Case summaryA 10-year-old male neutered domestic shorthair cat presented with nausea and 1.2 kg weight loss over a 6 month period. Physical examination was unremarkable, and haematological and biochemical results were considered clinically unremarkable. Abdominal ultrasound revealed an 18 mm diameter heterogeneous mass in the stomach at the pyloric sphincter, protruding into the gastric lumen with loss of gastric wall layering. The remainder of the intestinal tract and abdominal viscera were unremarkable and no free fluid was detected. The mass was surgically resected via celiotomy and the adjacent lymph node excised for histopathology. Histopathology of the mass demonstrated neoplastic spindle cell proliferation, which was considered most likely to be of smooth muscle origin, and so a preliminary diagnosis of gastric leiomyosarcoma was given. Complete excision was confirmed. Immunohistochemistry excluded a gastrointestinal stromal cell tumour as a differential and strongly supported the diagnosis of gastric leiomyosarcoma. The cat recovered well postoperatively with supportive treatment. Repeat abdominal ultrasonography 3 and 6 months postoperatively showed no evidence of mass regrowth. Survival time at the time of reporting is 10 months.Relevance and novel informationTo our knowledge, this is the first report of gastric leiomyosarcoma in a cat. Based on this case, gastric leiomyosarcoma should be a differential diagnosis for cats presenting with a gastric mass.
Dehydration is common among older adults and exacerbated in residential care. In this article, the authors summarise the reported prevalence of dehydration in this sub-population group and evaluate the associated risks before reviewing interventions designed to improve hydration. Heterogeneity in methods to assess dehydration inhibits interpretation of both prevalence and intervention studies (primarily small randomised control trials and case-control observational studies). The estimated prevalence of dehydration among older adults in residential care is 20-38%, with further increased prevalence of inadequate fluid intake, leading to increased urological, gastrointestinal, circulatory and neurological disorders or, in extreme cases, death. Multi-component interventions that include changes to drinks, vessels, placement and drinking opportunity, alongside staff training and support, are most effective in tackling dehydration in residential care. The detection and prevention of dehydration is crucial, and a practical, population-specific reference standard for adequate fluid intake is warranted. Future research should prioritise interventions that are individualised to residents' needs, according to dehydration typology. Ongoing investment in the care sector should address staff-to-resident ratios and enhance staff training on the detection and prevention of dehydration.
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