Meet Munchkin

Munchkin, a 12 year old DSHA cat, presented to us for an acute onset of vomiting and anorexia. On physical examination, she was overweight, febrile, and had moderate abdominal discomfort. Initial blood work showed evidence of an elevated white blood cell count. Abdominal ultrasound showed evidence of a thick-walled, discrete structure in the mid-cranial abdomen that was filled with echogenic fluid. This structure was consistent with an abscess. Because of the fever, abdominal pain, and elevated white blood cell count, we decided to take Munchkin to surgery.

Munchkin's appetite had been poor for 2-3 days. Because she was overweight, we were especially concerned that her lack of nutrition could quickly lead to hepatic lipidosis. Although we were hopeful that surgical intervention would be therapeutic, we were still concerned that she might not regain her appetite quickly enough to eliminate the possibility of hepatic lipidosis. It was therefore decided to place an esophagostomy tube while she was under anesthesia for surgery.

An abdominal exploratory surgery was performed, and a 3-4cm fluid filled structure was found in the area of the mesocolon. The structure was able to be removed in its entirety, the fluid within it was submitted for culture and sensitivity, and the tissue was submitted for histopathology. The pancreas appeared to be mildly inflamed, and the liver was diffusely mottled, thus biopsy samples were obtained from both of these organs. After closing the abdominal cavity, an esophagostomy tube was placed for nutritional support.

Munchkin recovered very well from her procedure. She was placed on antibiotics and medications to maintain comfort, and by the next day was bright and alert. Her appetite, however, did not return immediately, so we began to feed her through her esophagostomy tube. The biopsy results of the fluid filled structure confirmed an abscess, and the fluid culture was positive for an Enterococcus spp. that was sensitive to Clavamox. The biopsy of the pancreas did not demonstrate significant inflammation, however, the liver biopsy was consistent with small cell lymphoma.

Munchkin went home with directions for E-tube feedings, and antibiotics were continued. Because of the infection, treatment of her small cell lymphoma was delayed until we were comfortable that the infection was likely cleared, and the incisions were healed. Although her appetite did not return immediately, approximately one month after surgery she was eating her full requirement without supplemental E-tube feedings, and the tube was pulled.

She is currently eating well, and being treated for her small cell lymphoma. Although it is unclear why Munchkin developed the abscess, she has recovered well from her procedures, and is responding well to chemotherapy. At Munchkin's most recent recheck, her owner reported that Munchkin was doing great and back to her normal self!