11-year-old castrated male Domestic Short Hair

Jumped off the couch yesterday and became acutely ataxic

Candidates were expected to correctly describe the following:

  • Soft tissue attenuating material nearly completely filling the caudal abdominal aorta extending to the aortic trifurcation
  • Absence of contrast medium within the right external iliac artery
  • Sharply delineated triangularly shaped segmental contrast medium filling defect within the ventral cortex of the left kidney.
  • Chronic spondylosis deformans of the caudal lumbar and lumbosacral spine.
  • Heterogeneous contrast opacification of the spleen (this finding was not scored).
  • Aortic thromboembolism
  • Embolization of the right external iliac artery
  • Acute infarct of the left renal cortex
  • Based on average candidates’ scores, this was the most challenging case of the CT portion of the 2017 certifying examination.
  • A large number of candidates failed to recognize any vascular abnormalities and instead overinterpreted chronic degenerative findings of the spine as significant.
  • A few candidates recognized a vascular abnormality but localized the lesion in the caudal vena cava.  Additional candidates interpreted the normally contrast opacified caudal vena cava to be the aorta concluding that it was an arterial phase study despite the presence of contrast medium within the urinary bladder.
  • A few candidates interpreted the left renal lesion as a cyst, missing a clue that a vascular abnormality was the cause of the cat’s clinical signs.
  • One candidate recognized the vascular abnormalities but rejected the diagnosis because it was not stated in the history that the animal was painful, not realizing that history provided with cases is appropriate but not necessarily complete.