Case Study

Severe pancreatitis with peripancreatic inflammation in a 6 year old FS Siberian Husky

This 6-year-old FS Siberian Husky presented for vomiting and anorexia. The patient had been managed for reasonably well controlled diabetes for the previous 6 months. The clinical exam revealed moderate dehydration and abdominal pain. CBC and blood chemistry demonstrated a history of chronic moderately elevated SAP, moderately elevated cholesterol, and moderately elevated triglycerides with slightly elevated lipase. This profile was similar at the time of the clinical presentation with strong evidence of a urinary tract infection on the urinalysis with 3+ glucosuria.

This 6-year-old FS Siberian Husky presented for vomiting and anorexia. The patient had been managed for reasonably well controlled diabetes for the previous 6 months. The clinical exam revealed moderate dehydration and abdominal pain. CBC and blood chemistry demonstrated a history of chronic moderately elevated SAP, moderately elevated cholesterol, and moderately elevated triglycerides with slightly elevated lipase. This profile was similar at the time of the clinical presentation with strong evidence of a urinary tract infection on the urinalysis with 3+ glucosuria. Fructosamine level at that time was also mildly elevated.

DX

Low grade mixed suppurative inflammation.

Sonographic Differential Diagnosis

Severe pancreatitis with peripancreatic inflammation. Suspected parenchymal fibrosis suggests acute exacerbation of chronic pancreatitis may have occurred.

Image Interpretation

The imaged portion of the pancreas is enlarged with a markedly hypoechoic parenchyma. The surrounding omentum and mesentery are severely echogenic. Notice the pancreatic margination is irregular. This is likely the result of inflamed omentum overlying the serosal borders. The echogenic pinpoint foci noted within the center of the affected pancreas may represent regional fibrosis, suggesting previous inflammation may have occurred. Color flow Doppler demonstrates persistence of blood flow throughout the affected pancreas.

Outcome

The patient was discharged after 4 days of hospitalization and continued with similar blood values and intermittent episodes over the following 2 years.