Case Study

Bilateral adrenal gland masses in a 12 year old MN Labradoodle

This 12 year old MN Labradoodle dog presented with unresolved diarrhea, unresponsive to medication or food. Has been on tylan powder, metronidazole, GI diet. Elevated ALKP, feca negative

Image Interpretation

The left adrenal gland comprised a mixed, echogenic mass that measured 3.55 x 3.05 cm. Hyperechoic and hypoechoic changes were noted. The right adrenal gland revealed similar changes to the left adrenal gland and measured 4.63 x 3.35 cm.

The liver presented increased portal markings and isoechoic nodular changes. Excessive gallbladder debris was noted with minor, overt distension. The stomach revealed mild, pyloric hypertrophy without loss of detail. Prominent rugae was noted with echogenic remodeling. There was no evidence of foreign body or obvious neoplasia. The remainder of the intestinal tract was unremarkable.

DX

Bilateral adrenal gland masses. There is a strong potential for myelolipomas. However, adenocarcinoma, pheochromocytoma or adenoma are all possible. They appear resectable and no vascular invasion was noted. Diffuse, nodular liver pattern.

Outcome

Structurally unremarkable gastrointestinal tract. Adrenal function test would be recommended to rule out Addison’s disease, which could explain the unresolved diarrhea. Bile acid profile is recommended. Ultrasound-guided
FNA of the adrenal glands could be considered. Blood pressure measurements would
also be warranted.