3. small Anim. Pract. Vol. 9, 1968, pp. 231 to 233. Pergamon Press Ltd. Printed in Great Britain

Clinical Communication : A Case of Torsion of the Stomach in a Five-Year-Old Cat TREVOR TURNER 15 Mandeville Road, Northolt, Middlesex

Subject FIVE and a half year old spayed female cat.

Histoyv The animal had been spayed as an adult, at approximately 1 year old.

According to the owners, recovery etc., was uneventful and the animal had suffered no ill effects from the operation.

The cat had not been ill until approximately 24 hr before presentation, when the owner noticed she was disinclined to eat and that the abdomen appeared swollen, although she was drinking normally.

Symptoms and diagnosis On examination the animal appeared cyanosed. Temperature was 101 - 5°F.

Respiration about 50 per min and pulse about 150 per min. There was some fluid in the abdomen through which a hard mass could be palpated, anteriorly, at the level of the rib cage. A tentative diagnosis of an abdominal tumour was given and permission for exploratory laparotomy requested. An exploratory laparotomy via the mid line was performed 12 hr later. During the interval from the original examination, abdominal distension had increased although the animal did not appear to be distressed.

Treatment The animal was anaesthetised using metho-hexitone sodium." The cat weighed

11 lb 4 oz and 3 ml of 1 yo solution were used to induce anaesthesia which was maintained using 0 2 and ether via a No. 0 plain McGill tube. With the cat in dorsal

*Brietal Sodium, Eli Lilley & Co.

23 I

232 T. T U R N E R

recumbancy and observing the usual precautions of aseptic surgery, a mid line incision was made from the umbilicus to rim of pubis.

One and a quarter pints (approximately 600 ml) of clear straw coloured fluid were removed. The spleen immediately came into view, obscuring the rest of the field and it was then found that the stomach was lying with the greater curvature over towards the animal’s right side. The pylorus appeared to have undergone torsion and was thickened and it was this which had appeared as the “hard mass” on palpation. No obstruction appeared present. I t was apparent that the stomach had undergone torsion, in a clockwise direction, the cardiac portion having passed ventrally from left side to right side. The condition appeared to have been present for some time since adhesions between the greater curvature and the right parietal peritoneum were well established, also the pylorus was considerably thickened.

Correction of condition Adhesions were broken down manually and the stomach gently ‘cuntwisted”

care being taken to observe the pylorus to make sure that torsion was reduced at this site. Using 3/0 cat gut on an atraumatic needle, an attempt at gastropexia was made in order to prevent further torsion. A few interrupted sutures were placed joining the serous coat of the greater curvature of the stomach to the parietal peritoneum on the left side, in the region of the last rib. The viscera was lightly dusted with penicillin/sulphamethazine powder? and the mid line incision closed using 1 j O chromic gut for the muscle/peritoneal layers and 0 . 3 mm sheathed multi- filament nylon material1 for the skin.

The patient was kept in hospital and penicillin G§ at the rate of 300,000 units daily administered for 5 days. The cat was considerably shocked as a result of the operation and did not fully recover consciousness for 36 hr. Subsequent recovery was uneventful and the animal was released after 8 days, by which time no further return of ascitic fluid was evident. Skin sutures were removed after 10 days and the animal again examined. No return of ascites was palpable.

DISCUSSION

The case shows notable differences to those usually encountered in torsion of the stomach of dogs. In dogs the condition is usually confined to the larger breeds, although a case was encountered involving a Dachshund.** Here, however, the symptoms still followed the usual pattern. In the cat, the pattern appears to vary:

the cat was neither large nor overweight in this case, very acute symptoms were absent. The owner had noticed that the animal

had lost its appetite and appeared swollen in the abdomen 24 hr previous to exami- nation but did not appear unduly distressed. Operation was delayed a further 12 hr without any apparently untoward sequelae. Admittedly, in this case it was obvious that obstruction was only partial.

1. 2.

t Penicillin G with Sulphadmidine powder, I.C.I. Ltd.

tj Crystapen, Glaxo Laboratories Ltd. ** Turner, T. (Vet. Rec. 1964, 76, 243).

Armofil, 2/0, Armour Pharmaceutical Co. Ltd.

TORSION O F THE STOMACH IN A FIVE-YEAR-OLD CAT 233

3. A considerable quantity of ascitic fluid was present. This is not usually reported in the similar condition encountered in the dog, possibly because of the more acute nature.

Onset had obviously been slow-by the evidence of the adhesions-and obviously asymptomatic until the animal was presented for examination. Etiology is obviously different from that in the dog. No obvious cause of the condition could be found on operation. The stomach was only partially filled. No foreign bodies were palpable and no obvious signs of injury resulting in the adhesions could be found. Diaphragm was intact.

The only other recorded interference was the spaying operation and according to the owners this was quite uneventful.

5. The condition in the cat appears rare. No other recorded case could be found. I would welcome any comments.

4.