Case Study

Bilateral adrenal tumors and bilateral renal vein thrombosis with vena caval invasion in a 10 year old MN Cocker Spaniel

This 10 year old MN Cocker Spaniel dog presented with acute onset PU/PD. Recent anorexia, cranial abomen full on palpation and loss of detail near kidneyon rads. Glucose low.

DX

Bilateral adrenal tumors. Bilateral renal vein thrombosis with vena caval invasion.

Image Interpretation

Left kidney presented renal vein thrombus, swollen, irregular contour. Left kidney measured 6.9 cm. Right kidney also presented thrombus deriving from the right renal vein.

Left adrenal was significantly enlarged 3.7 x 1.66 cm cranial; 1.26 cm caudal with pericapsular inflammatory pattern noted. Right adrenal was also enlarged, mineralizing 4.83 x 2.37 cm.

Vena cava was severely invaded by thrombosis.

Outcome

Full coagulation panel is warranted. Suspect bilateral pheochromocytoma or similar neoplasia. Ultrasound guided FNA of the adrenals could be considered for further definition. Blood pressure measurements are also warranted; however, prognosis is extremely guarded to poor. CT evaluation would be ideal. Antithrombotic therapy would be warranted as well.