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Impressions of A Kidney…

Sonopath Forum

Sonopath Forum

Impressions of A Kidney…

Baby: 4 Year Old MN Cat Positive for FIV w/ History of ADR

Seen First on September 23:  Creatinine 13; SDMA 93 & BUN >130    LK Size 5.62cm & RK Size 5.71   Sonopath U/S DDx’s included FIP, Nephritis and to a lesser degree Lymphoma since the kidney architecture was not disrruptive although there is some capsular fluid/expanison present. No consent from owner at time for FNA so no cytology to go on.

 

Baby: 4 Year Old MN Cat Positive for FIV w/ History of ADR

Seen First on September 23:  Creatinine 13; SDMA 93 & BUN >130    LK Size 5.62cm & RK Size 5.71   Sonopath U/S DDx’s included FIP, Nephritis and to a lesser degree Lymphoma since the kidney architecture was not disrruptive although there is some capsular fluid/expanison present. No consent from owner at time for FNA so no cytology to go on.

 

Fast Forward 2 weeks to October 2 after Tx w/ Convnenia, 2 Injections of Dexamethasone and IV/SQ fluds: Creatine, SDMA & BUN are all NORMAL. LK & RK now measure 4.5cm

 

Does this clinical change support one Dx over another??? I’d assume that FIP is not a runner as I’d not expect it to really improve. I’d like to think resolved acute nephritis but I worry that Lymphoma could respond in a similar fashion?

 

Thanks in advance and have a good weekend.

Sam

Comments

EL
October 4, 2020 at 1:53 pm -

Lymphoma distorts

Lymphoma distorts architecture gets a subcapsular halo and hypoechoic cortical changes. This is a uniform interstital nephrosis echogenic pattern and the pericapsular fluid suggests acute insult. toxin infectious and such. in dogs you see this in lepto whether clinically the hepatic or renal form.

Here is a typical renal lymphoma case in a cat from the basic search int he sonopath archive… we are moving that search link soon to be more accessible as it got hidden wiht the new redesign my apology.

https://sonopath.com/members/case-studies/cases/renal-lymphoma-10-year-old-mn-dsh-cat-renomegaly

franklinanimalclinic
October 4, 2020 at 2:10 pm -

So, it’s safe to assume that

So, it’s safe to assume that an acute nephritis w/ enlarged kidneys can have a reduction in kidney size within a couple weeks with successful treatment? These kidneys reduced in size by about 20%….I wasn’t sure if that’s a normal response to an acute insult since I’ve not followed up a case like this w/ U/S.

 

Thanks and have a great day

Sam

rlobetti
October 4, 2020 at 7:45 pm -

When was FIV diagnosed as

When was FIV diagnosed as acute infetcion FIV can result in acute kidney injury with glomerulonephritis, tubular and interstitial alterations, as well as interstitial amyloidosis. In people with HIV the AKI often settles down.

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