This 15-year-old neutered male DSH cat presented for vague not-doing-right clinical signs. Dysuria, anorexia, and lethargy were described. The physical exam revealed a moderately painful mid-cranial abdomen and mild pyrexia. The first CBC was normal except for mild increased bands. The initial blood chemistry analysis revealed only slight azotemia which normalized during hospitalization. Repeat analysis, after 5 days of hospitalization and supportive intravenous care, revealed a mild leukocytosis with moderately increased bands and slight anemia with anisocytosis.
This 15-year-old neutered male DSH cat presented for vague not-doing-right clinical signs. Dysuria, anorexia, and lethargy were described. The physical exam revealed a moderately painful mid-cranial abdomen and mild pyrexia. The first CBC was normal except for mild increased bands. The initial blood chemistry analysis revealed only slight azotemia which normalized during hospitalization. Repeat analysis, after 5 days of hospitalization and supportive intravenous care, revealed a mild leukocytosis with moderately increased bands and slight anemia with anisocytosis. Moderately increased fPLI was also present.
Case Study
Chronic active pancreatitis diagnosed by ultrasound-guided FNA in a 15 year old MN DSH cat
DX
Sonographic Differential Diagnosis
Chronic active pancreatitis with remodeling and likely sectoral avascular necrosis. Carcinoma is possible.
Image Interpretation
A mixed hypoechoic and variably echogenic mass of tissue is present in the pancreatic region. Minimal color flow signals were present (not shown).
Outcome
The patient responded initially to IV fluid support, antibiotics, and pain management over a 9 day period. Surgical removal of the pancreatic sequestrum and biopsy was recommended but declined by the owner. The patient was humanely euthanized due to poor response to therapy and progressive deterioration. We cannot eliminate the possibility of an underlying infectious agent such as Toxoplasmosis and/or Bartonella playing a role in this case. In addition, even though the cytology and PLI were suggestive for a chronic pancreatitis, underlying neoplasia such as pancreatic carcinoma remains a concern.
Comments
No video available on this patient.
Clinical Differential Diagnosis
Pancreatitis, infectious disease, abscess, neoplasia, IBD.
Sampling
22-gauge US-guided FNA of the lesion revealed chronic active pancreatitis.
Patient Information
Clinical Signs
- "Not Doing Right"
- Anorexia
- Dysuria
- Lethargy
Exam Finding
- Abdominal Pain
- Fever
Images
Blood Chemistry
- BUN high
- Creatinine, High
CBC
- Anisocytosis
- Bands
- WBC, High
Clinical Signs
- "Not Doing Right"
- Anorexia
- Dysuria
- Lethargy
Special Testing
- fPLI Positive