Ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis: 20 cases (1994–2001)

H. Mark Saunders Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 VMD, MS, DACVR
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Thomas J. VanWinkle Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 VMD, DACVP
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Kenneth Drobatz Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 DVM, DACVIM, DACVECC
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Susan E. Kimmel Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
present address is Veterinary Internal Medicine and Allergy Specialists, 207 E 84th St, New York, NY 10028.

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Robert J. Washabau Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 VMD, PhD, DACVIM

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Abstract

Objective—To determine ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis.

Design—Retrospective study.

Animals—20 cats.

Procedure—Ultrasound reports and permanent ultrasonographic images were reviewed, and ultrasonographic findings were recorded. Thoracic and abdominal radiographs were also reviewed, when available. Anatomic localization of pancreatic necrosis was determined from the gross pathology report; duration and severity of pancreatic necrosis were determined by reviewing histologic specimens. The presence of concurrent disease was recorded from the final pathology report.

Results—The pancreas was considered ultrasonographically normal in 10 cats and was not observed in 3. Ultrasonographic findings were considered compatible with pancreatitis in the remaining 7 cats. Gross pathologic findings indicated that pancreatitis was multifocal in all 7 of these cats; histologically, pancreatitis was acute or subacute in 5 and associated with severe or moderate necrosis in 6. In the remaining 13 cats, gross pathologic findings indicated that pancreatitis was multifocal (n = 8) or focal (2), or gross pathologic findings were normal (3). Histologically, pancreatitis was peracute or acute in 11 of these 13 cats and associated with severe or moderate necrosis in 8. Thoracic and abdominal radiographic findings were nonspecific.

Conclusions and Clinical Relevance—Results of ultrasonography were consistent with a diagnosis of pancreatitis in only 7 of 20 cats with acute pancreatic necrosis in the present study. This suggests that new diagnostic criteria must be established if abdominal ultrasonography is to be an effective tool in the diagnosis of pancreatitis in cats. (J Am Vet Med Assoc 2002;221:1724–1730)

Abstract

Objective—To determine ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis.

Design—Retrospective study.

Animals—20 cats.

Procedure—Ultrasound reports and permanent ultrasonographic images were reviewed, and ultrasonographic findings were recorded. Thoracic and abdominal radiographs were also reviewed, when available. Anatomic localization of pancreatic necrosis was determined from the gross pathology report; duration and severity of pancreatic necrosis were determined by reviewing histologic specimens. The presence of concurrent disease was recorded from the final pathology report.

Results—The pancreas was considered ultrasonographically normal in 10 cats and was not observed in 3. Ultrasonographic findings were considered compatible with pancreatitis in the remaining 7 cats. Gross pathologic findings indicated that pancreatitis was multifocal in all 7 of these cats; histologically, pancreatitis was acute or subacute in 5 and associated with severe or moderate necrosis in 6. In the remaining 13 cats, gross pathologic findings indicated that pancreatitis was multifocal (n = 8) or focal (2), or gross pathologic findings were normal (3). Histologically, pancreatitis was peracute or acute in 11 of these 13 cats and associated with severe or moderate necrosis in 8. Thoracic and abdominal radiographic findings were nonspecific.

Conclusions and Clinical Relevance—Results of ultrasonography were consistent with a diagnosis of pancreatitis in only 7 of 20 cats with acute pancreatic necrosis in the present study. This suggests that new diagnostic criteria must be established if abdominal ultrasonography is to be an effective tool in the diagnosis of pancreatitis in cats. (J Am Vet Med Assoc 2002;221:1724–1730)

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