Chyloabdomen in a cat with pancreatic carcinoma

Véran, Emilie; Gallay-Lepoutre, Julie; Gory, Guillaume; Guillaumot, Pierre; Duboy, Julie

Complete blood count and biochemistry profile were within normal limits. In-house tests for feline immunodeficiency virus antibody and feline leukemia virus antigen were negative. A feline coronavirus research by polymerase chain reaction on effusion was negative. Echocardiography was unremarkable. Abdominal ultrasound showed remaining abdominal effusion and an ill-defined heterogeneous mesenteric aggregate in the cranial abdomen, assumed to be mesenteric fat reaction due to chronic effusion. No mass was identified and the pancreas showed no significant ultrasonographic abnormalities. Computed tomodensitometry (CT) with lymphangiography was planned. Thoracic CT scan was within normal limits. On abdominal CT scan, the amorphous mesenteric aggregate, previously identified on ultrasound, was seen, surrounding the portal vein ( Fig. 1) . The caudal extremity of the right lobe of the pancreas was slightly thickened and it was in contact with the mesenteric aggregate. It had ill-defined heterogenous contrast enhancement (Fig. 2) . CT scan lymphangiography was performed by injection of contrast media in perianal subcutaneous tissue, as previously described in dogs by Ando et al. (2012) . The perianal area was clipped and surgically prepared. Using a 25-gauge needle, a warmed water-soluble contrast media (iodixanol, Visipaque TM 320, GE Healthcare SAS, Vélizy-Villacoublay, France) was injected in the subcutaneous tissue surrounding the anus at 0.6 mL/kg. The administration site was subsequently massaged for 5 minutes. Images were obtained with a multi-detector helical CT scan at 5, 10, 15, 20, and 25 minutes after injection. Only two lymph nodes in the sacral region and one hypogastric were marked with iodixanol. The remaining lymphatic system was not correctly visualized.