Case Study - Abdominal Twist in a Cat
Fleur was presented having started to eat less and drink more. She had always been a friendly cat and keen on being stroked. However over a five day period she had growled as her owners tried to cuddle her, and when she came to the surgery she was lashing out when you touched her, then backing away. This combination of signs usually suggests pain somewhere, but we couldn't find out where. Her temperature, pulse, membrane colour were all normal. There was a temporary improvement with painkillers, but not antibiotics, so it wasn't an infection.
The fact she was drinking more, and was only five meant we needed to consider possible causes, for example Kidney problems – unlikely at this age; or Diabetes – when the body cannot use it's insulin properly. This is produced in the pancreas, the organ that also secretes the digestive juices but when it gets inflamed it squashes the insulin producing cells.
We decided to take some blood samples – a general profile to check out several things at once. We found her glucose level very high at 23 mmol/l (normal is about 6 mmol/l). Now in cats who are stressed just from having a blood sample taken, the level might rise to 15mmol/l, but Fleur's result was so high that there just had to be another reason.
Xrays showed a diffuse shadow at the front of the abdomen. This area has many organs, but the suggestion was it may be pancreas. She was treated accordingly but didn't improve.
So, there was only one thing left to do, and that was to have a look inside. The operation, an exploratory laparotomy involved shaving her belly and making an incision so we could look and feel all the abdominal organs. The procedure may sound drastic, and it certainly can be in humans, but in cats and dogs it is well tolerated, and they are usually back to normal the next day.
We found that the greater omentum had completely captured the intestines, stopping them from moving around properly. This would certainly feel like colic to Fleur. The greater omentum is a lace-like structure attached to the stomach. It is large and spreads over the intestines loosely to reduce friction and ease bowel movement. Fleur had an unusually large greater omentum and somehow it had got tangled up.
The process had squashed the pancreas, and hence it was inflamed, and the knock-on effect of this was to stop the insulin being produced – hence Fleur was drinking more.
Once the omentum had been unravelled and returned to it's proper place, Fleur was sewn up and brought round from the anaesthetic.
Half an hour later she was purring and wanting to be stroked! She stayed with us overnight on an intravenous drip, then went home, as happy as ever.
Photo 1: Xray: a lateral radiograph of Fleur's abdomen.
The tightly packed small intestines was one of the clues as to the problem she had.
Photo 2: The omentum is a lacey sack containing streaks of pale fat. You can just see the pink intestines trapped inside the net formed by the omentum.
Photo 3: You can see the omentum acting as a 'net', with the bowels trapped inside
Photo 4: The pancreas is bright red from bruising, having been squashed inside the net,which was the cause of her being so very thirsty.
