Case Study

Pancreatic abscess, possible necrosis in a 12 year old M Golden Retriever

A 12-year-old intact male Golden Retriever was presented for evaluation of a 2 week duration of hyporexic and reduced activity. Abnormalities on physical examination were a mid-abdominal mass, thoraco-lumbar spinal pain, and CP deficits of the left hind

DX

Pancreatic abscess, possible necrosis

Image Interpretation

The left pancreatic limb revealed a large, hypoechoic to echogenic cyst filled structure with regional inflammation. This is strongly suggestive for pancreatic abscess or possible necrosis. The echogenicity would suggest abscess. Ultrasound-guided drainage is recommended. If abscess is confirmed then Enrofloxacin injection is recommended. This appears to be occupying the left pancreatic base. Therefore, direct pancreatic resection could also be considered. Regional inflammation/peritonitis was noted.

The spleen was folded upon itself caudally. The spleen revealed a slight, enlargement of the mid splenic body.

Outcome

There is a minor potential for neoplasia. Surgical exploratory with expectations towards abscess removal and partial pancreatectomy is recommended. Power Doppler assessment of the abscess could also be considered to assess how much parenchyma is present versus fluid accumulation.
Slight enlargement at the mid splenic body. This is likely a benign lesion. However, this should be removed at the time of surgery or at least inspected. Ultrasound-guided FNA of the splenic lesion and drainage of the suspected pancreatic abscess is another option. Guarded prognosis.

Clinical Differential Diagnosis

Mass – cyst/abscess/granuloma/neoplasia of liver, spleen, kidney, pancreas, mesentery, lymph node
Splenic torsion
Hydronephrosis
Spine – arthrosis, disc prolapse, neoplasia