Case Study

Pancreatic mass in a 14 year old MN DSH cat

A 14-year-old MN DSH cat was presented for anorexia and lack of defecation. On physical examination, the eyes were sunken and the abdomen was soft and doughy. CBC showed leukocytosis, neutrophilia, lymphopenia, monocytosis, eosinopenia, and mild thrombocytosis. The only pertinent finding on blood chemistry was hyperglycemia. T-4 was within normal range. The patient was treated with subcutaneous fluids and force-fed A/D. Two days later the patient was hospitalized and treated with I.V. fluids, antibiotics, and supportive care. SPEC FPL result was high.

Sonographic Differential Diagnosis

Since there is no evidence of passive congestion, only minor hepatic changes that would not justify portal hypertension, normal albumin levels, and no evidence of organ perforation that could explain the free fluid, this presentation is suggestive for carcinomatosis likely deriving from the pancreas with metastasis to the liver. The nodular and coalesced omentum in the region of the pancreas supports this premise.

Image Interpretation

The abdomen in this patient presented multiple omental nodules with a 3cm hypoechoic ill-defined pancreatic mass (Image 1, 9 o`clock position). Power Doppler identifies the pancreatic duodenal vein. Mild to moderate amount of free fluid was noted which was mildly echogenic. Some minor nodular hepatic changes were also noted.