RTA cat with a ventral swelling

Re: RTA cat with a ventral swelling

Neil Wheadon — Fri, 09 Jan 2015 17:28:41 GMT

Brilliant and thankyou I started him on Metacam 2 days ago, figuring that relieve the pain and 'do no harm' I'm seeing him this W/E so will update. Neil

Re: RTA cat with a ventral swelling

Tim Charlesworth — Fri, 09 Jan 2015 13:54:13 GMT

I wrote up a case series a couple of years ago about cats getting major inguinal fat pad "shear injuries" post RTA that could mimic inguinal rupture etc. Now our cats had a very similar appearance to what you're describing but the trauma and abdnormal fat was external to the body wall. If your cat has had a documented trauma/RTA then I think it is reasonable to presume that the caudal intrabdominal fat has been injured by a similar mechanism in which case it should get better just with time/rest +/- NSAID's for any pain.

PUBMED abstract for the above is at: http://www.ncbi.nlm.nih.gov/pubmed/22390339

Tim

Re: RTA cat with a ventral swelling

Busybee — Thu, 08 Jan 2015 20:51:51 GMT

We had one case when I was a student at RVC. From my notes at the time, it was suggested to control pain, give 'potent' anti-inflammatories (preds) and to ex-lap and biopsy if it doesn't improve.

Re: RTA cat with a ventral swelling

Martin Atkinson — Thu, 08 Jan 2015 13:57:27 GMT

[quote user="Neil Wheadon"]I am though left with the question, what can I do about steatitis in the abdominal fat,[/quote]I would dissect/debride the obvious nasty necrotic/very inflamed bits but the problem is that this is self perpetuating and the more damage you do surgically the more tissue you damage which becomes a vicious cycle.

I had thought that this sort of case was a good reason for doing C reactive proteins to give a prognosis because as said in extreme cases it can be fatal.

Re: RTA cat with a ventral swelling

Neil Wheadon — Thu, 08 Jan 2015 13:02:53 GMT

[quote user="Sammy82"]

Could you just remove the affected part of fat while you are in there? Tummy tuck for Kitty? Maybe not the first line of treatment but if discovered on exploratory surgery it might be the easiest solution.

[/quote]

I popped this in a previous post

'Interestingly the subcutaneous fat (and there was a lot of it) was normal

The mesenteric fat within the caudal abdomen and all around the bladder was lumpy and varied in shade from white to light yellow. I did take biopsies but the owner isn't interested. Looking at Vetstream, Vitamin E seems to be the treatment.'

So no unfortunately, as feely round the caudal abdomen, there were lumpy masses of fat adhered to the body wall and throughout the mesentery's

Neil

Re: RTA cat with a ventral swelling

Sammy82 — Thu, 08 Jan 2015 12:58:40 GMT

Re: RTA cat with a ventral swelling

Hannah Wynne Richards — Thu, 08 Jan 2015 12:51:20 GMT

I'm with Martin. Sneaky.

Wynne

Re: RTA cat with a ventral swelling

Neil Wheadon — Thu, 08 Jan 2015 12:40:44 GMT

[quote user="Martin Atkinson"]Sneaky![/quote]

Potentially yes, but I thought it was a hernia too, that's why I went for the 'lets repair it route' , and I do like radiographs on this site (pattern recognition and all that)

What it turned into though was something that was quite interesting and maybe next time a reader of this sees one they'll add this to the differentials.

I am though left with the question, what can I do about steatitis in the abdominal fat, that's not sneaky, but I'd love an opinion or three.

Neil

Re: RTA cat with a ventral swelling

Martin Atkinson — Thu, 08 Jan 2015 08:53:14 GMT

[quote user="Neil Wheadon"] Nope, I did an exploratory and the abdominal wall was intact. Neil[/quote]Sorry Neil but I didn't realise this was trick post to try and test us, I thought you genuinely needed advice.

If I'd known that I would have realised the obvious hernia was not going to be a hernia and in all honesty once that has been determined the only other likely thing was going to be panniculitis, probably secondary to crush injury to the inguinal fat. This is a common sequel to abdominal trauma in cats and in extreme cases can be fatal.

Sneaky!

