A 7-year-old NM Rat Terrier with a history of pancreatitis and DKA was presented for evaluation of anorexia and vomiting. Blood glucose was severely elevated (475).
Case Study
05_00258 Mr. Grumbles M Pancreatic necrosis, pancreatitis
Sonographic Differential Diagnosis
Pancreatic necrosis and pancreatitis presentation. Fine needle aspirates are strongly recommended to rule out abscessation, confirm necrosis and to rule out underlying carcinoma which can present similarly. Treatment for pancreatitis is recommended given the diabetic status in this patient. As pancreatitis resolves medically, the need for insulin may diminish; therefore the hypoglycemia episodes should be monitored carefully.
Image Interpretation
Pancreas in this patient was significantly enlarged, nodular, and irregular with pericapsular inflammatory pattern consistent with pancreatic necrosis and concurrent pancreatitis; potential for neoplasia. Fine needle aspirates are strongly recommended. This involves primarily the right limb and the base of the pancreas and a region of 6.6 x 2.5 cm.
Hyperechoic ill-defined mesentery noted through the cranial abdomen primarily around the right pancreatic base and duodenum.
DX
Pancreatic necrosis, pancreatitis
Outcome
None
Clinical Differential Diagnosis
Uncontrolled diabetes mellitus
Pancreas – pancreatitis, neoplasia, abscessation
Sampling
None
Video
Patient Information
Gender :
Male, Neutered
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Clinical Signs
- Anorexia
- Vomiting
Images
Blood Chemistry
- Glucose, High
Clinical Signs
- Anorexia
- Vomiting