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Addison’s; flattened adrenals in a 4 year old MN Pomeranian dog

Case Study

Addison’s; flattened adrenals in a 4 year old MN Pomeranian dog

A 4-year-old MN Pomeranian was presented for evaluation of lethargy, decreased appetite, and vomiting. A barium study had shown no specific findings and the patient was treated with Cerenia, metronidazole, and subcutaneous fluids.  On physical examination dehydration and pain on palpation of L5-L6 and L6-L7 was present. Abnormalities on CBC and serum biochemistry were neutrophilia, mildly elevated AST activity, hyponatremia, hyperkalemia, and hypochloremia. The patient was given a Depo Medrol injection 6 days prior to the ultrasound.

 

Sonographic Differential Diagnosis

There is a strong suspicion for Addison’s disease.

Image Interpretation

The adrenal glands were flattened and isoechoic and barely visible. The right adrenal gland measured 1.57 x 0.3 cm. The left adrenal gland measured 1 x 0.22 cm. Otherwise unremarkable.

DX

Addison's

Outcome

None

Comments

ACTH stimulation and gastrointestinal protectants along with IV fluid support is recommended. 

Clinical Differential Diagnosis

Addison’s disease;
Fluid shift – pleural effusion, ascites, GI tract (diarrhea)

Sampling

None

Patient Information

Patient Name : Bert H
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 07_00150

Clinical Signs

  • Anorexia
  • Lethargy
  • Vomiting

Exam Finding

  • Dehydration

Images

hendrickson_bert_addisons_lt_adrenalhendrickson_bert_addisons_rt_adrenal

Blood Chemistry

  • AST (SGOT), High
  • Chloride, Low
  • Potassium, High
  • Sodium, Low

CBC

  • Neutrophils, High
  • WBC, High

Clinical Signs

  • Anorexia
  • Lethargy
  • Vomiting