- 16 yr old FS DSH presenting for anorexia, weight loss, elevated ALT>1000, elevated TBil (0.6).
- Is on methimazole for hyperthyroidism but not well controlled right now, and hypoallergenic desensitization therapy.
- Cat had an episode of cholangiohepatitis 2 and 1/2 years ago (coarse liver parenchyma and dilated pancreatic duct) that responded to medical management but this time round the ultrasound findings are more dramatic.
- 16 yr old FS DSH presenting for anorexia, weight loss, elevated ALT>1000, elevated TBil (0.6).
- Is on methimazole for hyperthyroidism but not well controlled right now, and hypoallergenic desensitization therapy.
- Cat had an episode of cholangiohepatitis 2 and 1/2 years ago (coarse liver parenchyma and dilated pancreatic duct) that responded to medical management but this time round the ultrasound findings are more dramatic.
- Abdominal US shows an enlarged , hypoechoic pancreas with a dilated pancreatic duct (2-4.5mm) pancreatic cysts, and adjacent, echogenic fat, small intestinal segments with an increased muscularis to mucosal ratio and adjacent, echogenic fat, full gallbladder with a slightly thickened wall and tortuous cystic duct, periportal lymphadenopathy, and a hypoechoic spleen with an irregular capsule.
- My primary differential is triaditis, but I am concerned about the severity of the pancreatic duct dilation and the new finding of pancreatic cysts (emerging neoplasia?)
- I am attaching images of the pancreas and portal hilus region.
