Case Study

Calculus in left pancreatic duct and pancreatitis in a 13 year old Siamese cat

A 13-year-old Siamese presented for hematuria. The physical exam revealed mild dehydration, poor body condition score, and mildly painful kidney palpation. CBC was normal. Blood chemistry revealed mild elevations in BUN, creatinine, and variable mild elevations in amylase and lipase on serial samples. The urine specific gravity was 1.025 with 3+ proteinuria and severe hematuria.

A 13-year-old Siamese presented for hematuria. The physical exam revealed mild dehydration, poor body condition score, and mildly painful kidney palpation. CBC was normal. Blood chemistry revealed mild elevations in BUN, creatinine, and variable mild elevations in amylase and lipase on serial samples. The urine specific gravity was 1.025 with 3+ proteinuria and severe hematuria.

DX

Calculus in left pancreatic duct, pancreatitis

Sonographic Differential Diagnosis

Due to the pain noted on palpation and pain upon imaging this region, chronic active pancreatitis is likely. Pancreatic duct lithiasis. Minor potential for neoplasia.

Image Interpretation

A largely hypoechoic mildly heterogenous swollen left pancreatic limb is noted. A calculus is present in the left pancreatic duct.

Outcome

The patient was focally painful upon imaging the region of the pancreas in which the calculus was noted. The patient improved after 5 days of intravenous fluid therapy with antibiotics and pain management but presented similar manageable signs 6 months post sonogram. Blood parameters returned to normal post therapy. The calculus was never surgically addressed, and the patient remained stable over the next 18 months until he was humanely euthanized due to worsening chronic renal failure.