Case Study

05-00097 Deuce K Pancreatitis——-NO IMAGES— (video)–

A 12-year-old FS mixed breed dog was presented for vomiting, intermittent diarrhea, and lethargy. On physical examination mild dehydration and a painful abdomen were present. Abnormalities on CBC and serum chemistry were anemia, leukopenia, thrombocytopenia, elevated ALP and ALT activity, amylase, and lipase. Survey abdominal radiographs revealed loss of detail in the cranial abdomen but no signs of obstruction or FB present. The patient was treated with fluids, famotidine, cerenia, and buprenex.

A 12-year-old FS mixed breed dog was presented for vomiting, intermittent diarrhea, and lethargy. On physical examination mild dehydration and a painful abdomen were present. Abnormalities on CBC and serum chemistry were anemia, leukopenia, thrombocytopenia, elevated ALP and ALT activity, amylase, and lipase. Survey abdominal radiographs revealed loss of detail in the cranial abdomen but no signs of obstruction or FB present. The patient was treated with fluids, famotidine, cerenia, and buprenex.

Sonographic Differential Diagnosis

Marked elevation in liver enzymes could be due to secondary cholangiohepatitis and pancreatitis but can also be due to infectious disease such as leptospirosis and unlikely neoplasia or toxicity. Enlarged hypoechoic pancreas with bright mesentery is consistent with pancreatitis.

Image Interpretation

Both the right limb and body of the pancreas were hypoechoic and enlarged with bright mesentery surrounding them. The left limb of the pancreas was more normal in appearance.

Outcome

The pet remained in the hospital for about 24 hours. The pet was treated with IV fluids, cerenia, buprenex, famotidine, ampicillin sodium, oral metronidazole, ursodiol, and denamarin. It was noted that the pet was no longer vomiting and that repeat blood work showed a decrease in the ALT (714). The pet was discharged from the hospital with famotidine, metronidazole, and clavamox, denamarin, and ursodiol. The owner reported that the pet’s health continued to improve after she was discharged from the hospital.

Clinical Differential Diagnosis

Pancreas – pancreatitis, neoplasia Liver – acute hepatitis (viral/bacterial/toxic), neoplasia GI tract – viral/bacterial infection, neoplasia, obstruction, ulceration Peritonitis