Chronic intestinal pseudo-obstruction secondary to intestinal leiomyositis in a ragdoll cat

A 1-year-old neutered male neutered Ragdoll cat was presented with a 4-week history of hyporexia, intermittent diarrhoea and weight loss. Initial imaging revealed a varying degree of distension of the intestinal loops by echoic fluid/gas and some loops had hyperechoic content with marked echo shadowing. Exploratory laparotomy was recommended but declined. Subsequent clinical deterioration prompted further investigation with CT scan revealing severe dilation of the intestine which was deemed likely secondary to small intestinal foreign body obstruction, and less likely to be secondary to a condition resulting in functional ileus. Surgical exploration revealed severe intestinal distension extending from mid-jejunum to the caecum and the distended portion of the intestine was impacted with hard faecal matter towards the caecum. Surgical resection of the ileum and caecum was performed. Unfortunately, following surgery the patient continued to decline and was euthansied. On post-mortem examination, histhopathology confirmed myopathic instestinal leiomyositis. To our knowledge, this is the first reported case of myopathic intestinal leiomyositis in a cat. This report supports inclusion of pseudo-obstruction as a differential diagnosis in cats with non-obstructive intestinal disease, highlights the need for further investigation to better characterize intestinal pseudo-obstruction in veterinary medicine, and suggests that insights from human medicine may inform diagnostic and disease classification approaches in the interim.