Case Study

Suspect pancreatic carcinoma in a 13 year old FS pit bull mix

A 13-year-old FS pit bull mixed breed dog presented to an emergency referral facility for vomiting of three weeks duration, anorexia and lethargy. She had been treated by the referring clinician for chronic, active hepatitis with Reglan, Pepcid, Amoxicillin, and Ursodiol. Serum chemistry provided by the referring clinician showed elevated ALP and elevated ALT activity and hyperbilirubinemia. Snap CPL Elisa was normal. The pet was treated with IV fluids, Cerenia, Pepcid, Ampicillin, and Baytril at the emergency facility. Liver values, however, continued to rise despite the treatment.

Sonographic Differential Diagnosis

Pancreatic mass, which may be a pancreatic sequestrum or a carcinoma, with secondary common bile duct obstruction.

Image Interpretation

The right pancreatic limb presented a significant amount of hypoechoic parenchyma with a 2.6 cm mineralizing mass type presentation. This is consistent with post hepatic obstruction. The liver revealed a chronic hepatitis pattern, with possible cirrhosis. Mesenteric root lymphadenopathy is also evident.

DX

Suspect pancreatic carcinoma

Outcome

The patient was hospitalized for a further two more days where the liver values continued to rise. The client subsequently elected for euthanasia.

Clinical Differential Diagnosis

Liver disease (neoplasia, infectious (bacterial, viral), nodular hyperplasia, cirrhosis, copper toxicosis), pancreatic pathology (pancreatitis, neoplasia).