10 year old M/N DSH cat.
Diagnosed with diabetes mellitus (hyperglycemia, glucosuria) Oct 17, 2014. Started glargine 1 IU BID SQ and was curved 2 weeks later. BG curve high, so increased to 1.5 IU BID SQ. Later that day, owner noticed gash on neck where insulin was given – was rechecked and cat had extremely fragile skin (was trying to deglove his neck). Has been treated as open wound, continued glargine. LDDST pending to rule out Cushing’s disease. CBC/CHEM/UA – WNL except glucosuria.
10 year old M/N DSH cat.
Diagnosed with diabetes mellitus (hyperglycemia, glucosuria) Oct 17, 2014. Started glargine 1 IU BID SQ and was curved 2 weeks later. BG curve high, so increased to 1.5 IU BID SQ. Later that day, owner noticed gash on neck where insulin was given – was rechecked and cat had extremely fragile skin (was trying to deglove his neck). Has been treated as open wound, continued glargine. LDDST pending to rule out Cushing’s disease. CBC/CHEM/UA – WNL except glucosuria.
On abdominal ultrasound there was a hyperechoic shadowing area on cranial ventral area of L renal cortex. I didn’t think it could be just fat in the sinus as it is only one pole, also didn’t appear to be renolith. Was thinking calcification? But why so focal? (attached 2 video clips). Right kidney was normal. Cat also had multifocal hyperechoic liver nodules ranging from 0.25cm to 0.50cm. Main ddx – neoplasia, nodular regeneration? Waiting to see whether they are interested in pursuing further…
Thanks in advance for how to interpret these renal findings.
Jennifer
Comments
Im pretty sure the renal
Im pretty sure the renal lesion is an infarct as its adjacent to the stone and when the stones move they often leave a hyperechoic infarct trail in the adjacent cortex that can be highly variable in size and shape. You can see a more dramatic version of this pattern in the basic search i found in this main coon I scanned a while back
http://sonopath.com/members/case-studies/cases/end-stage-renal-dystrophy-10-year-old-mn-maine-coon-cat
The hyperechoic liver lesions are likely lipogramulomas which are frequent in diabetics dogs and cats but easy enough to fna.
Hyperechoic usually good unless biliary carcinoma which can be hyperechoic or isoechoic. Bad nodules in cat livers are more often hypoechoic.
Im pretty sure the renal
Im pretty sure the renal lesion is an infarct as its adjacent to the stone and when the stones move they often leave a hyperechoic infarct trail in the adjacent cortex that can be highly variable in size and shape. You can see a more dramatic version of this pattern in the basic search i found in this main coon I scanned a while back
http://sonopath.com/members/case-studies/cases/end-stage-renal-dystrophy-10-year-old-mn-maine-coon-cat
The hyperechoic liver lesions are likely lipogramulomas which are frequent in diabetics dogs and cats but easy enough to fna.
Hyperechoic usually good unless biliary carcinoma which can be hyperechoic or isoechoic. Bad nodules in cat livers are more often hypoechoic.
Thanks so much! We’ll see
Thanks so much! We’ll see what the LDDST shows…
Jennifer
Thanks so much! We’ll see
Thanks so much! We’ll see what the LDDST shows…
Jennifer