Ureteral Cystic Structure

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Ureteral Cystic Structure

  • 12YO FS DSH

    • 12YO FS DSH
    • Recurrent cystitis:  rDVM treated 3 UTIs in the past 4 months. 
    • Today’s U/A: USG = 1.014 
    • Sediment with WBCs >100,  RBCs 60-75 pHPF, Bacteria > 40 pHPF 
    • BUN = 56, CREAT = 2.2 (0.9-2.5) , Alb = 2.5.  
    • Significant weight loss noted.  T4 WNLs.

    Findings:

    1. Left renal size is low normal and measures 3.5cm in length.
    2. Left kidney has a moderately irregular in shape. Mild renal pyelectasis is documented.
    3. The proximal left ureter is  dilated  (2.4mm). It remains mildly dilated for ~2-3 cm distally as it is visualized to connect to a round, thin-walled cystic structure (which I assume is a focal dilatation of the ureter). This cystic strucure measures 1.2cm in diameter.It is fluid filled (far field enhancement) and contains dependent and mildly hyperechoic debris. Color flow documents that some of this debris has a “sparkle affect” which is characteristic of discrete mineralization surrounded by fluid. 
    4. Approximately 2cm distal to this “cyst”, the left ureter is followed to a 1mm stone.

    So, I have all seen stones in the kidney and ureter causing some degree of out flow obstruction and ureteral dilation. But I have not seen a perfectly rounded thin walled cyst which appears to harbor a bacterial infection.

    Has anyone else seen this type ureteral cystic/abscess lesion in a dog or cat?

    Second video below follows ureter to the 1mm stone (with shadow).

     

     

     

Comments

EL
February 17, 2015 at 3:42 am -

Thsi is an oddball for sure

Thsi is an oddball for sure but stone movers do weird things with their ureters over time.

EL
February 17, 2015 at 3:42 am -

Thsi is an oddball for sure

Thsi is an oddball for sure but stone movers do weird things with their ureters over time.

randyhermandvm
February 17, 2015 at 11:34 am -

I did a VIN search and not

I did a VIN search and not much came up. Kathy James did write that these cysts are either a develpmental problem or secondary to obstruction by stones or neoplasia. I don’t think that helps much since I cant think of another reason. I guess they must have been seen before on ultrasound

I suppose it would be possible to get an “aneursyn” type lesion if there was injury or weakness in the wall of the ureter.

randyhermandvm
February 17, 2015 at 11:34 am -

I did a VIN search and not

I did a VIN search and not much came up. Kathy James did write that these cysts are either a develpmental problem or secondary to obstruction by stones or neoplasia. I don’t think that helps much since I cant think of another reason. I guess they must have been seen before on ultrasound

I suppose it would be possible to get an “aneursyn” type lesion if there was injury or weakness in the wall of the ureter.

VSI7tsherrill
February 17, 2015 at 1:43 pm -

Thanks Eric and Randy for

Thanks Eric and Randy for your comments. Good thought about the possibility of an aneurysm forming off the ureteral wall. I so wanted to drain this  and do C&S, but I think that would have done more harm than good.  I will post kidney images to complete this post.

randyhermandvm
February 18, 2015 at 2:55 am -

I did some research about

I did some research about ureteral cysts in people and they have drained them. They always recur- so they are a surgical issue. Thanks for sharing. I learn something new every day.

VSI7tsherrill
February 17, 2015 at 1:43 pm -

Thanks Eric and Randy for

Thanks Eric and Randy for your comments. Good thought about the possibility of an aneurysm forming off the ureteral wall. I so wanted to drain this  and do C&S, but I think that would have done more harm than good.  I will post kidney images to complete this post.

randyhermandvm
February 18, 2015 at 2:55 am -

I did some research about

I did some research about ureteral cysts in people and they have drained them. They always recur- so they are a surgical issue. Thanks for sharing. I learn something new every day.

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