The patient is an intact female, 10 month old English Bulldog. She presented for PU/PD of several week duration and decreased appetite. On pysical exam, the dog is in poor body condition. Blood chemistry revealed azotemia, with a BUN of 95 and creatinine of 5.3.
Primary renal dysplasia pattern with pyelectasia, potential concurrent urinary tract infection.
Polypoid bladder changes, suspect urinary tract infection.
The urinary bladder presented minor mural thickening with slight, micropolypoid changes.
Both kidneys in this patient presented significant, dysplastic changes with cortical irregularity and disruption of the corticomedullary structure. A significant amount of microinfarctions and hyperechoic areas of mineralization and fibrosis as well as cortical cysts were noted. Color flow assessment of the renal cortices was significantly subnormal. This is consistent with chronic disease. The left kidney measured 5.08 cm. The right kidney presented pyelectasia that measured 0.76 cm. The right kidney measured 5.04 cm.
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Renal biopsy would be necessary to confirm primary renal dysplasia that would be a congenital disease with secondary degenerative changes. However, the prognosis regardless is poor long term. Blood pressure measurements, urine culture and sensitivity especially derived from the right renal pelvis as well as renal cortical biopsy would be an ideal scenario in this patient for further definition.
Renal toxin, infectious, renal dysplasia, Addisons, UTI.
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