– 14 year old FS DSH presented for anorexia and dehydration
– urine (SG 1.015) and bloodwork consistent with renal failure, low normal HCT, Ca wnl, phos elevated
– urine culture pending
– left kidney hydronephrosis, right kidney small and degenerate
– the left ureter (confirmed on colour Doppler) could be seen and followed distally with the very distal part not being seen but the colon may have been in the way; no masses or ureteroliths identified
– the trigone looks normal
– 14 year old FS DSH presented for anorexia and dehydration
– urine (SG 1.015) and bloodwork consistent with renal failure, low normal HCT, Ca wnl, phos elevated
– urine culture pending
– left kidney hydronephrosis, right kidney small and degenerate
– the left ureter (confirmed on colour Doppler) could be seen and followed distally with the very distal part not being seen but the colon may have been in the way; no masses or ureteroliths identified
– the trigone looks normal
I have recommended an x-ray in case this is a stone problem but I am thinking unlikely as no other evidence of stones seen elsewhere. Could this degree of hydronephrosis be present due to severe infection? The fat around the ureter seems to be a bit inflamed. We have hospitalized with IV fluids, started broad spectrum antibiotics and pain meds.
Comments
Had a dog with TCC of the
Had a dog with TCC of the ureter that looked like your still of the ureter. Got a cytology hit on a FNA of the ureteral wall, didn’t worry about seeding ,needed a DX.
Maybe FNA and pyelocentesis for culture?
Had a dog with TCC of the
Had a dog with TCC of the ureter that looked like your still of the ureter. Got a cytology hit on a FNA of the ureteral wall, didn’t worry about seeding ,needed a DX.
Maybe FNA and pyelocentesis for culture?
yes pyelocentesis way to go
yes pyelocentesis way to go here decompresses and you can alayze for culture. Suspect ureteral stricture from prior stone passage. Congenital hydro is a zebra but I have one in the archive as well. Needs a stent.
yes pyelocentesis way to go
yes pyelocentesis way to go here decompresses and you can alayze for culture. Suspect ureteral stricture from prior stone passage. Congenital hydro is a zebra but I have one in the archive as well. Needs a stent.
Would you just use a 22gauge
Would you just use a 22gauge needle similarily used for cystocentesis and are there any bad things that can happen from sticking this kidney? Never performed pyelocentesis before but doesn’t look like it would be that hard on this kidney.
Would you just use a 22gauge
Would you just use a 22gauge needle similarily used for cystocentesis and are there any bad things that can happen from sticking this kidney? Never performed pyelocentesis before but doesn’t look like it would be that hard on this kidney.
I use 25 1 1/2 inch power
I use 25 1 1/2 inch power Doppler I stick from transverse and have assistant push and hold kidney against lumbar wall
I use 25 1 1/2 inch power
I use 25 1 1/2 inch power Doppler I stick from transverse and have assistant push and hold kidney against lumbar wall
Some good words from Sir
Some good words from Sir Viktor & Friends:
Ultrasound-guided percutaneous drainage for treatment of pyonephrosis in two dogs.
Source
Department and Clinic of Internal Medicine, University of Veterinary Science, Budapest, Hungary.
Abstract
Pyonephrosis refers to suppurative destruction of the parenchyma of the kidney with complete or nearly complete loss of renal function. In dogs, nephrectomy is still the most common treatment for pyonephrosis; however, in the present report, a method for percutaneous ultrasound-guided drainage of the renal pelvis in dogs with pyonephrosis that does not require local or general anesthesia was described, and results of the procedure in 2 dogs were reported. Briefly, dogs were positioned in lateral recumbency with the affected side up, and skin overlying the affected kidney was aseptically prepared. The dilated renal pelvis was punctured percutaneously, under ultrasound guidance, with a 22-gauge needle, and a sample of material was obtained for analysis. The needle was then replaced with an IV catheter, and as much pus as possible was removed from the renal collecting system. A povidone iodine solution was then used to lavage the renal pelvis. Ultrasound-guided drainage and lavage of the renal pelvis was repeated daily until the renal pelvis was so small that it could no longer be punctured. Both dogs recovered and were reported by the owners to be healthy after the procedure.
