- Abdominomegaly with peritoneal effusion noticed by owner about 1 week ago. Lethargic, eating less for about 2 days. No previous medical conditions, not seen by vet for at least 5 years. On exam found heart murmur, grade III/VI.
- Chemistry profile shows ALP 142 (10-90), ALT 105 (20-100),BUN 52 (10-30), creat=2.1 (0.3-2.1),Ca 12.4 (8-11.8).
- Radiographs show peritoneal effusion, enlarged and rounded kidneys, possibly areas of mineralization. Cardiac silhouette WNL size and shape.
- Abdominomegaly with peritoneal effusion noticed by owner about 1 week ago. Lethargic, eating less for about 2 days. No previous medical conditions, not seen by vet for at least 5 years. On exam found heart murmur, grade III/VI.
- Chemistry profile shows ALP 142 (10-90), ALT 105 (20-100),BUN 52 (10-30), creat=2.1 (0.3-2.1),Ca 12.4 (8-11.8).
- Radiographs show peritoneal effusion, enlarged and rounded kidneys, possibly areas of mineralization. Cardiac silhouette WNL size and shape.
- Echocardiogram was wnl except for a low velocity tricuspid regurgitant jet.
- Abdominal ultrasound shows bilateral markedly enlarged polycystic kidneys with moderate loss of normal renal architecture, moderate amount of ascites, a complex cystic liver mass, coarse hepatic parenchyma, a very large hepatic cyst, and irregular capsule contour. There is also a non-shadowing gravity dependent echogenic density in the bladder suggestive of a blood clot.
- Rule outs for the kidneys include advanced PKD, bilateral renal neoplasia, and acquired cysts secondary to renal insult. R/O’s for the liver include acquired or congenital hepatic cysts, biliary cystadenoma and neoplasia. The ascites may be due to portal hypertension, vasculitis, neoplastic infiltration of the lymphatic or venous systems, hemorrhage, cyst rupture, and less likely infection.
- Trying to figure out if this cat is sick due to renal failure or due to neoplasia. The complex mass in the liver is odd looking and not typical for biliary cystadenoma. FNA’s declined for now. Advised to tx for crf.
- Any other thoughts?
Comments
pkd and concurrent polycystic
pkd and concurrent polycystic liver, liver may have a cyst leakage givem the slight fluid between the liver lobes. Not neoplastic. Supportive care is all you can really do here.