A 6-year-old SF Golden Doodle was presented for evaluation of 5-day duration anorexia following eating party leftovers. Additional history was that there had been a bout of vomiting, including toothpicks. Abnormalities on CBC and serum biochemistry were monocytosis, neutrophilia, elevated ALT activity (220), amylase (2500), and GGT activity (12), and severely elevated ALP activity (1462) and lipase (5460).
This is consistent with pancreatic necrosis with potential for underlying pancreatic neoplasia. FNA of the hypoechoic area is recommended with appropriate tissue culture if possible. Abdominocentesis of the free fluid would also be warranted. Aggressive treatment for pancreatitis would be recommended. Guarded prognosis. A recheck sonogram is recommended in 48-72 hours to ensure proper resolution. Bilirubin values should be monitored carefully. If they continue to elevate then surgical intervention with bile duct reconstruction may be necessary.
The pancreas in this patient presented extensive, mixed hypoechoic parenchymal changes with pericapsular inflammatory pattern and ill defined fat that extended for approximately 12 cm x 4 cm primarily in the right limb. A mild amount of free fluid was noted around the pancreas.
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GIT – foreign body, ulceration, intussusception, focal perforation
Liver – acute hepatitis (viral, bacterial, toxins)
Gall bladder – cholecystitis
Pancreas – pancreatitis
Peritonitis
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