Some good words from Sir
Some good words from Sir Viktor & Friends:
Ultrasound-guided percutaneous drainage for treatment of pyonephrosis in two dogs.
Source
Department and Clinic of Internal Medicine, University of Veterinary Science, Budapest, Hungary.
Abstract
Pyonephrosis refers to suppurative destruction of the parenchyma of the kidney with complete or nearly complete loss of renal function. In dogs, nephrectomy is still the most common treatment for pyonephrosis; however, in the present report, a method for percutaneous ultrasound-guided drainage of the renal pelvis in dogs with pyonephrosis that does not require local or general anesthesia was described, and results of the procedure in 2 dogs were reported. Briefly, dogs were positioned in lateral recumbency with the affected side up, and skin overlying the affected kidney was aseptically prepared. The dilated renal pelvis was punctured percutaneously, under ultrasound guidance, with a 22-gauge needle, and a sample of material was obtained for analysis. The needle was then replaced with an IV catheter, and as much pus as possible was removed from the renal collecting system. A povidone iodine solution was then used to lavage the renal pelvis. Ultrasound-guided drainage and lavage of the renal pelvis was repeated daily until the renal pelvis was so small that it could no longer be punctured. Both dogs recovered and were reported by the owners to be healthy after the procedure.
Very interesting! Thanks
Very interesting! Thanks
Very interesting! Thanks
Very interesting! Thanks
22 gauge for dogs 25 g for
22 gauge for dogs 25 g for cats
22 gauge for dogs 25 g for
22 gauge for dogs 25 g for cats
Hi Eric, If there is
Hi Eric, If there is hydronephrosis with complete loss of the cortex and no hydroureter. Can you do pyelocentesis and just take a sample or do you must remove as much as possible? What are the odds of leaking and being a contraindication?
Hi Eric, If there is
Hi Eric, If there is hydronephrosis with complete loss of the cortex and no hydroureter. Can you do pyelocentesis and just take a sample or do you must remove as much as possible? What are the odds of leaking and being a contraindication?
If there is no functional
If there is no functional cortex int he kidney (thin or non existent cortex, no blood flow on power doppler, IVP if you feel so inclined…) it just needs to come out. The decompression may help restore some function if the cortex is live on dopper doppler but is usually temporary until a stent can be placed. I have never had a complication here but you can expect a little blood in the urine sample and the needle goes into the pelvis from the cortex. The patient is sedated of course and I used to play lots of video games as a kid so its fun… a sonographer’s “operation” game – don’t touch the sides:) This pyelocentesis is mainly to get a better concentrated sample to culture when recurrent uti is present despite negative bladder curine sample culture. The decompression is a minor temporary bend-aid to relieve pressure.
If there is no functional
If there is no functional cortex int he kidney (thin or non existent cortex, no blood flow on power doppler, IVP if you feel so inclined…) it just needs to come out. The decompression may help restore some function if the cortex is live on dopper doppler but is usually temporary until a stent can be placed. I have never had a complication here but you can expect a little blood in the urine sample and the needle goes into the pelvis from the cortex. The patient is sedated of course and I used to play lots of video games as a kid so its fun… a sonographer’s “operation” game – don’t touch the sides:) This pyelocentesis is mainly to get a better concentrated sample to culture when recurrent uti is present despite negative bladder curine sample culture. The decompression is a minor temporary bend-aid to relieve pressure.
I also have one of my
I also have one of my assistants place digital presure for a few minutes post pyelocentesis.
No complications yet.
I also have one of my
I also have one of my assistants place digital presure for a few minutes post pyelocentesis.
No complications yet.
Awesome Eric and Doug!
Awesome Eric and Doug! Thanks.
Awesome Eric and Doug!
Awesome Eric and Doug! Thanks.