Clinical pathology and ultrasonographic findings from a Warmblood gelding with primary, severe, acute pancreatitis

Abstract

SummaryA 24‐year‐old Warmblood gelding presented with a 6‐hour history of recurrent colic signs of increasing severity. Upon presentation, he was mildly painful, tachycardic and tachypnoeic and had decreased borborygmi. Nasogastric intubation resulted in no net reflux and rectal palpation revealed an ascending colon impaction. Percutaneous abdominal ultrasonography revealed dilated, thickened and hypomotile loops of small intestine. Complete blood count revealed leucopenia with neutropenia and an increased packed cell volume. Serum biochemistry revealed hyperproteinaemia, hyperglycaemia, hypocalcaemia, hyperbilirubinaemia, hypercholesterolaemia and elevated liver enzymes. Despite sedation and fluid resuscitation, the gelding became severely colicky. A repeat ultrasound was performed, revealing a moderate amount of free fluid and a mass effect between the liver and right dorsal colon. Abdominocentesis yielded a yellow, turbid fluid containing free‐floating white debris with an increased total protein and lactate concentration. Cytology of the fluid revealed necrotic mesothelial cells. The gelding was humanely euthanised due to poor prognosis. Necropsy revealed acute, severe pancreatitis and duodenitis. The mass effect on ultrasonography was retrospectively identified as the pancreas exhibiting a similar architecture to that seen in cases of acute pancreatitis in small animals.