Pancreas Cyst/Pseudocyst Causing Pain?


An aggressive Beagle  MN   6YO  presented for episodes of acute abdominal pain noted by owner, rDVM and tech.  No GI signs. No weight loss.

Gradual increasing liver enzymes:  Recently:  ALT   273  and ALKP  1486

Radiograph of spine and hips : NSFs      Liver size: WNLs   

An aggressive Beagle  MN   6YO  presented for episodes of acute abdominal pain noted by owner, rDVM and tech.  No GI signs. No weight loss.

Gradual increasing liver enzymes:  Recently:  ALT   273  and ALKP  1486

Radiograph of spine and hips : NSFs      Liver size: WNLs   

Sonogram reveals mild diffuse liver changes consistent with active/chronic hepatitis. Segments of small bowel are thickened with prominent mucosal layering suggestive of segmental IBD.  Those two findings could be related. But would not necessarily explain the pain.

A benign looking cyst is thought to be within the right limb of the pancreas or nearby mesentery.  I see no surrounding infammation. The pancreas is sonographically normal.

The cyst was drain. Grossly the fluid (~1.5cc) is clear/translucent.  I don’t have cytology or SG results but I expect a low cell count.

The clip shows a sweep from the right kidney through the ICCJ (right of screen) and then through the cyst. The cyst appears to be located just cranial to the ICCJ and LNs and ventral to the PV.

QUESTION:  Can a pancreatic cyst or pseudocyst be painful?    

In  this case, due to it’s agressive nature, the patient was heavily sedated . So I could not judge if the abdomen was painful to probe pressure.  I do not think that this benign looking cyst could be the source of this dog’s pain. Any comments?

Thanks,

Tom

 


10 responses to “Pancreas Cyst/Pseudocyst Causing Pain?”

  1. Having a hard time seeing

    Having a hard time seeing which thing is the cyst in the clip, but pancreatic cysts can be painful and create clinical signs of pancreatitis more so usually than just pain.  Since you drained it, it may become apparent soon whether this was the source.  I suspect not, but if the dog is a “wimp” maybe it is?  Please report back 🙂

  2. Having a hard time seeing

    Having a hard time seeing which thing is the cyst in the clip, but pancreatic cysts can be painful and create clinical signs of pancreatitis more so usually than just pain.  Since you drained it, it may become apparent soon whether this was the source.  I suspect not, but if the dog is a “wimp” maybe it is?  Please report back 🙂

  3. Here’s a still of the cyst.

    Here’s a still of the cyst. Just now noticed it did not upload earlier. 

    And yes the dog is a “wimp”. Maybe just behavioral.   Thanks:)

  4. Here’s a still of the cyst.

    Here’s a still of the cyst. Just now noticed it did not upload earlier. 

    And yes the dog is a “wimp”. Maybe just behavioral.   Thanks:)

  5. With no inflammation this is

    With no inflammation this is likely an incidental cyst especially with transudate type fluid… doesnt mean there isnt pancreatitis elsewhere though

  6. With no inflammation this is

    With no inflammation this is likely an incidental cyst especially with transudate type fluid… doesnt mean there isnt pancreatitis elsewhere though

  7. Ok. Just for

    Ok. Just for completeness’ sake…..the fluid drained from the cyst is acellular and SG=1.020.

    Owners gave new information that supports the notion that this is a behavior issue in that he acts “painful” when handled by any family member or DVM staff, BUT not the Mr. in the household.   

    Thanks for your comments Marty and Eric.

     

  8. Ok. Just for

    Ok. Just for completeness’ sake…..the fluid drained from the cyst is acellular and SG=1.020.

    Owners gave new information that supports the notion that this is a behavior issue in that he acts “painful” when handled by any family member or DVM staff, BUT not the Mr. in the household.   

    Thanks for your comments Marty and Eric.

     

  9. U bet makes sense:)… if its

    U bet makes sense:)… if its not in the abdomen or the chest it has to be metabolic orthopedic infectious or in the cns:)

  10. U bet makes sense:)… if its

    U bet makes sense:)… if its not in the abdomen or the chest it has to be metabolic orthopedic infectious or in the cns:)

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