11 yo F/S Lab, severe cholestasis (ALP 4100), mod cytolysis (ALT 650), asymptomatic. Overweight, W 80#.
On Denamarin, Amlodipine for hypertension, Apoquel.
U/s: heterogeneous liver, almost small, mild sludge. Splenic infarct area near head, w reactive LN nearby (5.9mm).
Both adrenals are large, left 1.8cm (cr), right 1.5cm (cr) with a preserved architecture. I don’t think it is invading the vessels.
Patient has no signs of Cushing’s. Rec low dose dex and urine metanephrine fractionation test. Recheck in 6 weeks.
11 yo F/S Lab, severe cholestasis (ALP 4100), mod cytolysis (ALT 650), asymptomatic. Overweight, W 80#.
On Denamarin, Amlodipine for hypertension, Apoquel.
U/s: heterogeneous liver, almost small, mild sludge. Splenic infarct area near head, w reactive LN nearby (5.9mm).
Both adrenals are large, left 1.8cm (cr), right 1.5cm (cr) with a preserved architecture. I don’t think it is invading the vessels.
Patient has no signs of Cushing’s. Rec low dose dex and urine metanephrine fractionation test. Recheck in 6 weeks.
What do you think of these adrenals?
Thank you!
Julie
Comments
Bilateral hyperplasia likely
Bilateral hyperplasia likely or maybe adenomas if non clinical. Capsular expansion without escape, no inflammation, nor invasion. This is where the medicine steps in to see if clinical…. USG< 1025? UCCR elevated? BP elevated?, ADR clinical signs? Central CNS signs like expansive pituitary tumor? Look Cushingoid? Adrenal panel at U Tennessee?
I see this a lot in non clinical dogs so sometimes its best to just monitor and recheck in 4-6 weeks clinical parameters and sonogram to get differential evaluations/measurements.
Bilat hyperplasia would be
Bilat hyperplasia would be awesome! High BP (on meds), rec UCCR and u/a too.
Will update w recheck.
Thank you!
Julie
add-on: BTW, I use your techniques from the online CE for the adrenals. It really helps. #noadrenalleftbehind