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A 13-year-old SF DSH cat was presented for evaluation of hypokalemia, anorexia, hindquarter ataxia, and a single seizure. Leukocytosis, neutrophilia, and elevated amylase were also present on bloodwork.
A 13-year-old SF DSH cat was presented for evaluation of hypokalemia, anorexia, hindquarter ataxia, and a single seizure. Leukocytosis, neutrophilia, and elevated amylase were also present on bloodwork.
Left adrenal gland mass with concurrent hepatic nodules/mass. Suspect metastatic disease. The left adrenal gland is strongly consistent with carcinoma.
The left adrenal gland, which measured 1.62 x 1.5 cm, was enlarged and irregular with mixed, hyperechoic changes. This appeared to be a mass. Focal mineralization was noted. No vascular invasion was noted. Carcinoma is strongly suspected; however, pheochromocytoma and hyperplasia are also differentials. The liver was diffusely hyperechoic to the falciform fat with a hypoechoic nodule that measured 0.94 cm and was located adjacent to the falciform. A heterogeneous nodule was noted in the deep left liver. That measured 2.14 x 1.73 cm. The coalescing nodules in the deep left liver created a 2.5-3.0 cm mass. However, separate, hypoechoic nodules were noted.
None
Guarded prognosis. Given the hypokalemia, Conn’s syndrome (primary hyperaldosteronism) is likely. Serial blood pressure measurements are recommended since high aldosterone levels cause hypertension.
Hypokalemia – renal disease, anorexia, hyperaldosteronism. Seizure – primary CNS disease (neoplasia, infectious such as toxoplasmosis, bacterial, fungal, vascular), metabolic. Ataxia – spinal cord neoplasia, abscess, granuloma, disc prolapse. Pancreatitis.
Ultrasound-guided FNAs were recommended but not completed. If by chance FNAs reveal benign processes, then left adrenalectomy and liver biopsy would be recommended.
