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Decreased appetite, concern for abdominal mass on rads. Lethargy, severe hypokalemia. Hx of diabetes mellitus, hypothyroidism, asthma. Meds inclde methimazole 2.5 mg transdermal BID, glargine 0.5 units QD.
Abnormal labwork: K+ 2.3, SDMA 19 (high), TT4 6.9, glucose 181, platelets decreased but clumping noted. urine glucose neg, ketones neg.
Conn’s Syndrome; adenocarcinoma vs pheochromocytoma (extremely rare in cats)
A mass was noted in the region of the right adrenal gland. The mass appears to be mineralized, impinging upon the vena cava without overt invasion. Regional inflammation was noted around the mass. The mass impinges upon and deviates the right kidney and impinges upon the right liver.
Right adrenal mass, mineralized
Urinary bladder sediment (should be medically manageable)
Age-related renal changes
Given the hypokalemia, Conn’s syndrome is strongly suspected. Serial blood pressures are warranted. CT evaluation for surgical planning would be ideal, given the impingement upon the vena cava and the size of the mass. Suspect adenocarcinoma or possibility of pheochromocytoma (extremely rare in cats). If hypertension is an issue, then urine metanephrine level is indicated.
