Cat with vomiting and duodenal perforation from rare gut disease

Abstract

OBJECTIVE: To provide a case description, including perioperative management, of a young cat with feline gastrointestinal eosinophilic sclerosing fibroplasia that presented with septic peritonitis. CASE SUMMARY: A 1.5-year-old male castrated British Shorthair was presented with an acute history of vomiting, inappetence, and periuria. On presentation, the patient was in shock and was apparently painful on abdominal palpation. Abdominal radiographs identified a mass effect within the stomach, pneumoperitoneum, and a mild lack of serosal detail consistent with scant peritoneal effusion. Exploratory laparotomy confirmed a mass affecting the pylorus and proximal duodenum, which was ruptured at the level of the major duodenal papilla. Mass resection with concurrent gastroduodenostomy and cholecystojejunostomy was performed, and feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) was diagnosed histopathologically. The cat was discharged 4 days postoperatively. Two weeks after surgery, treatment with prednisolone was initiated, and a hypoallergenic diet was recommended. Short-term medical management was challenged by poor owner compliance, and the patient was lost to follow-up 7 months after surgery. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first report of FGESF as a cause of gastrointestinal perforation and septic peritonitis. FGESF should be considered a differential for perforated gastrointestinal masses in cats.