A 10 year-old SF DSH with a history of renoliths was presented for evaluation of a week’s duration of vomiting, inappetence, and lethargy. Isosthenuria was present on urinalysis. Abnormalities on CBC and serum biochemistry were anemia, hyperkalemia, and azotemia. Survey radiographs showed bladder and renal calculi.
Renal – renoliths, pyelonephritis, obstructive uropathy, acute kidney injury superimposed on chronic kidney disease, Leptospirosis
Bladder uroliths
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Moderate hydronephrosis and acute on chronic nephritis in the left kidney.
Chronic, mild hydronephrosis/pyelectasia in the right kidney with moderate to severe dystrophic changes.
Renal and bladder calculi. This patient has likely been passing calculi periodically with a recent acute event. Secondary ureteral strictures appear to be an issue.
The urinary bladder appeared unremarkable. Bladder calculi were noted with an accumulation of approximately 1.0 cm. The largest calculus measured 0.62 cm.
The kidneys in this patient presented moderate to severe dystrophic changes, irregular contour, cortical infarcts and remodeling were noted. The left kidney presented moderate hydronephrosis with interstitial nephrosis pattern. Swollen contour and periserosal inflammatory pattern was noted. Color flow assessment of the renal cortex appeared adequate. However, significant disruption of architecture was noted. The right kidney revealed pyelectasia that measured 0.38 cm with no obstructive calculi at this time. The right kidney was subnormal in size and measured 2.45 cm. The left kidney measured 4.46 cm. The left kidney also revealed pyelectasia that measured 0.73 x 1.5 cm. Slight, pericapsular fluid accumulation was noted near the left kidney. This is consistent with acute nephritis owing to hydronephrosis. The left proximal ureter revealed either a stricture or calculus that measured approximately 1.0 cm from the left renal pelvis. However, this is more consistent with stricture.
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