RESUMEN CORTO - SHORT SUMMARY:

A 7-week-old male intact domestic short-haired kitten was referred for evaluation of vomiting and weight loss of 2 week duration. He was not eating and he had not defecated for 48 hours. According to the owner, the other 3 siblings were twice his size. On admission, the cat was depressed, dehydrated and showed decompensated hypovolemic shock. Initial venous blood gas analysis showed severe metabolic alkalosis, which raised the suspicion of an upper gastrointestinal obstruction. Abdominal X-rays showed a dilated stomach however no image of paralytic ileus nor foreign bodies were identified. Abdominal ultrasound demonstrated moderate gastric distention with fluid content. The rest of the intestines were empty. After stabilization and treatment with fluid therapy, his hypochloremia and alkalosis improved. The next day the cat vomited and regurgitated twice, and severe gastric distention was palpated. Repeat ultrasound revealed severe gastric and duodenal dilatation, together with pendular peristalsis in the proximal duodenum. An exploratory laparotomy was performed. There was a moderately stenotic duodenal segment of 10 cm in length with a diameter smaller than the rest of the duodenum, containing the major duodenal papilla and the major pancreatic duct. An annular-type fibrotic duodenal stenosis was identified on endoscopy, affecting 90% of the lumen. The owners elected euthanasia, and no necropsy was performed.

Benign intestinal strictures are extremely rare in cats. To the authors’ knowledge, this is the first report of a cat with an ante-mortem diagnosis of a congenital stricture, and the first case involving the proximal duodenum.

BIBLIOGRAFÍA:

Morales-Miranda A: Congenital intestinal stenosis and Hirschsprung’s disease: two extremely rare pathologies in a newborn puppy. BMC Veterinary Research 2019; volume 15, Article number: 92
Rowe J, Huang A, Heo J, Parnell N, Rudinsky A: Benign Duodenal Stricture Treated with Surgical Correction and Dietary Therapy in a Golden Retriever: Case Rep Vet Med 2020; Apr (6) 4283175.
Holloway A, Pivetta A, Rasotto R: Ultrasonographic and histopatholoical features in 8 cats with fibrotic small intestinal stricture. Vet Radiol Ultrasound 2019; Jul;60(4):423-431.
van der Gaag I; Tibboel D: Intestinal Atresia and Stenosis in Animals: A Report of 34 Cases. Veterinary Pathology 1980, 17(5), 565–574.
Morris G, Kennedy A Jr, Cochran W.: Small Bowel Congenital Anomalies: a Review and Update. Curr Gastroenterol Rep. 2016 Apr;18(4):16.

CONGENITAL DUODENAL STENOSIS WITH ANNULAR STRICTURE IN A CAT