A 9-year-old FS Shih Poo was presented for evaluation of chronic cystitis with elevated ALP activity on blood work.
A 9-year-old FS Shih Poo was presented for evaluation of chronic cystitis with elevated ALP activity on blood work.
Case Study
Adrenal Gland Nodule in a 9 year old FS Shih-poo dog
Sonographic Differential Diagnosis
Left adrenal gland nodules, likely adenoma, possible emerging adenocarcinoma or pheochromocytoma. Nodule in the right adrenal gland. This is likely a fatty nodule, potential concurrent adenoma.
Image Interpretation
The left adrenal gland presented a progressively enlarged nodule. The left adrenal gland was hyperechoic with capsular expansion, which is likely adenoma. The left adrenal gland nodule measured 1.22 x 0.81 cm. A second, heterogenous, nodular change was noted at the caudal pole of the left adrenal gland and measured 0.8 x 0.71 cm. The right adrenal gland revealed a hyperechoic nodule at the cranial pole. The right adrenal gland measured 2.74 x 1.05 cm.
DX
Adrenal gland nodules
Outcome
The owners have decided to medically watch this patient.
Comments
Serial blood pressures and adrenal gland panel are recommended. I recommend full adrenal gland panel in this patient. Justification towards removal of the adrenal gland could be decided based on the progressive changes noted especially if any evidence of PU/PD or elevated blood pressures are present. I strongly recommend left adrenalectomy. There was no evidence of metastatic disease noted.
Clinical Differential Diagnosis
Bladder pathology – resistant bacterial cystitis, neoplasia, uroliths, granulomatous cystitis, polyploid cystitis
Elevated ALP – Cushing’s disease, adrenal neoplasia, gallbladder pathology, hepatic neoplasia
Sampling
None
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Patient Information
Patient Name :
Chloe F
Gender :
Female, Spayed
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Liz Wuz Here :
Yes
Code :
07_00126
Clinical Signs
- Dysuria
Images
Blood Chemistry
- Alkaline Phosphatase (SAP), High
Clinical Signs
- Dysuria