2010 Image Interpretation Session - Case 1

Signalment: 3-year-old, female spayed, Boxer

History: Presented to the emergency room after an acute onset of vomiting and hematemesis. Her owners noted that she vomited first at about 5 hours earlier, and then vomited multiple times throughout the day, with hemorrhage noted in the last few. Her owners noted normal stool in the morning, but tenesmus with no stool produced throughout the afternoon. She seemed uncomfortable and vocalized throughout the day. Patient does not have a history of eating or chewing on things she is not supposed to. She is current on her vaccinations and received a monthly heartworm preventive. Patient’s owners noted that she does have a history of vomiting when nervous or anxious, but it has never manifested as this severe or frequent in the past.

Clinical Findings: T=102.7 F P=150 bpm R=60 breaths/min
On physical exam, patient seems globally uncomfortable and painful. Her posture includes an arched back and “tucked up” abdomen. Her mucous membranes are pink with a normal CRT (< 2 seconds). Tachycardia and tachypnea were noted, but the heart and lung sounds were normal on thoracic auscultation. Patient is diffusely uncomfortable and tense on abdominal palpation.

Images provided: 2 radiographs of the abdomen