Case Study

Focal nodular pancreatitits in a 13 year old FS Mixed breed

This 13-year-old mixed breed FS dog presented for vomiting, diarrhea, lethargy and anorexia. The physical exam revealed mild dehydration and cranial abdominal pain. CBC and blood chemistry panel revealed only a severely elevated lipase and mildly elevated amylase. The patient had been treated unsuccessfully on an outpatient basis for one week and then was hospitalized and treated with intravenous therapy for pancreatitis 3 days prior to the sonogram with partial resolution of symptoms.

This 13-year-old mixed breed FS dog presented for vomiting, diarrhea, lethargy and anorexia. The physical exam revealed mild dehydration and cranial abdominal pain. CBC and blood chemistry panel revealed only a severely elevated lipase and mildly elevated amylase. The patient had been treated unsuccessfully on an outpatient basis for one week and then was hospitalized and treated with intravenous therapy for pancreatitis 3 days prior to the sonogram with partial resolution of symptoms.

DX

Focal nodular pancreatitis with mixed inflammation and hyperplastic epithelial cells.

Sonographic Differential Diagnosis

Pancreatic nodule with surrounding inflammation. Differentials include neoplasia inflamed nodular hyperplasia, atypical focal pancreatitis.

Image Interpretation

An ovoid, approximately 1 cm x 1.5 cm, discretely marginated, hypoechoic region is seen within the pancreas. The surrounding mesenteric fat is mildly echogenic.

Outcome

The patient responded to an additional 3 days of hospitalization and thrived at home. Lipase levels continue to remain moderately elevated 3 months post hospitalization.