This is a 15 year old Chinese crested. I can’t tell if this is a right adrenal mass, or something else. I wasn’t able to find the right adrenal but that is not unusual for me.
The first two clips are from the suspect area.
The third clip is the stomach, and I wonder if this gastric thickening needs to be addressed. He is not vomiting, but his appetite is off.
This is a 15 year old Chinese crested. I can’t tell if this is a right adrenal mass, or something else. I wasn’t able to find the right adrenal but that is not unusual for me.
The first two clips are from the suspect area.
The third clip is the stomach, and I wonder if this gastric thickening needs to be addressed. He is not vomiting, but his appetite is off.
Comments
Hey Judy!!! As you know, I’m
Hey Judy!!! As you know, I’m not a specialist and I’m sure they’ll weigh in, but happy to confirm for you that is indeed the right adrenal, and a beautiful image of it! You can see the cava above it, but it’s squished I think. As for the stomach, I’d describe this as a thickened muscularis layer and hyperechoic mucosal layer. The wall itself isn’t overly thickened – and the layering is distinct. Gastritis would be a differential. That said, I see this appearance not infrequently in asymptomatic dogs with completely empty stomachs (maybe a little extra acid production in the moment due to fasting overnight?), so I link the finding with what I see in the intestines (how did the muscularis layer look in the pyloric antrum, pylorus, duodenum, jejunum, and are the mesenteric lymph nodes ok?), whether there’s local gastric/portal lymph node enlargement, and the clinical signs/ biochem findings. The other thing is that you’re catching the body of the pancreas and the cranial aspect of the right limb in your stomach clip, and I think I see a hint of swelling and inflammation around it. How did it look further down by the duodenum. I could be making it up. I basically think that treatment for gastritis/gastroenteritis never hurts, so maybe start there with cerenia and empirical treatment and recheck in a few days? I often will ask owners to try to feed the dog a watered down can of wet food the morning of the scan when I am rechecking these cases because a little bit of luminal contents sometimes helps me decide how abnormal the wall is, if at all. Some look entirely normal on recheck. Hopefully that’s helpful information. This article is helpful: http://www.sonopath.com/sites/default/files/downloads/article_casey_GASTRO_Ultrasound_The_GI_Tract.pdf
Thanks Liz! the rest of the
Thanks Liz! the rest of the intestinal tract looked normal to me. I didn’t submit the scan however, so we’ll try some symptomatic treatment and maybe rescan if he’s not improving. He’s a very old little guy! Judy
I am also not a doctor
I am also not a doctor specialist but that looks like a bowling-pin style right adrenal to me.
Assuming the near field
Assuming the near field vessel is the cvc and the far field one is the aorta then this is a right adrrenal mass and looks like early phrenic invasion (arrow) which means pheo or carcinoma but still resectable.
OK, thanks! i am going to
OK, thanks! i am going to recheck him in 2 weeks so will make sure of landmarks but it was in the right location. jas