06_00260 Mau R Hydronephrosis secondary to ureteral stricture

History

A 5-year-old MN Maine Coon was presented for evaluation of progressive azotemia and a urine specific gravity of 1.016.

Clinical Differential Diagnosis

Chronic kidney disease, congenital renal disease, pyelonephritis, neoplasia, renoliths, obstructive uropathy, hydronephrosis

DX

Hydronephrosis, ureteral obstruction, cause unknown

Sampling

None

Sonographic Differential Diagnosis

Hydronephrotic right kidney with ureteral stricture, possible invisible calculus or blood clot obstruction.
Moderate interstitial nephrosis renal pattern in the left kidney with slight pyelectasia. This is likely pyelonephritis.

Image Interpretation

The right kidney in this patient presented moderate hydronephrosis and increased cortical echogenicity. Swollen contour and renomegaly was noted. The right kidney measured 5.85 cm with pyelectasia. Renal pelvic dilation was noted and measured 1.22 x 2.0 cm. Power Doppler assessment appeared to be mildly subnormal in the renal cortex. The right ureter was dilated near the renal pelvis at 0.3 cm and 0.17cm at the distal aspect. Echogenic debris was noted within the ureter. This is likely consistent with a blood clot. The ureter was followed distally approximately 2.0cm past the renal pelvis. The cause of obstruction is unknown, likely stricture. The left kidney revealed a chronic interstitial nephrosis pattern with subcapsular fluid accumulation and pyelectasia that measured 0.18 cm. Cortical infarcts were noted in the left kidney.