Case Study

Gastric foreign body and flattened adrenals (due to chronic prednisone therapy) in an 8 year old FS Golden Retriever

An 8-year-old SF Golden retriever dog was presented for evaluation of anorexia, vomiting, distended abdomen, and weight loss. The dog had been on chronic prednisone therapy.

An 8-year-old SF Golden retriever dog was presented for evaluation of anorexia, vomiting, distended abdomen, and weight loss. The dog had been on chronic prednisone therapy.

DX

Flattened adrenals with prednisone therapy

Sonographic Differential Diagnosis

Gastric foreign body. Possible concurrent, underlying gastric mural disease. Flattened adrenal glands. Baseline cortisol would be recommended. If it is greater than 2.0, then gastrotomy and gastric biopsies should be performed.

Image Interpretation

The gastrointestinal tract revealed a 12+ cm progressively shadowing fabric type foreign body in the stomach. The small intestine was empty and structurally uneventful. The gastric wall was mildly thickened. Underlying gastritis may be present. Both adrenal glands were flattened and isoechoic. This is consistent with negative feedback from iatrogenic treatment with prednisone. However, Addison’s disease should be ruled out prior to surgery.

Outcome

The patient was on prednisone, which would explain the appearance of the adrenal glands. Surgery was declined because the patient was on steroids. Oil was given. A few days later the patient vomited rags.

Clinical Differential Diagnosis

Effects of prednisone on the gastrointestinal tract. Non-specific gastro-enteritis (viral/bacterial/helminths/protozoal, dietary indiscretion, toxins), GI ulceration, foreign body, dietary hypersensitivity, IBD, or neoplasia. Pancreatic disease – pancreatitis, neoplasia.