-13 year old FS Shih Tzu
– presented for some mild vomiting
– bloodwork showed marked elevation on ALP and mild elevation ALT, cPLI normal
– slight pot belly
– owner does not think pet is pu/pd
– enlarged left adrenal gland with a mass in the cranial pole
– right adrenal gland normal
– small non-obstructive renolith in left kidney, liver normal
– LDDS recommended and urinalysis to rule out Cushings
Could this be adrenal dependent hyperadrenocortism?
-13 year old FS Shih Tzu
– presented for some mild vomiting
– bloodwork showed marked elevation on ALP and mild elevation ALT, cPLI normal
– slight pot belly
– owner does not think pet is pu/pd
– enlarged left adrenal gland with a mass in the cranial pole
– right adrenal gland normal
– small non-obstructive renolith in left kidney, liver normal
– LDDS recommended and urinalysis to rule out Cushings
Could this be adrenal dependent hyperadrenocortism?
Do you have any suggestions on how to properly evaluate the surrounding vasculature for invasion? My colour Doppler was horrible on this patient for some reason but she was really breathing heavy – is it better to sedate these guys for this?
Comments
As the right adrenal gland is
As the right adrenal gland is normal, a non-functional adrenal nodule is most likely but the only way to rule in/out hyperadrenocortism would be either with the ACTH stimulation test or LDSS test as non-functional incidental nodules may be found on the adrenal glands.
As the right adrenal gland is
As the right adrenal gland is normal, a non-functional adrenal nodule is most likely but the only way to rule in/out hyperadrenocortism would be either with the ACTH stimulation test or LDSS test as non-functional incidental nodules may be found on the adrenal glands.
Hi Jacquie spreading out the
Hi Jacquie spreading out the scanning hand pressure and getting as close to the cvc as possible where the phrenic vein enters the cvc is where you want to look for invasion. For the right i go right intercostal and follow the cvc to look for invasion. For the left adrenal i actually approach from the right to see invasion just a short slide caudally from the position for the right adrenal. See attached image of the left adrenal in the far field from the cvc and the invasion into the cvc. This is one of the images from the Atlas dvd (400). I Never have to sedate for these panting patients as long as I work with them gradually and have a hand on the video clip button an push it any time they push back when I have the image….so its captured and i can scroll back to the view I want and then zoom postprocessing if need be.
Hi Jacquie spreading out the
Hi Jacquie spreading out the scanning hand pressure and getting as close to the cvc as possible where the phrenic vein enters the cvc is where you want to look for invasion. For the right i go right intercostal and follow the cvc to look for invasion. For the left adrenal i actually approach from the right to see invasion just a short slide caudally from the position for the right adrenal. See attached image of the left adrenal in the far field from the cvc and the invasion into the cvc. This is one of the images from the Atlas dvd (400). I Never have to sedate for these panting patients as long as I work with them gradually and have a hand on the video clip button an push it any time they push back when I have the image….so its captured and i can scroll back to the view I want and then zoom postprocessing if need be.
My 2 cents on this one…..
My 2 cents on this one….. TRANSVERSE VIEW helps a lot too on top of what EL has mentioned. The invasions I have seen to CVC usually are more obvious by also doing the transverse view.
Good luck!
Veronica
My 2 cents on this one…..
My 2 cents on this one….. TRANSVERSE VIEW helps a lot too on top of what EL has mentioned. The invasions I have seen to CVC usually are more obvious by also doing the transverse view.
Good luck!
Veronica