An 8-year-old FS Terrier Mix dog presented with symptoms of progressive vomiting and anorexia after having eaten bird seed 3 weeks prior. The clinical exam was uneventful except for mild scleral jaundice. The CBC and blood chemistry revealed severely elevated SAP elevated, elevated ALT, with mildly elevated AST, mildly elevated bilirubin, and mildly elevated cholesterol elevations.
An 8-year-old FS Terrier Mix dog presented with symptoms of progressive vomiting and anorexia after having eaten bird seed 3 weeks prior. The clinical exam was uneventful except for mild scleral jaundice. The CBC and blood chemistry revealed severely elevated SAP elevated, elevated ALT, with mildly elevated AST, mildly elevated bilirubin, and mildly elevated cholesterol elevations.
Case Of the Month
Pancreatitis and Lymphadenopathy
DX
Outcome
The patient was euthanized 2 weeks later due to persistence of signs despite medical treatment.
Clinical Differential Diagnosis
Pancreatitis, cholangiohepatitis, toxicity, biliary obstruction, GB mucocele, gastroenteritis, IBD.
Sampling
16-gauge US-guided biopsy of the right pancreatic base (see image) as well as the hypoechoic structure revealed in image 2 ( ln met) revealed pancreatic adenocarcinoma with nodal metastasis.
Sonographic Differential Diagnosis
Mixed echogenic nodular mass suggestive for pancreatic carcinoma, or severe pancreatic necrosis/pancreatitis. Aggressive regional lymphadenopathy would suggest a metastatic process.
Image Interpretation
A mixed hypo and hyperechoic mass is noted in the region of the pancreas. US-guided core biopsy is visible in both images at 2`oclock position (linear hyperechoic focus) in image 1 and in mid image in the hypoechoic lymph node in image 2.
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