Case Study

05-00083 Bogie L Pancreatitis and pancreatic necrosis——-NO IMAGES—-

A 14-year-old MN Maltese dog was presented for vomiting with a previous history of borderline Cushing’s disease, collapsing trachea, and pancreatitis. On physical examination a distended abdomen was present. Abnormalities on CBC and serum chemistry were neutrophila, thrombocytosis, hyperproteinemia, hyperalbuminemia, elevated cholesterol, triglycerides, amylase, lipase, and AST, ALP and GGT activity, bilirubinemia, hyperphosphatemia, hypoglycemia, hypernatremia, and hyperkalemia.

A 14-year-old MN Maltese dog was presented for vomiting with a previous history of borderline Cushing’s disease, collapsing trachea, and pancreatitis. On physical examination a distended abdomen was present. Abnormalities on CBC and serum chemistry were neutrophila, thrombocytosis, hyperproteinemia, hyperalbuminemia, elevated cholesterol, triglycerides, amylase, lipase, and AST, ALP and GGT activity, bilirubinemia, hyperphosphatemia, hypoglycemia, hypernatremia, and hyperkalemia.

Sonographic Differential Diagnosis

Extensive pancreatitis and pancreatic necrosis of the left pancreatic limb, base and early right pancreatic limb.

Image Interpretation

The left pancreatic limb presented a large amount of hypoechoic parenchyma that was color flow negative. This is consistent with pancreatic necrosis and a minor amount of free fluid. This pattern continued into the pancreatic base and into the beginning of the right pancreatic limb.

Outcome

It was recommended that the pet be hospitalized and treated with IV fluids, antibiotics, and Cerenia. The owner declined hospitalization and the patient was treated with Cerenia and Pecid. The owner reported that the pet’s appetite improved while at home, but was still lethargic and having diarrhea. A few weeks after the initial exam the owner elected to euthanize.

Clinical Differential Diagnosis

Pancreas – pancreatitis, abscess, neoplasia Liver – infectious (bacterial/viral/fungal), trauma, toxins, metabolic, neoplasia GI tract – IBD, foreign body, neoplasia

Patient Information

Gender : Male, Neutered

Species : Canine

Type of Imaging : Ultrasound

Clinical Signs

Vomiting

Exam Finding

Abdominal Distension

Blood Chemistry

Albumin, High
Alkaline Phosphatase (SAP), High
Amylase, High
AST (SGOT), High
Cholesterol, High
GGT High
Glucose, Low
Hypertriglyceridemia
Lipase, High
Potassium, High
Sodium, High
Total Protein, High

CBC

Neutrophils, High
Platelet Count, High

Clinical Signs

Vomiting