12 year old Castrated Male Domestic Shorthair Cat

Patient Demographics: A 12 year old castrated male domestic shorthair cat  had lived in California where he was an outdoor cat, Chicago, and now North Carolina where he lives indoors only.  He is not up to date on vaccines or preventative medications.

History:  The patient presented to the emergency service for a 2 day history of vomiting, hyporexia, and vocalizing. The patient has a history of chronic intermittent vomiting, no more than once a week, which improved with a diet change.

Exam findings:  The patient was 5% dehydrated with normal cardiovascular sounds.  The abdomen was distended and the stomach palpated as enlarged. Abdominal radiographs were obtained, a nasogastric tube was placed and the stomach evacuated and additional radiographs obtained.   The patient’s breathing became labored during evacuation of the stomach and thereafter.

  

 

The last image is the same image as the penultimate image but with altered contrast.

Questions for discussion after reviewing images:

What are the radiographic findings and conclusions?
What is the origin of the lesion and what organ(s) are involved?
What additional imaging if any is recommended?
What additional treatment if any is recommended?

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