Cat vomiting and not eating due to gas in stomach wall and belly fluid

Abstract

Case summary A 9-year-old male neutered domestic shorthair cat was presented with a 2 day history of anorexia and vomiting. A minimum database, including a complete blood count, serum biochemistry profile and urinalysis were unremarkable apart from a toxic neutrophilic left shift and borderline proteinuria. Abdominal ultrasound revealed intramural gas entrapment with thinning of the gastric wall, a hypoechoic pancreas, peritoneal fluid and a small volume of peritoneal gas along with a hyperechoic mesentery. CT was performed and demonstrated gas within the gastric submucosa and gas in the peritoneal cavity. Generalised gastric erythema was present at surgery and histopathology of excised abnormal areas reported gastric erosion with no obvious causative agents; however, pretreatment with dexamethasone may have been a contributing factor. Culture from biopsied gastric tissue was sterile. Clinical signs resolved after partial gastrectomy and medical management. Relevance and novel information Feline gastric pneumatosis is a rare clinical finding. Imaging is essential for diagnosis and to decide on the appropriate treatment; this is often medical but in cases where there is suspicion or evidence of gastric perforation, surgery is indicated. To our knowledge, this is the first case of feline gastric pneumatosis secondary to gastric ulceration, diagnosed via CT and where dexamethasone may have been a contributing factor.