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Ureterolith with hydronephrosis in a 12 year old FS Burmese cat

Case Study

Ureterolith with hydronephrosis in a 12 year old FS Burmese cat

A 12-year-old spayed female Burmese cat was presented for evaluation of renal disease, weight loss, and anorexia. Urinalysis showed isosthenuria and azotemia were present on blood work. CBC was normal.

A 12-year-old spayed female Burmese cat was presented for evaluation of renal disease, weight loss, and anorexia. Urinalysis showed isosthenuria and azotemia were present on blood work. CBC was normal.

DX

Ureterolith with hydronephrosis

Sonographic Differential Diagnosis

Obstructive left ureteral calculus with chronic hydronephrosis. Significant renal dystrophy in the right kidney.

Image Interpretation

The right kidney presented chronic dystrophic changes with an interstitial nephrosis pattern, subnormal size (2.67 cm), loss of corticomedullary detail and microinfarcts. Pyelectasia was noted, and measured 0.17 cm. The left kidney revealed mild to moderate hydronephrosis at 1.5 x 1.5 cm, with minor dystrophic mineralization at the corticomedullary junction. There was also a left hydroureter with echogenic debris, and a hyperechoic inflammatory pattern surrounding the proximal ureter measuring 0.35 cm in width. The left ureter was followed caudally and was tortuous. It appeared to be obstructed by small calculus approximately 3.0 cm distal from the left renal pelvis. The left kidney was swollen in contour and measured 4.1 cm.

Outcome

None

Comments

Recommend referral for stent placement in this patient. Ultrasound-guided decompression of the left renal pelvis is recommended with appropriate culture. Aggressive pain management, antibiotics and fluid therapy is warranted. This may allow for the small calculus to pass. However, given the compromised right kidney, stent placement would be ideal in this patient.

Clinical Differential Diagnosis

End-stage renal disease, acute kidney injury, pyelonephritis, renoliths, ureteroliths, potassium-losing nephropathy, neoplasia.

Sampling

Pyelocentesis and decompression with culture was recommended.

Patient Information

Patient Name : Mai Ling U
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 06_00173

Clinical Signs

  • Anorexia
  • Kidney disease
  • Weight loss

Images

cropped_urbanski_mai_ling_rk_dystrophiccropped_urbanski_mai_ling_lk_hydro_2cropped_urbanski_mai_ling_left_hydroureterurbanski_mai_ling_left_ureter_stone_doppler

Blood Chemistry

  • Azotemia

Clinical Signs

  • Anorexia
  • Kidney disease
  • Weight loss

Urinalysi

  • Isosthenuria Present