Case Study

05_00134 Blackjack B Pancreatic inflammation, chronic

An 11-year-old NM Labrador Retriever was presented for evaluation of urinary incontinence. On urinalysis, SG was inappropriate (1.026) and leukocytes were evident. Abnormalities on serum biochemistry were elevated ALP and ALT activity, cholesterol, and lipase. Lyme serology was positive.

Sonographic Differential Diagnosis

Chronic pancreatic inflammatory presentation with remodeling. The pancreatic presentation is likely disrupting glucose metabolism.
FNA of the right pancreatic limb is strongly recommended. 72 hour IV fluid protocol, aggressive antibiotics and diet change to a hypoallergenic, diabetic friendly diet is advised.

Image Interpretation

The pancreas presented heterogenous mixed hypoechoic and hyperechoic changes. This is consistent with remodeling. Dilated pancreatic duct was noted at 0.22 cm. Chronic, active inflammation is likely. Areas that were void of blood flow were noted. This is indicative of nodular hyperplasia, potential necrosis. The more prominent portion of the pancreas was the right pancreatic limb approximately 4.0 cm distal from the duodenal papilla with mixed hyperechoic and hypoechoic changes. This is consistent with chronic active or sectorial pancreatitis.