- 12 yr old FS yorkie-poo with anorexia for 3 weeks, intermittant vomiting of food x 2 weeks
- 2 weeks ago chem profile was wnl,CBC showed a neutrophilia, U/A showedproteinuria PLN, 8-18-21 labs rerun chem pancreatic lipase WNL
- Abdominal US shows a 5.0cm hypoechoic mass in the left abdomen impining upon the cranial pole of the left kidney, clumping echogenic fat adjacent to the mass, stomach, and liver, nodular hepatic parenchyma, bilateral loss of renal corticomedullary defintion.
- Differential diagnoses for the mass include pancreatic carcinoma, severe pancreatitis, pancreatic abscess, other neoplasia, metastatic lymph node, and less likely adrenal mass (wrong side of renal artery).
- US guided FNA of the mass showed chronic neutrophilic inflammation and mineralization. The pathologist suggests core biopsies next but since this is likely pancreatic (and less likely adrenal) in origin, I am wondering if exploratory laparotomy would be a better choice.
Comments
Is there a normal spleen? The
Is there a normal spleen? The posiiton and relationship to the kidney would suggest spleen or caudal left panc as i think im seeing the left adrenal in your clips. Lots of inflammation and free fluid. I would likely explore as the fna would be consistent with pancreatic necrosis and dogs can live with necrotic panc limbs for a while especially left limb and yorkies but needs to be removed or have a debridement. If no other organs are involved then may be surgical.
Thank you for your input.
Thank you for your input. Spleen appears ok…normal shape, parenchyma, and echogenicity but has adjacent echogenic fat. Tried to upload it to above, but was not allowed. I also believe I am seeing the normal left adrenal gland dorsal to the mass and caudal to the cranial mesenteric and celiac arteries.