Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

[molly muffin]

Ultrasound comparions I'm posting the results from 2012 first followed by the 2014 results.


July 15, 2012

liver mildly enlarged, diffusely hyperechoic, and margins are rounded

gall bladder moderate amount of echogenic debris present

bile duct normal

stomach wall measures .25cm to .27cm

spleen normal

left kidney 4.86cm hyperechoic speckling in the cortex and mild decrease in corticomedullary definition

left adrenal gland .80cm and .68cm, mildly enlarged with the caudal pole larger than the cranial pole

urinary bladder wall mildly thickened at the apex .32cm to .43cm, lumen not fully distended

mucosa mildly hperechoic and irregular and two small calculi presnet .18cm and .24 cm

colon normal .14cm - .17cm

right kidney similar to left kidney 4.44 cm length

small non-obstructive calculi present .28cm

right adrenal gland .56cm and .74cm (.69cm and .60cm) and is upper reference of size to mildly enlarged

pancreas normal

small intestine normal .35cm

mesenteric lymph nodes mildly enlarged .33cm by 1.97cm


April 20, 2014

liver is enlarged and hyperchoic with rounded margins

gall bladder has mild echogenic debris, no obstruction

bile duct is normal

stomach is normal and wall measures .28cm

spleen is normal

left kidney measures 5.22cm mild loss of corticomedullary definitions, cortical speckling no obstructive mineralizations and renoliths .16cm by .39cm

left adrenal gland enlarged cranial pole .73cm and caudal pols has a nodule present measures 1.30cm by 1.26cm

urinary bladder wall appears mildly thickened but not fully distended

colon is normal wall measures .14cm

right kidney measures 4.70cm and is similar in appearance to the left, renolith .18cm

right adrenal gland mildly enlarged, .82cm and .93cm

pancreas is mildly mottled

small intestine is normal wall measures .22cm

lymph nodes are normal


Case summary, ultrasound demonstrated mild hepatomegaly with rounded margins and a diffusely hyperechoic echogenicity.
adrenal glands mildly enlarged and a nodule noted on left adrenal gland.

blood pressure measurement demonstrated mild hypertension.

urinalysis demonstrated concentrated urine and proteinuria

liver changes and adrenal gland enlargement could be supportive of hyperadrenocorticism.

Differential diagnoses based on ultrasound include pituitary dependent hyperadrenocorticism with asymmetrical hypertrophy of benign or malignant adrenal nodule (adenoma, functional adrenal tumour, phechromocytoma) or hypertrophy secondary to systemic disease (unlikely).

Previous LDDS normal. Could reflect false negative testing, atypical hyperadrenocorticism or possible that molly does not have hyperadrenocorticism.

If University of Tenn results is negative, liver biopsy may be warranted.

I was VERY sure she told me she thought benign on the adrenal nodule when speaking with her but she clearly writes malignant on the report, so I think I want some clarification on that. Still waiting on UTenn results to come back before any further discussions.

I admit, it is so hard, when molly is running around, playing, bright eyed to even think of a malignant tumor and it has me feeling a bit down every since I read the report last night. It still seems that they don't know what is going on with her, what is actually causing the high cortisol, nor what kind of tumor this is. Plus they seem to say if she does have cushings, she has both pituitary and an adrenal tumor. What the heck!!

I have to go to my other computer to do it, but I will post 3 jpegs of the latest ultrasound report. Hopefully readable as I had to convert from pdf.

hugs all
Sharlene and molly muffin