7 year old FS Catahoula cross. A month ago was vomiting twice per day, hours after eating. Also having diarrhea. The vomiting resolved after about a week. TX A&M panel showed folate 5.4 (7.7-24.4) and cobalamine more towards the low end of normal. Diarrhea has been improving with implementation of a bland diet and folate/B12 supplementation. Does this look like a region of ulceration (mid duodenum)? The rest of the bowel looks normal. Would an irregularity like this be enough to cause the drop in folate or is there likely additional enteropathy present?
7 responses to “duodenal ulcer? 11/9/23”
I’m not appreciating an ulcer here and i think thats the accessory panc duct maybe as there is no inflammation/fuzzy fat around it so that usually means its normal like the access duct causing the finger like echogenic projection. rest of intestine is normal
Ok, thank you. When looking for an ulcer, am I looking for more thickening of the area along with inflammation changes?
The abnormal folate and low-normal cobalamin is indicative of of a more diffuse enteropathy, even thought the intestines appear ultrasonographically normal. Scope with biopsies would be required.
Thank you for that – I was wondering, for future reference, if we would see changes on the GI panel for things like ulceration
Typical biochemical changes would be anaemia (regenerative if acute, and poorly-non regenerative and microcytic if chronic), low proteins, elevated urea.
Thanks so much for posting the example!