11 yr FS Mixed breed dog – per owner not PUPD, but persistent elevations in ALP and amylase/lipase + proteinuria and borderline hypertension. These adrenals look so irregular – is pituitary dependent hyperadrenocorticism still most likely? ACTH stim pending.
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The capsular expansion on the left is a concern. Ensure you get good cvc views from the right sdep 14 and its relationship with the right adrenal phrenic and cvc and slide caudally to get the left adrenal form the right approach and its relationship wiht the phrenic and cvc. You can have pdh and adh at the same time as well as pheo and pdh and peho and adh… BP elevated? then urine metanephrine testing as well as cushings testing if usg is < 1020 and uccr is elevated. here is an example of the left adrenal tumor that looked similar to yours from the left but imaging form the right showed cvc invasion.
Wow, that is a great video. Thank you for the tips!
Blood pressure was 176 mmHg systolic average – patient is already on telmisartan and benazepril for proteinuria