Conn’s Syndrome/Right Adrenal Gland Mass In An 11-Year-Old FS DSH : Our Case Of the Month June 2020
Conn's syndrome in cats is not a pathology we see every day, but an SDEP-trained sonographer is always prepared, having been drilled in the 17-point abdominal protocol including every adrenal every time, for both dogs and cats. Melding the clinical signs, labwork, and thorough ultrasound imaging allowed for a prompt diagnosis and internist referral visit within 24 hours.
Dr. Cathy Jarrett, SDEP® Certified clinical sonographer and owner of Potomac Mobile Veterinary Ultrasound (Ashburn, VA) imaged this patient, and Dr. Gouri Krishna, DVM from Silver Spring Animal Hospital managed the case. Thank you to Amy Roth Jones, DVM, DACVR for her detailed interpretation of these diagnostic images.
An 11-year-old FS DSH cat was presented for poor appetite, hyperthyroidism, and previous episode of hypertension. The patient perked up a bit after receiving SQ fluids, Cerenia, and mirtazapine. CBC was WNL, blood chemistry found phosphorous 2.7, Na 156, K 2.6, bicarb 27, CK 441, Total T-4 7.3, USG 1.021.
The right adrenal gland presents as an enlarged somewhat bilobed homogeneously hypoattenuating soft tissue mass measuring 3.7 cm by 2.3 cm. The mass appears well encapsulated with a mildly hyperechoic surrounding retroperitoneal fat. The mass is vascular; however, no definitive vascular invasion of the cauda vena cava is seen. The mass does deviate the cauda vena cava dorsal medial. Pancreas: The right limb of the pancreas near the pylorus is slightly hypoechoic and effaces the right adrenal mass.