This week’s case is a 7-year-old male neutered Cocker Spaniel. Vomiting, lethargy, and coughing for one week. There is a subtle abnormality in this case. Can you find it?
The abdomen is distended, and there is poor peritoneal detail. In the craniodorsal portion of the abdomen, there is gas lucency which appears to outline the liver lobes and proximal extremity of the spleen. The liver is enlarged. The urinary tract appears normal. The small intestine appears corrugated in some areas. There are several gas bubbles near the small intestinal loops that are not clearly contained within bowel.
A horizontal beam radiograph was obtained with the dog in right lateral recumbency. A small bubble of free gas is present at the highest point of the abdomen.
Abdominal effusion and free peritoneal gas may be due to bowel rupture or penetrating wound resulting in septic peritonitis. Exploratory laparotomy or abdominal ultrasound is warranted to determine the cause.
Ruptured duodenal ulcer with septic peritonitis. The patient was also diagnosed with diabetes mellitus and a pancreatic abscess.