Case Study

Pancreatic abscess in a 7 year old MN Cairn Terrier

The patient is a 7 year old neutered male canine Cairn Terrier Mix. The dog had a history of seizures, lethargy, and decreased appetite. There had been no vomiting or diarrhea. Bloodwork revealed an ALKP of 298, potassium of 3.5, amylase of 3167, lipase of 2314, and a white blood cell count of 30000 with toxic neutrophils and band cells.

DX

Pancreatic abscess

Sonographic Differential Diagnosis

Pancreatic abscess, acute on chronic pancreatitis, and likely regional peritonitis.

Image Interpretation

The pancrease shows contains a mixed hypoechoic marginated abscess with extensive hyperechoic ill-defined omental inflammation noted.

Outcome

A recheck ultrasound was performed one week later.
The right pancreatic limb revealed hypoechoic tissue that was thickened and relatively regular. The inflammation has significantly decreased, and the lesion itself is much more organized. The abscess in the right pancreatic limb now measured 2 x 1.5 cm, which may be necrosis or residual abscessation. A separate hypoechoic nodule was noted in the right pancreatic limb and measured 0.63 cm. This was void of bloodflow on Power Doppler. Persistent pancreatic necrosis is likely, but there is significant resolution of approximately 50-60% of the pancreatic presentation from the prior sonogram.