Stephen J. Birchard DVM, MS, Diplomate ACVS

Monday, August 26, 2013

What's Your Diagnosis?

This is an 11 year old female spayed Shih Tzu with a 2 month history of intermittent vomiting. The vomitus sometimes looks like coffee grounds. She had a right sided enucleation 2 years ago that was unrelated to her current problem.

Physical examination was unremarkable except for the absent right eye.

A CBC showed mild neutrophilia and serum chemistry profile was normal. A urinalysis was also normal.

Plain film radiographs, abdominal ultrasound, and an upper GI study with barium were performed:

Area between the cross marks in the pylorus

What further diagnostics would you do?
What are your differential diagnoses?
What definitive treatment would you recommend? (hint: it probably involves some kind of surgery.)

Answers in the next blog!