Ureterolith in a 19 week old FS Rottweiller mix dog

History

The patient is a spayed female canine Rottweiler mix, 19 weeks old who had a previous visit to emergency veterinarian for urinary problems. On physical the patient had slight dehydration but was otherwise normal. UA found no infection. Patient sent home on Rimadyl. CBC: two days ago: Anemia of 28.8, normocytic, normochromic. Azotemia (BUN = 34, CRE = 1.6) Hyponatremia (Na = 135) today: Anemia of 35. Improvement in BUN and CRE values (27 and 1.3 respectively), Hypoalbuminemia. Sodium back up to 145. UA: SG = 1.015, Glycosuria, proteinuria, pH=6

Comments

Surgical intervention is necessary for cystotomy and manual manipulation of the calculus or potential ureterotomy. Urine culture and sensitivity along with stone analysis would be recommended. Stent placement could be considered as well. However, surgical intervention to remove the calculus will likely be necessary regardless. The kidneys appear approximately 50-60% compromised from a subjective structural standpoint.

Clinical Differential Diagnosis

renal pathology – Renal dysplasia, renal toxin, infectious, UTI; Addisons

DX

Ureterolith

UA PH

6.0

Sampling

None

Sonographic Differential Diagnosis

Obstructive left ureteral calculus at the ureteral papilla.

Image Interpretation

The urinary bladder itself did not present any calculi. However, the distal left ureter was obstructed with a 0.6 cm calculus that was embedded in the ureteral papilla. It was debatable on whether the calculus at this size will pass with aggressive fluid therapy and pain management. Surgical intervention with manual manipulation of the calculus may allow for it to enter into the bladder. Urine flow appeared to be present on color flow Doppler. However, a minor inflammatory pattern was noted around the ureter.
The right kidney presented pyelectasia that measured 0.3 cm with echogenic, ill defined fat and interstitial nephrosis pattern. The right kidney measured 6.15 cm. Pyelectasia was also noted in the left kidney at 0.36 cm with ill defined fat. The left kidney measured 5.9 cm.