Case Study

Pancreatitis and gastric stasis in a 4 year old female spayed Welsh Terrier

A 4 year old spayed female Welsh Terrier dog was presented for vomiting. Abnormalities on initial examination included pyrexia at 102.1, polypnea, and a soft, tense cranial abdomen on palpation. The patient was treated for pancreatitis and was discharged once she had improved. After the owner removed the patient’s Fentanyl patch, she once gain developed polypnea and anorexia. Urinalysis and CBC were normal, however the serum biochemistry revealed elevated BUN, elevated BUN/creatinine ratio, and elevated GGT activity. The patient was treated with Clavamox, enrofloxacin, and Pepcid.

Sonographic Differential Diagnosis

Diffuse chronic active pancreatitis. Potential pancreatic carcinoma. Gastric stasis.

Image Interpretation

The left limb of the pancreas contains a heterogeneous mass-like structure consistent with sequestered pancreatic inflammation or potential carcinoma. A minor amount of free fluid was noted as well as adhesions to portions of small intestine. The stomach presented a moderate amount of stasis. No overt foreign body was noted.

DX

Diffuse chronic active pancreatitis. Gastric stasis.

Outcome

The patient was referred to a specialty facility for further treatment and has since recovered.

Clinical Differential Diagnosis

Pancreatic disease (acute pancreatitis, pancreatic abscess, granuloma), GI tract disease (obstruction, ulceration, IBD, bacterial infection or neoplasia).

Sampling

Fine needle aspirates of the left pancreatic limb, multiple regions of pancreas, as well as the hemorrhagic free fluid was performed and submitted for culture and cytology review. Cytology revealed mixed pancreatic inflammation, and culture was negative.