Re: RTA cat with a ventral swelling

Mark Hedberg — Thu, 08 Jan 2015 08:40:36 GMT

[quote user="Anthony Todd"]

No indication for steroids

[/quote]

Tony? Are you feeling all right?

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 23:47:26 GMT

[quote user="Anthony Todd"]If the cat got a lot of tuna that'd be a clincher[/quote]

Which was the reference to 'older disease' as steatitis is less common now on commercial foods

What's the best source of Vit E for a cat?

Neil

No haven't looked at WikiVet

Re: RTA cat with a ventral swelling

Anthony Todd — Wed, 07 Jan 2015 23:39:44 GMT

[quote user="Neil Wheadon"]Anthony would approve[/quote]

I suppose I'm the "Anthony"so here goes.

No indication for steroids AFAIK or see from what you've said. I'd do a low fat diet ?? dried and supplement Vet E orally but I'm sure you've looked at WikiVet already!

If the cat got a lot of tuna that'd be a clincher, so it implies.

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 23:11:26 GMT

Yes it was, though I described it to the owner as steatitis.

Interestingly the subcutaneous fat (and there was a lot of it) was normal

There is controversy though about how else to treat. Immunosuppressive doses of steroids are suggested, but an old reference said that few cases had been treated and so proper data wasn't available.

So in a roundabout way, has anyone treated one of these as I'd be really interested.

Is there any other reason aside trauma? Finances were tight on this. The estimate of £1100 was greated with 'You're having a laugh aren't you?' so I took the view (and Anthony would approve) that may as well just go for it and try to do something.

Neil

Re: RTA cat with a ventral swelling

Sara Ramsey — Wed, 07 Jan 2015 22:36:22 GMT

Panniculitis?

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 21:34:57 GMT

Yes it's interesting isn't it. I operated on it as I too thought this must be some kind of rupture, so needed repairing. I do have an answer that was revealed on the ex lap and it is an unusual sequelae to trauma, but not so common in modern day cats. Neil

Re: RTA cat with a ventral swelling

Yantha Smyth — Wed, 07 Jan 2015 21:26:51 GMT

[quote user="Neil Wheadon"][quote user="Martin Atkinson"]

Am I the only one who can see a hernia here? The abdominal muscle is not attached to the pelvis. Seems logical after an RTA.

[/quote] Nope, I did an exploratory and the abdominal wall was intact. Neil

[/quote]

it really does appear on the X-ray that the abdominal wall is defective caudally/inguinal region. if not that is it the pre-pubic fat pads with bruising?

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 20:44:50 GMT

[quote user="Martin Atkinson"]

Am I the only one who can see a hernia here? The abdominal muscle is not attached to the pelvis. Seems logical after an RTA.

[/quote] Nope, I did an exploratory and the abdominal wall was intact. Neil

Re: RTA cat with a ventral swelling

Linda Filshie — Wed, 07 Jan 2015 19:49:33 GMT

[quote user="Martin Atkinson"]

Am I the only one who can see a hernia here? The abdominal muscle is not attached to the pelvis. Seems logical after an RTA.

[/quote]

That's what I see too.

Re: RTA cat with a ventral swelling

Martin Atkinson — Wed, 07 Jan 2015 18:36:04 GMT

Am I the only one who can see a hernia here? The abdominal muscle is not attached to the pelvis. Seems logical after an RTA.

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 17:59:18 GMT

Not that painful at all

Yes has eaten and drunk fine since being at home. The owner brought him back because he wasn't quite right

Neil

Re: RTA cat with a ventral swelling

Will McMullan — Wed, 07 Jan 2015 17:57:32 GMT

I presume the cat is stable now? Has it urinated? Are the lumps painful?

Re: RTA cat with a ventral swelling

Neil Wheadon — Wed, 07 Jan 2015 17:55:33 GMT

Not reducible and no ultrasound here I'm afraid

No bruising on the skin either

Neil

Re: RTA cat with a ventral swelling

Will McMullan — Wed, 07 Jan 2015 17:54:17 GMT

Consolidating haematoma? Fat that was there before the RTA now turgid due to bleeding? Ultrasound might help, and you could reassess the bladder. Are they reducible?