Large Benign Stomach Tumour
Priscilla, a 12 year old female Siamese cat, presented to us for being unwell. She was off her food and lying around more than normal. There was the occasional vomit of undigested food.
On examination, her vitals were all normal- good gum colour, heart and lungs ok, temperature normal and she was reasonably bright and alert. On palpating her abdomen, a very large firm mass could be felt. It was approx. the size of a mango and had smooth edges and an undulating surface. It was the largest mass I had ever felt in a cat.
We suspected a nasty tumour in the abdomen and offered exploratory surgery just in case it was benign. Priscilla had some bloods taken and all the biochemistry and haematology results came back normal.
X-rays showed a solid large mass in the abdomen displacing her intestines to the rear. Her lungs were clear.
She was premedicated and placed on an IV drip. We gave Priscilla some IV Alfaxan and then placed her on Isoflurane gas for the surgery.
Upon opening the abdomen, we found a large dark mass which we were able to pull out. It only had one attachment to the stomach wall- approx 2cm wide and 3mm thick. The rest of the stomach looked ok as did the other organs in the abdomen. We cut the attachment to the stomach wall and removed the entire tumour. An incision was made in the stomach wall around the attachment’s base and the hole that was left was closed using a double layer of inverting dissolving Monosyn 3-0 sutures.
Some cephalexin antibiotic powder was placed in the abdomen and we closed the wound using normal sutures. Priscilla made a quick recovery and was sitting up crying out for food 2 hours later.
On cutting the mass in half, we found large chunks of food in the middle mixed with lots of inflammatory scar tissue. We thought there may have been a previous sharp object e.g. chicken bone; perforate the stomach allowing food to slowly enter the abdomen where the body’s self healing process sealed it off. This had probably happened over several months.
Priscilla looked well on the road to recovery that evening. We kept her on the drip along with pain killer injections and antibiotic cover.
The next day she was a bit flat. Her vitals were all normal and temperature ok. We kept the drop running and eventually offered her first meal 24 hours post op. This went down well.
On day 3, she refused to eat and was drooling and lethargic. Her temperature had risen and she vomited some of the special Hills A/D (recovery) diet she had eaten. Being a Friday evening, we decided to open her up just to check there were no adhesions or leaking for the stomach wall surgery site.
On examining the operation area, all looked fine. There was some mild localised peritonitis, but nothing major. However, her liver was slightly enlarged and had a fatty texture throughout. We flushed the abdomen with sterile saline several ties, and placed more antibiotics inside. She made another quick recovery and on Sat morning looked brighter thane the day before.
Over the weekend, she had to be force fed and given anti vomiting injections (Cerenia) and continued pain relief and antibiotic cover. At 11pm on Sat night, she looked like she was ready to go to Devon (“Dog and cat heaven”). We kept up the pain relief and fluids and lots of TLC.
We thought she may have developed fatty liver necrosis (damage to the liver) as a result of the major surgery. The only cure for this is what we were doing- force feeding, pain relief, IV fluids etc.
On Sunday morning, she looked a bit stronger and she even ate a tiny amount of cooked chicken brought in by her Mum. Each day for the next week she made tiny improvements. On day 10, Priscilla went home even though she was till weak and only picking at her food.
She was given a nice low voltage heat mat to sleep on and her Mum kept up the nutrition, antibiotics and pain relief.
By 3 weeks, she was a much happier cat. She is eating 7-8 times a day, running around following her Mum everywhere she goes and demanding to be allowed on her lap at every opportunity.
This was one of our trickiest cases and just goes to show that even though I have been in practice since 1981, I still have not seen all the different possible medical and surgical cases that present themselves to vets. It was a great result and one where we just had to go with the flow and get on with the surgery and intensive care.