Chloe is a 12 year old Peke X. Had one episode of V/D last week and Lots of V/D in past 24 hours.
PE was not enlightening & owners declined bloodwork. Did quick abd scan…
I see hyper-echoic uniformly granular “masses” in association w/ each kidney??? Or possibly pancreas??? What I see of the rt/lt pancreatic limbs looks normal so I’m not sure what I’m looking at.
Owner elected symptomatic Tx for now and will call if not improving. I think these need needled but any thought as to what they may be so I can convince the owners to move forward?
Sam
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updated
Images are a little dark on my screen but they look adrenal to me and are likely large myelolipomas which are benign but pheos and carcinomas and adenomas possible. Serial BP and urine catecholamines would be the way to go here to surmise if clinical and of course UCCR and LDDST if cushingoid. Pheos in my experienmce can manifest with GI signs. I have one case of bilateral myelolipomatous adrenals that was actually addisonian so could check that out as well and would explain the V/D.
Thanks,
So does the myeolipoma surround the adrenal, or originate from within the adrenal? I thought about those being adrenals while driving home last night…Odd, my mind always works better when I’m NOT at work :).
Sam
In the one I had it occupied the entire adrenal parnechyma on both sides inside out thing and theoretically destroyed the functional parenchyma hence becoming addisonian. Because a bag of fat essentially. It was a total zebra case for sure. I got the dx on bilateral 25g us guided fna.