360° gastric dilatation‒volvulus secondary to adhesions associated with a splenogonadal shunt and subsequent delayed hypersensitivity reaction to human serum albumin in a cat

Abstract

A 9‐year‐old female spayed Scottish Fold cat presented with acute onset collapse, abdominal distension and haemorrhagic diarrhoea. Initial diagnostic evaluation revealed marked gastric distension with dorsal displacement of the pylorus and concurrent small intestinal distension, prompting an emergent exploratory laparotomy. Intraoperatively, an abnormal vascular structure consistent with a splenogonadal shunt, with adhesions to the falciform fat and omentum, was discovered, resulting in entrapment of the proximal gastrointestinal tract and a 360° gastric dilatation–volvulus. Surgical treatment involved adhesiolysis, division and sealing of the abnormal vessel, gastric derotation and routine gastropexy. Postoperatively, the cat required a human serum albumin (HSA) transfusion for haemodynamic stabilisation and survived to discharge. Fifteen days later, the cat developed urticaria, lymphadenopathy and bilateral uveitis with hyphema and fibrin deposition, which was suspected to represent a delayed hypersensitivity reaction to the prior HSA transfusion.