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Suspect Cushing’s In An 11-Year-Old MN Boston Terrier: Our April Case of the Month 2022

Case Of the Month

Case Of the Month

Suspect Cushing’s In An 11-Year-Old MN Boston Terrier: Our April Case of the Month 2022

Patient presents for suspicion of possible Cushing’s. LDDST did not support a diagnosis of Cushing’s, however the chemistry panel does have generalized increased liver values; all considered mild-mod. ALT, AST, ALKP all mildly increased. Mild thrombocytosis – likely excitement. SDMA mildly increased. BUN/Crea normal. Abdominal ultrasound was recommended.

Patient presents for suspicion of possible Cushing’s. LDDST did not support a diagnosis of Cushing’s, however the chemistry panel does have generalized increased liver values; all considered mild-mod. ALT, AST, ALKP all mildly increased. Mild thrombocytosis – likely excitement. SDMA mildly increased. BUN/Crea normal. Abdominal ultrasound was recommended.

DX

Right adrenal mass with possible early phrenic +/- caval invasion. No obvious large invasion, appears potentially resectable.

Outcome

Surgical consult is recommended. This is likely carcinoma given the patient’s history. Further adrenal work-up is warranted including Urine cortisol to creatinine ratio is recommended.

Image Interpretation

The left adrenal gland was visualized and recognized as having normal shape, size, position and echogenicity for this breed. The phrenic vasculature, glandular echogenicity and detail were unremarkable. Capsule, cortex, and medullary definition were normal for this age patient. The left adrenal gland measured 2.58 x 0.46 cm at the caudal pole and 0.51 cm at the cranial pole. The right adrenal gland had a disrupted curvilinear pattern with microcystic changes. The right adrenal gland measured 3.1 x 2.02 cm at the cranial pole and 1.14 cm at the caudal pole. Capsular expansion was noted. The right adrenal gland was moderately vascular. The right adrenal gland impinges upon the vena cava without obvious invasion. Minor invasion into the phrenic cannot be ruled out. The right adrenal gland appears potentially resectable. The vena cava prior to and after the adrenal gland did not appear invaded.

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Patient Information

Patient Name : Dudley Makin - The Ark VC - ASNW - Jenna :)
Gender : Male, Neutered
Species : Canine

Images

normal_lad_makinright_adrenal_gland_mass_2022_im-0001-0041

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • AST (SGOT), High