Wow- Electrocute stole my post this week.
Larkin is a 16 week old Golden Retriever puppy with a history of “dribbling” urine.
Previous vet did a urine MIC and Profile (no UA that I can find in the records).
The profile was normal but the CBC was over 28,000 with a neutrophilia, lymphocytosis and monocytosis.
The Urine MIC was + for E Coli. 1 bout of Amoxicillin and 2 bouts of Clavamox and the
urine MIC came back no growth. Was placed on another 2 weeks of Clavamox when I saw him
Wow- Electrocute stole my post this week.
Larkin is a 16 week old Golden Retriever puppy with a history of “dribbling” urine.
Previous vet did a urine MIC and Profile (no UA that I can find in the records).
The profile was normal but the CBC was over 28,000 with a neutrophilia, lymphocytosis and monocytosis.
The Urine MIC was + for E Coli. 1 bout of Amoxicillin and 2 bouts of Clavamox and the
urine MIC came back no growth. Was placed on another 2 weeks of Clavamox when I saw him
I did a UA and the SG was 1.020 with bacteria still in the urine. The CBC had returned to normal.
I am placing 2 cine of the kidneys. The L kidney looks irregular to me with a wedge shaped loss of contour
of the cauda pole and the caudal kidney has a homogenous echogenicity. I am also concerned if there is an indication of
dilation of the renal pelvis and I am not sure about the cortical medullary definition.
This pup was sweet but all over the table. We went through lots of treats just to get a few images.
The bladder and prostate looked normal.
Any feedback would be appreciated. The owners say the pup is normal while on antibiotics but tends to dribble when they suspect the cystitis is back. I may have to sedate this pup to get decent images.
Comments
Pyelonephritis mor edramatic
Pyelonephritis mor edramatic on the left note the ill defined renal pelvic fat along with the dilation and there is a dorsal caudal indentation of the LK owing to possible primary renal dysplasia mild from or infarct from the pyelonephritis. 8 week ab protocol based on C&S likely necessary here and if azotemia occurs then needs renal bx to look for primary dysplasia.
What about the possibility of
What about the possibility of ectopic ureters predisposing to chronic pyelonephritis?
Possible of course but should
Possible of course but should be able to see them readily especially when infection is present they tend to dilate even more and become more prominent an dhyperperistaltic tubes that shouldnt be betweent he rigone and the colon and occasionally cranial entry to the UB. Tough to miss an ectopic ureter in patients over 6 months with today’s resolution and a linear probe following positions 2 and 3 SDEP covers the area well.
Here are the SDEP links for download and poster for reference if you arent familiar with the pscanning protocol.
https://sonopath.com/products/downloadable
https://sonopath.com/products/education-support-products
Here are some ectopic ureter cases from the sonopath search engine key words “ectopic ureter”
http://sonopath.com/members/case-studies/search?text=ectopic+ureter&species=All
Thanks all for your help
Thanks all for your help
Would still considered ruling
Would still considered ruling out ectopic ureters by means of contrast studies (IVP/retrograde urethrogram) or CT.