A six-year-old FS Pug was presented with a history of vomiting. On physical exam, a tense and painful abdomen was present. Thickening of the small intestines was evident on radiographs. Isosthenuria, glucosuria, and trace ketonuria was present on urinalysis. Abnormalities on CBC and serum biochemistry were elevated MCHC, lymphopenia, eosinophilia, elevated AST activity, elevated cholesterol, elevated Spec cPL and elevated triglycerides, hyperglycemia, and hyponatremia.
A six-year-old FS Pug was presented with a history of vomiting. On physical exam, a tense and painful abdomen was present. Thickening of the small intestines was evident on radiographs. Isosthenuria, glucosuria, and trace ketonuria was present on urinalysis. Abnormalities on CBC and serum biochemistry were elevated MCHC, lymphopenia, eosinophilia, elevated AST activity, elevated cholesterol, elevated Spec cPL and elevated triglycerides, hyperglycemia, and hyponatremia.
Case Study
Pancreatitis in a 6 year old FS Pug dog
DX
Sonographic Differential Diagnosis
There is a minor chance of underlying carcinoma is present. However, this is most consistent with acute necrotizing pancreatitis. The prognosis is very guarded. Repeat sonogram would be recommended in the next week after aggressive treatment with plasma expanders, potentially plasma transfusion, aggressive antibiotics and fluid therapy is warranted over the next 5 days. Guarded long term prognosis.
Image Interpretation
Extensive pancreatitis was noted with sequestered portions of hypoechoic parenchyma in the right pancreatic base and tail end of the right pancreatic limb. Associated duodenal spasm was also noted.
Outcome
Coco was hospitalized and treated with IV fluids, cefazolin, famotidine, butorphanol, and insulin. No vomiting was noted after starting the food trial. Coco was released from the hospital a few days after the ultrasound. A recheck ultrasound was performed 10 days after the initial ultrasound and it was noted that there was much improvement and the pancreatitis was resolving.
Comments
No video is available on this patient.
Clinical Differential Diagnosis
Pancreas – acute pancreatitis, abscess, neoplasia, Diabetes mellitus.
Sampling
None.
Patient Information
Clinical Signs
- Vomiting
Exam Finding
- Abdominal Pain
- Tense Abdomen
Images
Blood Chemistry
- AST (SGOT), High
- Cholesterol, High
- Glucose, High
- Hypertriglyceridemia
- Sodium, Low
CBC
- Eosinophils, High
- MCHC, High
- WBC, Low
Clinical Signs
- Vomiting
Special Testing
- cPLI Positive
Urinalysi
- Glucose Present
- Isosthenuria Present
- Ketones Present