Case Of the Month

Protein losing nephropathy, glomerulonephritis, and uremic gastritis in a 3 year old intact male Labrador Retriever: Our December Case Of The Month

A 3-year-old intact male Labrador Retriever was presented for anorexia and weight loss. CBC was within normal limits, however blood chemistry showed hyperproteinemia, hypoalbuminemia, low albumin/globulin ratio, marked azotemia, hyperphosphatemia, mild hypocalcemia, hyperkalemia, and hyperamylasemia. T4 was within normal range. The urine had a cloudy appearance; 3+ proteinuria and 3+ hematuria were present on urinalysis.

DX

Protein-losing nephropathy, glomerulonephritis, uremic gastritis.

Outcome

The patient was euthanized due to financial limitations and poor prognosis.

Clinical Differential Diagnosis

Renal disease – acute, chronic, congenital, pyelonephritis, neoplasia. Nephrotic syndrome. Primary glomerulonephritis with secondary renal failure.

Sampling

None.

Sonographic Differential Diagnosis

Glomerulonephritis – protein losing nephropathy. Suspect Lyme nephritis, or similar immune complex disease. Uremic gastritis.

Image Interpretation

The kidneys present thickened and uniformly echogenic cortices that are hypervascular on power Doppler evaluation. Slight pyelectasia is present due either to fluid therapy (< 0.3 cm) or due to infection (pyelonephritis). The gastric wall is edematous and uniformly thickened consistent with gastritis.