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A 9.5 yr old Yorkshire terrier presented with chronic intermittent vomiting and lethargy of 1.5 yr duration that progressed to generalized weakness. Insulin:glucose ratio was consistent with an insulinoma. Triple-phase computed tomography revealed a mid-body pancreatic nodule. The mid-body pancreatic nodule was enucleated; histopathology was consistent with an insulinoma. Two weeks after the operation, the dog presented for anorexia and diarrhea. Abdominal ultrasound revealed a thick-walled cystic lesion along the dorsal stomach wall. An intramural gastric pseudocyst was diagnosed via exploratory laparotomy and intraoperative gastroscopy. Comparison of amylase and lipase levels of the cystic fluid with that of concurrent blood serum samples confirmed the lesion was of pancreatic pseudocyst origin. The gastric pseudocyst was omentalized. Two weeks after the operation, the dog re-presented for anorexia, regurgitation, and diarrhea. An intramural duodenal pseudocyst was identified and treated with a duodenal resection and anastomosis. The dog has remained asymptomatic and recurrence free based on serial abdominal ultrasounds 22 mo following insulinoma removal. To our knowledge, this phenomenon of pancreatic pseudocysts forming in organs other than the pancreas has not been reported in dogs. This case report and comprehensive human literature review purpose is to raise awareness of this disease process in dogs., (© 2022 by American Animal Hospital Association.)

A six-year-old, spayed female Shetland sheepdog was presented with acute onset of anorexia and vomiting. An inflammatory leukogram and elevated serum amylase, lipase, alkaline phosphatase, alanine transferase, and triglycerides supported a diagnosis of severe acute pancreatitis. An enlarged, hypoechoic pancreas was visualized on abdominal ultrasonography. The patient clinically responded to medical therapy consisting of nothing per os, total parenteral nutrition, and supportive care. She presented again three weeks later with anorexia and vomiting. A large, anechoic mass was seen in the left limb of the pancreas on ultrasonographic examination of the abdomen. Differentials for this mass included abscess, focal peritonitis, and pancreatic pseudocyst. Clinical signs resolved with supportive care. The mass failed to resolve. Sterile fluid (35 ml) was removed via ultrasonographic-guided centesis 42 days after initial presentation. Ultrasonographic appearance, biochemical analyses, and fluid examination with negative cultures suggested pancreatic pseudocyst. The pseudocyst gradually resolved over the next seven months postcentesis.