Case Colleen Monahan 3 rd Year Veterinary Student University of Tennessee College of Veterinary Medicine
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1 Case Colleen Monahan 3 rd Year Veterinary Student University of Tennessee College of Veterinary Medicine
2 30 year old American Paint Horse gelding Signalment
3 History! 1-day history of colic signs! At presentation, the patient was trembling! Ultrasound: Distended small intestine with decreased motility! Rectal Exam: Possible displaced colon
4 Postmortem
5
6 4x
7 20x
8 Churukian-Schenk Staining
9 Morphologic Diagnosis Right adrenal gland: Pheochromocytoma
10 Equine Pheochromocytomas! Infrequent finding
11 Equine Pheochromocytomas! Infrequent finding! Functional or Non-functional
12 Equine Pheochromocytomas! Infrequent finding! Functional or Non-functional! Low incidence of malignancy
13 Equine Pheochromocytomas! Infrequent finding! Functional or Non-functional! Low incidence of malignancy! Unilateral
14 Functional Pheochromocytomas! No known breed or gender predilection
15 Functional Pheochromocytomas! No known breed or gender predilection! Only reported in horses >12 years
16 Functional Pheochromocytomas! No known breed or gender predilection! Only reported in horses >12 years! Tumor cells produce catecholamines
17 Functional Pheochromocytomas! No known breed or gender predilection! Only reported in horses >12 years! Tumor cells produce catecholamines! Similar clinical signs to colic, rhabdomyolysis, or acute laminitis
18 Clinical Signs! Abdominal pain
19 Clinical Signs! Abdominal pain! Muscle tremors
20 Clinical Signs! Abdominal pain! Muscle tremors! Profuse sweating
21 Clinical Signs! Abdominal pain! Muscle tremors! Profuse sweating! Tachycardia
22 Clinical Signs! Abdominal pain! Muscle tremors! Profuse sweating! Tachycardia! Tachypnea
23 Diagnosis! Difficult to diagnose
24 Diagnosis! High serum concentration of catecholamines or their metabolites in urine
25 Diagnosis! High serum concentration of catecholamines or their metabolites in urine! Catecholamines labile
26 Diagnosis! Additional Diagnostics:! Ultrasonography! Blood Pressure
27 Prognosis! Poor prognosis due to surgical complications
28 Prognosis! Poor prognosis due to surgical complications! Induction of fatal arrhythmias
29 Prognosis! Poor prognosis due to surgical complications! Induction of fatal arrhythmias! Anatomic location of adrenals
30 Prognosis! Poor prognosis due to surgical complications! Induction of fatal arrhythmias! Anatomic location of adrenals
31 Prognosis! Poor prognosis due to surgical complications! Induction of fatal arrhythmias! Anatomic location of adrenals
32 Prognosis! Poor prognosis due to surgical complications! Induction of fatal arrhythmias! Anatomic location of adrenals
33 Comparative Pheochromocytomas! More common in cattle, laboratory rats, and dogs
34 Comparative Pheochromocytomas! More common in cattle, laboratory rats, and dogs! Bulls: may be part of multiple endocrine neoplasia
35 Comparative Pheochromocytomas! More common in cattle, laboratory rats, and dogs! Bulls: may be part of multiple endocrine neoplasia! Dogs: tachycardia, edema, cardiac hypertrophy, polyuria and polydipsia
36 Comparative Pheochromocytomas! More common in cattle, laboratory rats, and dogs! Bulls: may be part of multiple endocrine neoplasia! Dogs: tachycardia, edema, cardiac hypertrophy, polyuria and polydipsia! 50% metastasize to the liver, regional lymph nodes, spleen, and lungs
37 Case Summary! Presented as a colic
38 Case Summary! Presented as a colic! Pheochromocytoma found on necropsy
39 Case Summary! Presented as a colic! Pheochromocytoma found on necropsy! Catecholamines produce clinical signs
40 Case Summary! Presented as a colic! Pheochromocytoma found on necropsy! Catecholamines produce clinical signs! Poor prognosis
41 Acknowledgements! Dr. Danielle Reel! Dr. Linden Craig! UTCVM Pathology Department! UTCVM Histology Lab
42 Questions?
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