Hello,
Lizzie is a 15 years old DMH F/S that presented with chronic vomiting and weight loss.
Her LK I suspect is nonfunctional, however the right one is abnormal : increased cortical echogenicity with 1: 1 ratio, preserved corticomedullary junction and mild pyelectasia. Wondering if this changes are suggestive of Lymphoma, end stage CRF or compensatory hypertrophy only? I have to tell you that there is mesenteric mild lymphadenopathy and pylorus wall is thickened with a 1:1 ratio of mucosa to muscularis.
Hello,
Lizzie is a 15 years old DMH F/S that presented with chronic vomiting and weight loss.
Her LK I suspect is nonfunctional, however the right one is abnormal : increased cortical echogenicity with 1: 1 ratio, preserved corticomedullary junction and mild pyelectasia. Wondering if this changes are suggestive of Lymphoma, end stage CRF or compensatory hypertrophy only? I have to tell you that there is mesenteric mild lymphadenopathy and pylorus wall is thickened with a 1:1 ratio of mucosa to muscularis.
owner didn’t allow an FNA, so I’m considering treatment trial.Thank you.
Comments
Vetecho I’m not thinking LSA
Vetecho I’m not thinking LSA here at all but this is a pyelonephritis pattern. The long arrow shows the hypoechoic dilated renal pelvis, middle arrow shows ill-defined pelvic fat which are indicative of pyelonephritis. You can get pyelectastia with fluid tx up to 0.3 cm wide or peyelectasia with pelvic scarring but in the presence if ill-defined pelvic fat this is pyelo until proven otherwise…you can decompress and cuulture with a 25 g pyelocentesis as well here.
Now you can have LSA with pyelo at times but my argument against lsa is that the the small arrows show a very in tact corticomedullary junction and renal capsule respectively. LSA and other neoplasia disrupt these structural elements indicated by the small arrows and will often distort the renal pelvis as well. None of these issues are present here.
Here is a more aggressive version of pyelo in a cat with cortical infarcts. This one I made sure there was no lsa with an fna because of the distorted capsule but that was from an infarct which often happens in pyelo.
http://sonopath.com/members/case-studies/cases/pyelonephritis-and-left-renolith-10-year-old-fs-dsh-cat
25 gauge cortical fna is always a goiod idea in these cases to ensure you dont have a monocellular lymphoma infiltrate vs a mixed inflammatory cell population like you get in pyelo and fip as well.
Now compare with these renal lymphoma cases from the basic search:
http://sonopath.com/members/case-studies/search?text=renal+lymphoma&species=All
Vetecho I’m not thinking LSA
Vetecho I’m not thinking LSA here at all but this is a pyelonephritis pattern. The long arrow shows the hypoechoic dilated renal pelvis, middle arrow shows ill-defined pelvic fat which are indicative of pyelonephritis. You can get pyelectastia with fluid tx up to 0.3 cm wide or peyelectasia with pelvic scarring but in the presence if ill-defined pelvic fat this is pyelo until proven otherwise…you can decompress and cuulture with a 25 g pyelocentesis as well here.
Now you can have LSA with pyelo at times but my argument against lsa is that the the small arrows show a very in tact corticomedullary junction and renal capsule respectively. LSA and other neoplasia disrupt these structural elements indicated by the small arrows and will often distort the renal pelvis as well. None of these issues are present here.
Here is a more aggressive version of pyelo in a cat with cortical infarcts. This one I made sure there was no lsa with an fna because of the distorted capsule but that was from an infarct which often happens in pyelo.
http://sonopath.com/members/case-studies/cases/pyelonephritis-and-left-renolith-10-year-old-fs-dsh-cat
25 gauge cortical fna is always a goiod idea in these cases to ensure you dont have a monocellular lymphoma infiltrate vs a mixed inflammatory cell population like you get in pyelo and fip as well.
Now compare with these renal lymphoma cases from the basic search:
http://sonopath.com/members/case-studies/search?text=renal+lymphoma&species=All
Thank you EL I all try to
Thank you EL I all try to get owner to allow an fna
A bit scarred because it s her only kidney….
Calin
Thank you EL I all try to
Thank you EL I all try to get owner to allow an fna
A bit scarred because it s her only kidney….
Calin
Hi Calin. Does blood work
Hi Calin. Does blood work point towards chronic kidney disease? Can also try and culture urine from the bladder as may get a result.
Hi Calin. Does blood work
Hi Calin. Does blood work point towards chronic kidney disease? Can also try and culture urine from the bladder as may get a result.
Hi Remo,
Bun was a bit high,
Hi Remo,
Bun was a bit high, creatinine normal and good concentration ability. I can’t remember CBC . I will check and update. I think also culture from bladder as owner declined any needle closer to her only kidney…
Hi Remo,
Bun was a bit high,
Hi Remo,
Bun was a bit high, creatinine normal and good concentration ability. I can’t remember CBC . I will check and update. I think also culture from bladder as owner declined any needle closer to her only kidney…