3 year old MN DSH presented to RDVM as owner felt a mass in the abdomen.

3 year old MN DSH presented to RDVM as owner felt a mass in the abdomen. Pet otherwise doing well but slowing down, grade 4 systolic heart murmur – bloodwork showed slight elevation in BUN but urine SG 1.030 (complete U/A not performed) – very large mass, cystic filling most of the abdomen – appears to be coming from left kidney but a second half may be coming from somewhere else – normal left kidney not found but can see what looks like part of left renal cortex (see below) – right kidney normal in size but internal architexture starting to distort – liver, spleen and urinary bladder normal -could not assess pancreas, adrenals and SI due to mass occupying most of abdomen – abdominal effusion – possible HCM, no LAE, no pleural or pericardial effusion (quick look in chest) – multiple FNA’s taken and sent out but not overly hopeful they will be diagnostic – what could this be? to me not typical for PKD – contemplating surgery to remove as renal function still good however right kidney may be soon to follow. Below is lateral x-ray sent by RDVM and u/s images (taken from iPhone (sorry) as my MyLab 50 is on the blitz and could not save images – an Alpha may be on its way soon!) Third image not labelled but is the right kidney.