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Pancreatic inflammation and pseudocysts in a 15 year old MN DSH cat

Case Study

Pancreatic inflammation and pseudocysts in a 15 year old MN DSH cat

A 15-year-old neutered male DSH cat presented for chronic renal disease. The presenting bloodwork revealed a moderately elevated BUN, moderately elevated creatinine, amylase, and CPK, with a concurrent mild nonregenerative anemia. These biochemical changes were persistent over a 6 month period.

A 15-year-old neutered male DSH cat presented for chronic renal disease. The presenting bloodwork revealed a moderately elevated BUN, moderately elevated creatinine, amylase, and CPK, with a concurrent mild nonregenerative anemia. These biochemical changes were persistent over a 6 month period.

Sonographic Differential Diagnosis

Pancreatic pseudocyst formation and potential necrosis and inflammation or nodular hyperplasia. There is the potential for cystic pancreatic carcinoma.

Image Interpretation

A mixed cystic hypoechoic and complex pancreas mass was noted occupying the left pancreatic body.

DX

Pancreatic cysts and chronic active pancreatitis with concurrent chronic renal failure.

Outcome

The renal presentation was consistent with end stage chronic renal disease. The patient continued to respond multiple times to IV therapy until fulminant renal failure ensued 6 months after the sonogram.

Comments

No video available on this patient.

Clinical Differential Diagnosis

Chronic renal failure, interstitial nephritis, protein losing nephropathy, pancreatitis.

Sampling

A 20-gauge ultrasound-guided intravenous catheter was used to drain the cystic portion of the lesion. Cytology revealed a modified transudate with low grade inflammation. 22-gauge ultrasound-guided FNA of the parenchymal portion of the lesion revealed mixed pancreatic inflammation.

Patient Information

Patient Name : Rusty O
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 05_00030

History

  • Colitis

Images

Rusty_1_11252009044949

Blood Chemistry

  • Amylase, High
  • BUN high
  • CPK, High
  • Creatinine, High

CBC

  • RBC, Low