# Successful Management of a Pancreatic Abscess in a Dog with Juvenile Diabetes Mellitus Through Ultrasound-Guided Drainage and Medical Therapy

## TL;DR

A young dog with diabetes and a pancreatic abscess was successfully treated using ultrasound-guided drainage and medical therapy, with no recurrence observed.

## Contribution

This case report presents a rare successful non-surgical treatment of a pancreatic abscess in a dog with juvenile diabetes.

## Key findings

- Ultrasound-guided drainage effectively managed the pancreatic abscess without complications.
- Medical therapy with insulin and antibiotics maintained diabetes control and prevented recurrence.
- Follow-up ultrasounds confirmed no recurrence up to five months post-treatment.

## Abstract

Pancreatic abscesses are uncommon in veterinary medicine and typically result from complications of acute pancreatitis. They are defined as localized collections of necrotic purulent material, often with infection. Reports of successful non-surgical treatment in dogs are scarce, but minimally invasive approaches are being explored. This case describes a five-month-old mixed-breed female dog with a two-week history of polyuria, polydipsia, and vomiting. Clinical examination revealed poor body condition and clinicopathological abnormalities included neutrophilic leukocytosis with a regenerative left shift, fasting hyperglycemia, elevated fructosamine, glycated hemoglobin, and β-hydroxybutyrate concentrations, with no evidence of pancreatitis or exocrine pancreatic insufficiency. Abdominal ultrasonography identified a thick-walled pancreatic cavity with mixed echogenic fluid. Ultrasound-guided drainage was safely performed, and cytology confirmed a pancreatic abscess with pyogranulomatous inflammation; cultures were negative. The dog received antibiotics and insulin, showing no recurrence on follow-up ultrasounds up to five months. One year post-discharge, the diabetes remained well managed. This case demonstrates successful treatment of a pancreatic abscess in a dog with juvenile diabetes mellitus using percutaneous drainage and medical management.

A five-month-old female mixed-breed dog presented with a two-week history of polyuria, polydipsia, and vomiting. Clinical examination revealed poor body condition, growth retardation, pale oral mucous membranes, weak pulse, and prolonged capillary refill time. Laboratory findings included neutrophilic leukocytosis with a regenerative left shift, fasting hyperglycemia, elevated fructosamine, glycated hemoglobin, and β-hydroxybutyrate concentrations, while the acid–base balance remained normal. Canine-specific pancreatic lipase and trypsin-like immunoreactivity concentrations ruled out an underlying pancreatitis or exocrine pancreatic insufficiency, respectively. Urinalysis showed glycosuria and ketonuria. Supportive care included antibiotics and regular insulin administration. Abdominal ultrasonography identified a pancreatic cavity with a thick wall and mixed echogenic fluid. Ultrasound-guided drainage was performed without complications. Cytology confirmed a pancreatic abscess with pyogranulomatous inflammation, though the culture results were negative. The dog was discharged with intermediate-acting lente insulin. Follow-up ultrasonographic evaluations at 7, 14, and 21 days and 5 months post-drainage showed no recurrence. The diabetes remained well-controlled one year post-discharge. This case report describes the successful management of a dog with juvenile diabetes mellitus complicated by a pancreatic abscess, highlighting the effectiveness of percutaneous ultrasound-guided drainage combined with medical therapy.