1. Presented by: Rebecca McIntosh June 22, 2011 NCSU Ultrasound Rotation

2. Signalment Canine 6 year old English Setter White and Black Intact female Hunting/breeding

3. Presenting Complaint Anorexia, vomiting 7 days duration Diarrhea, weight loss 6 weeks

4. History April 2011 Had litter of puppies 3 survived Treated with Cephalexin for diarrhea May 22 Became anorexic May 24 Began vomiting, hypoalbuminemic on bloodwork

5. History May 28 Barium study performed Showed mild irregular, rough appearing mucosa of stomach and SI Started on Baytril Given Dexamethasone SP May 30 Presented to NCSU SAES

6. Physical Exam Abdomen tense on abdominal palpation No peripheral lymphadenopathy Remainder of PE unremarkable BCS 3/9 No melena on rectal

7. Diagnostic Imaging Lateral abdominal radiograph Loss of serosal detail Mass effect in cranial abdomen Remainder of radiographs aborted at owner’s request Abdominal ultrasound strongly recommended

8. Differential Diagnosis Neoplasia GI Foreign Body Inflammation -IBD

9. Diagnostic Imaging Abdominal Ultrasound

10. Diagnostic Imaging Abdominal Ultrasound

11. Diagnostic Imaging Abdominal Ultrasound

12. Diagnostic Imaging Normal Bowel

13. Diagnostic Imaging

14. Abdominal Ultrasound

15. Diagnostic Imaging Abdominal Ultrasound

16. Diagnostic Imaging Abdominal Ultrasound

17. Diagnostic Imaging Abdominal Ultrasound Normals 40mm <7.5mm 5-10mm <25mm 3-4mm <3mm 5-10mm <5mm

18. Diagnostic Imaging Abdominal Ultrasound Normals 40mm <7.5mm 5-10mm <15mm 5mm 5-10mm <50mm

19. Diagnostic Imaging Abdominal Ultrasound-typical finding

20. Differential Diagnosis-revised Lymphoma IBD

21. Diagnostics LN Aspirates Large granular lymphoma Most commonly splenic in origin

22. Conclusion Owner elected euthanasia No necropsy was performed

23. Acknowledgements: Dr. Phillips Dr. Campbell Dr. Duhadway American Cancer Society http://www.cancer.org/Cancer/SmallIntestineCancer/D etailedGuide/small-intestine-cancer