Pancreatitis is a very satisfying diagnosis to make on ultrasound. Its a tough disease to diagnose on bloodwork, so any additional evidence is appreciated. Acute pancreatitis in dogs and cats has fairly specific ultrasonographic signs. The things to look for are
- a thickened, hypoechoic pancreas (calipers)
- hyperechoic, attenuating surrounding fat (arrow)
- free abdominal fluid
Often, the inflammation surrounding the pancreas in the mesenteric fat is severe. Inflamed fat is hyperechoic to normal fat, in contrast to the pancreas, which usually becomes hypoechoic when inflamed. This hyperechoic fat can make it very hard to see the pancreas. The inflammation of the fat also causes it to absorb more of the sound waves, or attenuate them. But this sign in itself is indicative of pancreatitis in the right cranial abdomen (arrow).
Cats don’t always show these signs with acute pancreatitis, so you can’t rule it out on ultrasound. It may also be too early in the disease process for inflammation to develop, so it’s sometimes worth repeating the scan in a day or two.
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