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Right adrenal mass in a 12-year-old, FS, DSH cat

Case Study

Right adrenal mass in a 12-year-old, FS, DSH cat

Decreased appetite, concern for abdominal mass on rads. Lethargy, severe hypokalemia. Hx of diabetes mellitus, hypothyroidism, asthma. Meds inclde methimazole 2.5 mg transdermal BID, glargine 0.5 units QD.

Abnormal labwork: K+ 2.3, SDMA 19 (high), TT4 6.9, glucose 181, platelets decreased but clumping noted. urine glucose neg, ketones neg.

Sonographic Differential Diagnosis

Conn’s Syndrome; adenocarcinoma vs pheochromocytoma (extremely rare in cats)

Image Interpretation

A mass was noted in the region of the right adrenal gland. The mass appears to be mineralized, impinging upon the vena cava without overt invasion. Regional inflammation was noted around the mass. The mass impinges upon and deviates the right kidney and impinges upon the right liver.

Outcome

 

Right adrenal mass, mineralized

Urinary bladder sediment (should be medically manageable)

Age-related renal changes

 

 

Comments

Given the hypokalemia, Conn’s syndrome is strongly suspected. Serial blood pressures are warranted. CT evaluation for surgical planning would be ideal, given the impingement upon the vena cava and the size of the mass. Suspect adenocarcinoma or possibility of pheochromocytoma (extremely rare in cats). If hypertension is an issue, then urine metanephrine level is indicated.h

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Patient Information

Patient Name : Mia Butler VH
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound

Clinical Signs

  • Anorexia
  • Lethargy

History

  • asthma
  • Diabetes, controlled
  • Hyperthyroidism

Images

Blood Chemistry

  • Glucose, High
  • Potassium, Low

Clinical Signs

  • Anorexia
  • Lethargy

Special Testing

  • SDMA high
  • T4 high