I think this is a case of a urachal diverticulum, +/-hydronephrosis…. or other interesting pathology ?
I think this is a case of a urachal diverticulum, +/-hydronephrosis…. or other interesting pathology ?
- 4 mo. old F Siamese mix kitten
- presented in lateral recumbency 1 mo. ago, dx w/acute renal failure
- recovered w/hosp, IV fluids, IV antibiotics
- on recheck today, QAR w/normal BW, but palpable irregular extremely large bladder
- kitten also has a 0.5 cm reducible umbilical hernia
I think the bladder is the smaller more caudal portion, and a huge diverticulum extends off of the cranial pole of the bladder, taking up most of the space in the abdomen.
I could not find the left kidney (but right one looks WNL). I question if at the end of the second video clip, the remnants of a hydronephrotic kidney pop into view?
Do you think it’s a urachal diverticulum? And do you think this would be surgically fixable?
Thanks!
Karen Ebersole
Comments
Looks like a completely
Looks like a completely hydronephrotic LK and maybe an ectopic dilated ureter attached to the UB apically… apical ectopy is rare btu it happens.
If the rk is in good shape then sx would be the option.
Thanks EL! It was the apical
Thanks EL! It was the apical part that threw me off…. I’ve never seen that before.
I’ll update after we go to sx. Hopefully the O can afford to do the exploratory.
Update, kitten went to
Update, kitten went to surgery…
It was indeed a completely hydronephrotic L kidney. I’ll attach a few pics.
From the limited US views I had, I really thought the fluid filled structure was attached to the apical bladder, but it was not. That was all hydronephrotic kidney.
The kitten was found at sx to have bilateral ectopic ureters, attaching to urethra. The surgeon reattached the remaining ureter to the bladder. Microsurgery, as the kitten was only 3 lbs….
Sadly the kitten was euthanized this morning due to uroabdomen. The surgeon said that was the complication that could happen despite his best efforts.
I did a limited “table-side” US of the kitten for the O, who couldn’t afford much. I should have tried harder to get views from all directions so they could know more before sx. I’m not sure I would have been able to find the tiny ectopic ureter?
So, some interesting pictures for future reference.
Wow unfortunate outcome but
Wow unfortunate outcome but thank you for the follow up. Genetics are tough to cure.