- 12YO DSH FS
- Asymptomatic cat (Two house cats were brought in for testing, because one was urinating out of the box. It turns out the other cat is in end stage renal failure was the guilty one )
- Chemistry, Lytes, CBC, T4 = NSFs
- U/A (cysto): USG = 1.024, Trace protein, Urine Culture : negative –> treating with ab anyway
- Abdominal ultasound revealed bilateral pyelectasis R>>L
- Proximal 1/3 of the right ureter is dilated. Point of stricture visualized without evidence of a urolith or mass?
- Literature search: Feline Ureteral Strictures: 10 Cases (2007 ?2009), J Vet Intern Med 2011;25:222?229 reports that 6 of 11 cats with ureteral strictures had hyperechoic periureteral tissue seen near the stricture on ultrasound exam (as seen in this case).
- R/Os pyelonephritis with debris within the ureter vs. Previous injury by urolith passage with secondary ureteral fibrosis vs. Mass? vs. Idiopathic
Question: 1. Does anyone see a sonographic finding that explains this right ureteral dilation? Mass?
2. Has anyone seen this presentation with adjacent hyperechoic periureteral tissue as reported in JVIM ?
Any comments would be appreciated.
Tom
3 responses to “Ureteral Stricture in an asymptomatic cat”
yes i personally think the majority of ureteral strictures in cats come from passing stones. yes they will often have a fuzzy echogenic periserosal inflammatory fat pattern when recent or more orgnaized echogenic fat if past episode. Theis cat the Lk has also an infact in the first image at the 9-11 oclock position and this happens a lot when they are stone movers. Lost lots of stone movers out there . Lulich study came out recently how the oxalate epidemic is ubiquitous. if a young cat you have to worry about ureters tied off inadvertently at spay…older cat wiht these kidneys I’m betteing its a stones passer. May have pyelo in the pelvis as well so you can decompress it wiht usg pyelocentesis 25 gauge needle and culutre. Could consider stent as well.
http://veterinarynews.dvm360.com/dvm/Medicine/Feline-urolith-epidemiology-update-1981-to-2012/ArticleStandard/Article/detail/833606
http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=729117
Eric,
Regarding the abnormal shape to the left kidney, I had noticed that the entire 1/3 of the cranial pole is absent! I wasn’t sure whether to attribute this finding to an infarct or dysplasia. Thanks for your comment.
Regarding the renal crest of the left kidney. I added two stills. One in sag and the other in transv. There is a hyperechoic region of the renal crest that I assume is fibrosis/fat as a result of a previous infarct. Is that what you would think is causing this finding?
The arrows are pointing to a cortical collapse owing to infarct and the pelvic fat is ill defines with pyelectasia suggests pylelonephritis. 25g centesis into that should give you infected urine unless therapy is cleaning it up already