Extensive Pancreatitis in a 6yr old, FS, DSH

Case Study

Case Study

Extensive Pancreatitis in a 6yr old, FS, DSH

DSH, FS, 6 years. Beginning about a week ago started vomiting after eating, went on for about 3 days, then owner tried to with-hold food and water, vomiting continued, seen by RDVM – with BW had NSF and x-rays show thickened stomach wall, abnormal gas pattern, owner wanted to start with outpatient therapy – subcutaneous fluids and anti-nausea injection, has continued to vomit since going home, current diet Purina gentle and gets Friskies wet occasionally, does have a history of inappropriate urination – has been going on for approx. 2 years.

DSH, FS, 6 years. Beginning about a week ago started vomiting after eating, went on for about 3 days, then owner tried to with-hold food and water, vomiting continued, seen by RDVM – with BW had NSF and x-rays show thickened stomach wall, abnormal gas pattern, owner wanted to start with outpatient therapy – subcutaneous fluids and anti-nausea injection, has continued to vomit since going home, current diet Purina gentle and gets Friskies wet occasionally, does have a history of inappropriate urination – has been going on for approx. 2 years. The patient is on Ampicillin, famotidine, maropitant. Blood work unremarkable.

DX

Extensie pancreatitis

Image Interpretation

Extensive pancreatitis.

Reactive spleen.

Outcome

Ultrasound-guided FNA of the pancreas and spleen is strongly recommended. Strong potential for pancreatic necrosis. Aggressive pancreatitis therapy is recommended with pain management. Broad spectrum antibiotics as well as fluid support. Recheck sonogram in 72-hours.

Clinical Differential Diagnosis

The pancreas was enlarged, hypoechoic, irregular measuring nearly 2 cm in width. Ultrasound-guided FNA is recommended for further definition. Differentials include necrosis, carcinoma and simple pancreatitis. Regional hyperechoic surrounding fat was noted. The pathology was largely localized to the left limb. Slight regional lymphadenopathy was also noted.
The spleen was mildly enlarged with undulating capsular contour. This is consistent with reactive spleen owing to immune stimulus or early infiltrative disease such as mast cell disease or lymphoma. 25-gauge FNA would be ideal.

Video

Patient Information

Patient Name : OC Molyneaux
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Liz Wuz Here : Yes

Clinical Signs

  • Vomiting

Images

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Clinical Signs

  • Vomiting
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