Case Of the Month

Feline Pancreatitis

Feline Pancreatitis (“Il Grande Mistero”), the sonogram, & the needle. Cutting to the chase in feline pancreatic pathology.

Case managed by Dr. Erno Hollo, Dr. Keith Ross & staff at Basking Ridge Animal Hospital, Basking Ridge, NJ, USA. Sonogram and diagnostic evaluation performed by Eric Lindquist DMV (Italy), DABVP (Canine & Feline Practice), NJ Mobile Associates & SonoPath.com.?

Sonogram: Nala

Feline Pancreatitis (“Il Grande Mistero”), the sonogram, & the needle. Cutting to the chase in feline pancreatic pathology.

Sonogram: Nala

History: (Colleen Puelsch BS, Kelly Vasquez RVT)): An 10-year-old FS Burmese cat was presented for anorexia, vomiting, and soft stool. The physical exam revealed mild dehydration, tacky mucous membranes, fever of 104 degrees F, and mild cranial abdominal pain upon palpation. CBC and blood chemistry analysis revealed only mild elevation in triglycerides. fPLI and urinalysis were not performed.

Outcome

The patient was stable as an outpatient after 1 month of zithromax and hypoallergenic diet.

Comments

At the time of this on line presentation, the author is unaware of any studies evaluating cytology or U/S guided biopsies of the pancreas and they are not done routinely. However, the author has performed the procedure multiple times without any complications. It is imperative when performing FNA or biopsies that multiple regions of the organ be aspirated/biopsied due to the risk of missing a very localized lesion, which is very common with the pancreas. There are a number of ultrasonographers, including the author, who have performed the procedure multiple times without any complications (personal communications).

Clinical Differential Diagnosis

(Remo Lobetti PhD, DECVIM):
GI tract – IBD/neoplasia/foreign body
Pancreas – pancreatitis/neoplasia/cyst/abscess
Liver – cholangio-hepatitis/hepatitis/neoplasia
Peritonitis

Sampling

(Lindquist DMV, DABVP): US-guided fine needle aspiration of multiple areas of the pancreas revealed well differentiated pancreatic cells with increased neutrophils admix with blood consistent with suppurative inflammation. US-guided fine needle aspiration of the spleen also revealed suppurative inflammation.

Sonographic Differential Diagnosis

(Lindquist DMV, DABVP): Pancreatic necrosis/pancreatitis with possibility of pancreatic carcinoma, lymphoma, or nodular hyperplasia.

Image Interpretation

(Lindquist DMV, DABVP)