Case Study

06_00061 Maxie N Renal amyloidosis and adrenal adenoma BK NVC

A 9 year old FS Labrador retriever dog was presented for anorexia. Previous laboratory work had shown an inappropriate urine SG, 3+ proteinuria, microalbuminuria, azotemia, thrombocytosis, and negative 4Dx. The only significant abnormality on physical examination was dehydration. On baseline measurement, there was an elevated androstenedione and an elevated estradiol and on ACTH stimulation there was elevated cortisol, elevated estradiol, and elevated progesterone.

A 9 year old FS Labrador retriever dog was presented for anorexia. Previous laboratory work had shown an inappropriate urine SG, 3+ proteinuria, microalbuminuria, azotemia, thrombocytosis, and negative 4Dx. The only significant abnormality on physical examination was dehydration. On baseline measurement, there was an elevated androstenedione and an elevated estradiol and on ACTH stimulation there was elevated cortisol, elevated estradiol, and elevated progesterone.

DX

Functional adrenocortical adenoma and renal amyloidosis and tubular atrophy

Sonographic Differential Diagnosis

Left adrenal mass, resectable – adenocarcinoma, pheochromocytoma, adenoma and hyperplasia possible. Kidney – interstitial nephrosis, amyloidosis, degenerative cortical disease.

Image Interpretation

Left adrenal mass is heterogenous with loss of internal architecture. No overt vascular invasion is noted imaging from both right and left sides. The kidneys revealed diffuse uniform hyperechoic cortical changes with minor loss of corticomedullary detail.

Outcome

The left adrenal mass was removed and a wedge biopsy of the left kidney taken, which showed an adrenocortical adenoma and renal amyloidosis. No further medication was recommended for the adrenal gland.