- 12 yr old FS Yorkshire terrier presented to the E-clinic 3 days ago for several weeks of PU/PD and lethargic for a few days.
- E-clinic diagnosed the dog with pancreatitis and DKA. The dog’s electrolyte values and glucose values stabilized over the weekend at the E-clinic but her depression and anorexia have persisted.
- 12 yr old FS Yorkshire terrier presented to the E-clinic 3 days ago for several weeks of PU/PD and lethargic for a few days.
- E-clinic diagnosed the dog with pancreatitis and DKA. The dog’s electrolyte values and glucose values stabilized over the weekend at the E-clinic but her depression and anorexia have persisted.
- Abdomminal ultrasound today shows severe pancreatitis: echogenic fat surrounding the stomach, visceral liver, dorsal to the duodenum, and pancreatic body and right pancreas. The pancreas itself appears as an enlarged, poorly defined hypoechoic mass surrounded by clumping echogenic fat.
- What concerns me is the hypoechoic mass seen in the caudal right abdomen. At first I thought it was more diseased and mineralized pancreatic tissue, however, it is in close association with some abnormal looking small bowel (not duodenum). The adjacent small bowel has a strongly shadowing, linear echogenic lumenal content, but there is no obstructive pattern. The whole descending duodenum is empty and very normal in appearance.
- I suspect that this mass is connected to the GI but am not sure it this is neoplasia or pancreatitis gone wild. I aspirated the mass and cytology is pending, but am recommending plasma transfusion and exploratory surgery if the dog is stable enough.
- What are your thoughts on this caudal right abdominal mass? GI origin? Pancreatic origin? Peritonitis? FB?
Comments
Well there is very unhealthy
Well there is very unhealthy bowel there and may have a perforation like a toothpick or something. it would be the right spot. regardless there is a lot of necrotic and possibly neopplastic tissue there to investigate. i would explore ensure there isnt a perf and debride the badness with a shopping spree of Bx. Not a typical pancreatitis here.
Thanks Eric. The owner has
Thanks Eric. The owner has declined surgery for now and the dog is slightly improved on heavy pain meds. I am going to do a follow up ultrasound today to see if the inflammation is resolving or just smoldering away. I will keep you posted.
Exploratory done today
Exploratory done today revealed a mass in the distal jejunum which had perforated. Multiple adhesions were present.
Makes sense thank you for the
Makes sense thank you for the follow-up. Great thread for everyone! This is what we designed the forum for. Love to see it manifesting as such!