled uterine horn would be the primary consideration. Differentials for fluid-filled uterine horns include pyometra, mucometra, hydrometra and pregnancy. The clinical signs would make a closed pyometra most likely. Segmental bowel dilation is a secondary consideration. 2) No evidence of ascites or peritonitis.

Recommendations: Abdominal ultrasound to confirm pyometra. Screening chest radiographs prior to laparotomy to assess for pneumonia, given the history of vomiting.

WYD Winners

Congratulations to the following people for their correct diagnosis!

Grant Mayne, Relief Vet, San Diego

Sharon Sprouse, Peñasquitos Pet Clinic, San Diego

Ira Abrams, VCA Scripps Ranch, San Diego (Winner of a pizza party through our raffle!)

John Beccari, Academy Animal Hospital, San Diego

Imran Samad, Askey Animal Hospital, Burlington, Ontario