Bilateral hydronephrosis in a chronically vomiting cat

Bilateral hydronephrosis in a chronically vomiting cat

18 year old MN Siamese with history of chronic vomiting, chronic renal failure, HCM, and hyperthyroidism. Owner feels that the vomiting has become worse. Abdominal US shows bilateral renal pelvic dilation/hydronephrosis with dilation of the proximal ureters as well.  The right kidney was normal in renal length at 3.9cm.  The left kidney was slightly decreased…

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