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Perirenal cyst with calculus

Sonopath Forum

Sonopath Forum

Perirenal cyst with calculus

Hi all, I apologize for the quality of this clips as they are actually screen shots.
This is an old 3kg FN DSH cat with a 10cm diameter cyst. Appears to be Peri renal since the RK appears to be inside. There is a 3 cm moving floating calculus. The other kidney does not look in good shape. Bloodwork is being done.
We are trying to decide what we can do…

Hi all, I apologize for the quality of this clips as they are actually screen shots.
This is an old 3kg FN DSH cat with a 10cm diameter cyst. Appears to be Peri renal since the RK appears to be inside. There is a 3 cm moving floating calculus. The other kidney does not look in good shape. Bloodwork is being done.
We are trying to decide what we can do…
In my opinion, what should be done is cyst drainage and removal… But that would imply neprhectomy. I think draining only will be unsuccessful as it will fill up again. My colleague suggests drainage and partial removal leaving kidney in… What would you do?? I can’t quite see the rest of the organs as this is massive and all is pushed away and the only thing I could see is a small splenic nodule.
Any suggestions?

Thanks for your help…

Comments

Anonymous
November 25, 2015 at 5:45 am -

May be a pseudo cyst? And
May be a pseudo cyst? And really won’t fill up again if we drain it? But the large calculus… I was expecting on the calculus a more obvious distal acoustic shadow… May be its not a calculus???

Anonymous
November 25, 2015 at 11:34 am -

I wonder whether this can
I wonder whether this can potentially be neoplasia? The kidney that is not involved and is outside the cyst measures 4×3.5 cm and is totally abnormal in echo structure, the inner kidney is aprox 3cm but it has been subjected to cyst pressure …

randyhermandvm
November 26, 2015 at 12:33 pm -

Have you seen the lab results

Have you seen the lab results yet? Is overall kidney function normal?

Are you sure this cat is spayed?

May be worthwhile – if all the labs are Ok to just go in and assess the situation at the time

of surgery. 

 

Anonymous
November 26, 2015 at 12:52 pm -

Thanks Randy. Not sure yet
Thanks Randy. Not sure yet but I will update you.
I’m curious at what the floating hyperechoic ball is… Any ideas? Do you think it is a calculus or debrie material

randyhermandvm
November 26, 2015 at 2:28 pm -

I have no idea. I was

I have no idea. I was wondering if it is not even associated with the kidney. 

I wonder if others will give an opinion. Let us know if you go

in surgically.

EL
November 26, 2015 at 6:15 pm -

stripping the perirenal

stripping the perirenal pseyodcyst surgically is likely the way to go here but there are renal infarcts and pyelectasia and ill defined pelvic fat so lilely pyelnonephriotis too. I would push fluids and injectable abs 36 hours then strip the capsule and maybe bx the kidney given the convenience to manage long term. Check BP first.  Im not seeing a floating 3cm stone but a floating kidney not sure if im missing something.

Anonymous
November 26, 2015 at 11:19 pm -

Thanks, EL. So the floating
Thanks, EL. So the floating structure is basically the one in picture 1, with the measurements. That picture is with the patient in the same position as the video, and that is right lateral recumbency. At some point in the video, after seeing the 2 kidneys in the near field, you can see some echogenic strings going down to distal field. Those strings lead to the round structure in picture 1.
Thanks for your help. I guess surgical is the way to go here since it appears then to be a pseudo cyst.
I will keep you posted. Thanks so much.

Anonymous
November 27, 2015 at 12:47 pm -

So, patient has marked
So, patient has marked azotemia. She is definitely spayed.
My colleague will treat with fluid therapy and we will drain it first to relieve pressure and try to give the kidneys a rest. Then may be surgery:). Thanks for help.

Anonymous
November 27, 2015 at 12:47 pm -

So, patient has marked
So, patient has marked azotemia. She is definitely spayed.
My colleague will treat with fluid therapy and we will drain it first to relieve pressure and try to give the kidneys a rest. Then may be surgery:). Thanks for help.

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