A 14-year-old MN Yorkshire Terrier dog was presented for a routine dental prophylaxis. On preoperative blood work, elevated ALP activity was identified. Physical examination was unremarkable and urinalysis was within normal limits. Abnormalities on CBC and blood chemistry were monocytosis, elevated albumin and ALP activity, hypernatremia, and mild hypoglobulinemia. On survey abdominal radiographs hepatomegaly was evident.
A 14-year-old MN Yorkshire Terrier dog was presented for a routine dental prophylaxis. On preoperative blood work, elevated ALP activity was identified. Physical examination was unremarkable and urinalysis was within normal limits. Abnormalities on CBC and blood chemistry were monocytosis, elevated albumin and ALP activity, hypernatremia, and mild hypoglobulinemia. On survey abdominal radiographs hepatomegaly was evident.
Case Study
07-00056 Bandit F Adrenal mass—NEEDS HISTO—JEN #3
Sonographic Differential Diagnosis
Left adrenal gland mass. No visible metastatic disease. This appears resectable.
Image Interpretation
The left adrenal gland presented a 3.16 x 2.3 cm mass with no visible caval invasion. The mass had mixed hyperechoic changes. This may represent myelolipoma, adenoma, or potential non-cortisone producing functional adenocarcinoma or pheochromocytoma. Fine-needle aspiration could be performed. However, adrenalectomy would be warranted. No visible metastatic disease was noted. The right adrenal gland was normal in size and contour.
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Outcome
Blood pressure measurements were within normal limits. Thoracic radiographs showed no abnormalities. The patient was sent to referral facility, underwent left adrenalectomy surgery, and was discharged on Clavamox and meloxicam. The patient was presented at referral facility 8 days post-op for not eating. Recheck blood work was all within normal limits. The patient was treated with I.V. fluids and after eating was discharged with mirtazapine. Physical examination two days later found the patient BAR, and improving, with a nicely healed incision. The patient was further recommended for consultation with an oncologist.
Clinical Differential Diagnosis
Dehydration, Cushing’s disease – pituitary dependent, adrenal neoplasia. Liver disease – neoplasia, nodular regeneration, vacuolar hepatopathy. Gall bladder disease – infection, partial obstruction, mucocele
Sampling
Full-thickness surgical biopsy of the left adrenal gland
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