Browning is a 4 year old golden retreiver with a history of chronic hematuria that presented to have a urinary tract ultrasound. the dog was worked up at the referring vets, an the cheistry was normal and culture of the urine was negative for bacterial growth. the bladder and prostate appeared normal. The left kidney appeared to have mild pylectasia. the right kidney was not identifiable as a normal kidey. On the rads it appeared slightly larger than the left, but the internal architecture was messed up.
I thought maybe the right was dysplastic given the breed and there might be pyelonephritis in the left, so I put him on antibiotics even thought the culture was negative.
It is 2 weeks today and the dogs urine is brownish red. The sg was 1032, there were 4++ rbcs phf on sediment. I was thinking it may be pigment. there was still a browninsh red color to the urine after spinning, but significant rbcs.
The mass/kidney appears larger. I am planning on doing a core biopsy, but am getting a coag. panel done first to make me feel better. There is a “clot” of blood in the bladder. Cbc was normal (hct, platelets ok)
Was looking for any comments on the left kidney and the mass/kidney. Concerned the bleeding is coming from a neoplastic kidney. I havent seen a kidney so totally destroyed/ unrecognizable. I searched for a kidney for a long time on the first ultrasound convinced this was a mass somewhere else, bu couldnt find one.
Comments
Second video strong concern
Second video strong concern for renal neoplasia needs fna. Renal dysplasia possible but that usually involves both kidneys. Renal carcinoma or round cell neoplasia my guess on the rk. 25g fna should tell the story.
I read somewhere that an fna
I read somewhere that an fna might not tell the story and to do a biopsy. Good to know that may not be necessary. I dont do many organ fnas. Do you just do them under sedation and local? I did a coagulation profile thinking I would be doing a biopsy. I take it just for fna that wouldnt need to be done.
Thanks
FNA for cellular disease,
FNA for cellular disease, round cell neoplasia and carcinoma, core bx for structural disease like GN and primary dysplasia. Cyto is often very interpreter dependent. In our cytopathology circles its very reliable in this scenario assumiing you get a solid sample. 25g in the cortex should do it. If your cyto description is solid and the definitive dx isnt there get a second opinion on the sample interpretation.