This 15 year old FS Yorkshire Terrier has a suspected mass on the left adrenal (on ultrasound), some Cushingoid symptoms, speckling of the small intestine. Albumin has been 2.0-2.2 for the past two months.
This 15 year old FS Yorkshire Terrier has a suspected mass on the left adrenal (on ultrasound), some Cushingoid symptoms, speckling of the small intestine. Albumin has been 2.0-2.2 for the past two months.
CT of the abdomen –
The left adrenal gland presents nodular enlargement of the cranial and caudal pole, with a caudal pole height of 1.3 cm and cranial pole height of 0.9 cm. After contrast administration the left adrenal presents irregular contrast enhancement. There is no evidence of vascular invasion. The right adrenal gland is within normal limits for size, shape, attenuation and contrast enhancement. The subjective impression of the small intestine is transmural thickening of the wall with moderate contrast enhancement. However, the measurement of the thickness by CT is not reliable. The liver protrudes beyond the rib cage and the liver margins are rounded. Caudodorsal rotation of the gastric axis is noted.
Possible differential diagnoses are nodular hyperplasia, adenoma,
adenocarcinoma or pheochromocytoma. According to the history a functional
hyperplasia, adenoma or adenocarcinoma is more likely than a pheochromocytoma. The liver changes are compatible with steroid induced hepatopathy which can either be
iatrogenic (immunosuppressive treatment of PLE) or due to functional
hyperadrenocorticism (Cushing’s syndrome. The findings of the small intestinal tract are consistent with the history of protein-losing enteropathy.
Complete blood work including testing of the pituitary adrenal axis and urinalysis are
recommended
