A 5-year-old NM Maine Coon was presented for evaluation of progressive azotemia and a urine specific gravity of 1.016.
06_00348 Felis R Hydronephrosis
History
Clinical Differential Diagnosis
Chronic kidney disease, congenital renal disease, pyelonephritis, neoplasia, renoliths, obstructive uropathy, hydronephrosis
DX
Unilateral hydronephrosis
Sampling
None
Sonographic Differential Diagnosis
Hydronephrotic right kidney with ureteral stricture, possible non-visible calculus or blood clot obstruction.
Moderate interstitial nephrosis renal pattern in the left kidney with slight pyelectasia. This is likely pyelonephritis.
Urine culture and sensitivity as well as 72 hours of IV fluid protocol and referral for subcutaneous ureteral bypass would ideal. This can be performed at Animal Medical Center with Dr. Berent. Guarded prognosis.
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. 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 0.17 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 2.0 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.
UA Specific Gravity Range
1.016
Outcome
None
Video
Patient Information
Age : 5 Years
Gender : Male, Neutered
Species : Feline
Status : Complete
Blood Chemistry
- Azotemia
Images
