* almost 14 yo FS Shitzu with hyporexia and decreased bowel movement and tense abdomen
* BW 12 lbs (normal for her) RT – 101.5 F, PE – unremarkable except for mildly tense/hard abdomen
* Prior DVM did X-Rays and confirm a mass in right mid to upper quadrant
* Chem/CBC and BGA – all WNL
* did abdominal US – mostly noraml other than a large anechoic, cyst like structure projecting caudally as if a blood vessel with increased diameter (much larger than aorta or CVC); this was found in right mid section of abdomen caudal to umbilicus and cranial to RKidney!
* Left Adrenal was identified but the right one was not found!
I need an input from some of you as to what this structure might be!
More images are available if needed!
Comments
Could be a pancreatic cyst
Could be a pancreatic cyst and as the fluid is very cellular abscess also possible although CBC is normal. Consider needle drainage but rupture may be a complication. Laparotomy should also be considered.
Im thinking this is
Im thinking this is hydronephrotic left kidney here…the ureter is persialtic if you watch closely. See my still of your last video and what I think are the residual structures…
EL- I never even considered
EL- I never even considered this because I thought the probe was on the right side. I was thinking pancreatic cyst too. What you are saying makes perfect sense. The probe must have been on the L side. That would certainly account for the abdominal pain.
Thank you everyone for help!
Thank you everyone for help! My diffrentials include 1) panc cyst and 2) some bizzare DDxs – anuerysm ( never diagnosed before??) , and atypical type of adrenal gland disease, ie., cyst or tumor or cyst/tumor independent from these organs! Looks like this dog needs an exploratory surgery, but before that I am going to have another look with US! Uploaded 1 more image (still pic of LK) and 1 video!
Thank you everyone for help!
Thank you everyone for help! My diffrentials include 1) panc cyst and 2) some bizzare DDxs – anuerysm ( never diagnosed before??) , and atypical type of adrenal gland disease, ie., cyst or tumor or cyst/tumor independent from these organs! Looks like this dog needs an exploratory surgery, but before that I am going to have another look with US! Uploaded 1 more image (still pic of LK) and 1 video!
Hi, Drs. EL & RH! Since the
Hi, Drs. EL & RH! Since the LK looks quite normal, can we say this could be a pancreatic cyst? Also my bizzare DDx should be thrown out the window, right? Your additional comments willbe greatly appreciated!!
its odd because i do not know
its odd because i do not know of another structure that contracts like the tubular structure in your second video if its not a ureter. Are you sure you are seeing the true left kidney and not the right kidney from the left side like in video 1 where you have the cystic structure in the near field and the right kidney in the far field? To get the left kidney in this view you would have to lighten the probe pressure considerably and drop the probe tail pointing to the spine or go left intercostal 12-13/paralumbar. If there is nothign there on these maneuvers then this is the left kidney thats a bag of blood wiht a contracting ureter. If there is a true left kidney on the maneuvers described please post it and then please let us know what the heck this thing is because Im very curious.
Pancreatic cysts do not have contractile components. Regardless I would just explore and let us know what you find this thing looks quite resectable… bag of blood/infection.
Would go with pancreatic
Would go with pancreatic cyst.