Right adrenal gland mass with phrenic vein thrombosis in a 14 year old FS Beagle mix

Case Study

Case Study

Right adrenal gland mass with phrenic vein thrombosis in a 14 year old FS Beagle mix

A 14-year-old spayed female Beagle mix was presented for PU/PD. She had a recent history of anaplasmosis which was treated with doxycycline and amoxicillin. Urinalysis showed isosthenuria, proteinuria, hematuria, and microalbuminuria. Abnormalities on CBC and blood chemistry were leukocytosis, thrombocytosis, neutrophilia, monocytosis, elevated ALT, elevated GGT, elevated ALP, mild hypernatremia, and hypercholesterolemia. Pre and post-prandial bile acids were elevated. The patient had a low T-4 and a low free T-4. ACTH stimulation test was within normal range.

A 14-year-old spayed female Beagle mix was presented for PU/PD. She had a recent history of anaplasmosis which was treated with doxycycline and amoxicillin. Urinalysis showed isosthenuria, proteinuria, hematuria, and microalbuminuria. Abnormalities on CBC and blood chemistry were leukocytosis, thrombocytosis, neutrophilia, monocytosis, elevated ALT, elevated GGT, elevated ALP, mild hypernatremia, and hypercholesterolemia. Pre and post-prandial bile acids were elevated. The patient had a low T-4 and a low free T-4. ACTH stimulation test was within normal range. The patient was re-presented within several days for worsening PU/PD, episodes of vomiting, decreased appetite, and anorexia for the past 24 hours. Urinalysis was similar to the previous findings; urine protein:creatinine ratio was elevated at 3.6. The patient was treated with Clavamox and thyroid medication.

DX

Right adrenal gland mass.

Sonographic Differential Diagnosis

Right adrenal gland mass with possible invasion or thrombosis into the phrenic vein. Differentials would include adenocarcinoma or pheochromocytoma. Prominent left adrenal gland.

Image Interpretation

The right adrenal gland presented a 5 x 3.5 cm mass with mixed echogenic changes. This is consistent with hyperplasia. There is a concurrent blood clot or extension of the right adrenal mass that appears to be invading the phrenic vein. The left adrenal gland was prominent at 2.6 x 1.15 cm.

Outcome

No further outcome.

Clinical Differential Diagnosis

Liver disease, neoplasia, infection, adrenal disease (neoplasia/hyperplasia)

Sampling

None

Video

Patient Information

Patient Name : Molly D
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 07_00080

Clinical Signs

  • Anorexia
  • PU-PD
  • Vomiting

History

  • Amoxicillin (Clavamox) therapy
  • Anaplasmosis
  • Doxycycline therapy

Images

CVCinvasion_07012012020427

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • Cholesterol, High
  • GGT High
  • Hypothyroidism
  • Post-Prandial Bile Acids, High
  • Pre-Prandial Bile Acids, High
  • Sodium, High

CBC

  • Monocytes, High
  • Neutrophils, High
  • Platelet Count, High
  • WBC, High

Clinical Signs

  • Anorexia
  • PU-PD
  • Vomiting

Urinalysi

  • Albumin Present
  • Blood Present
  • Isosthenuria Present
  • Protein Present
  • Urine Protein:Creatinine High
Skip to content