- 6 year old fs Brussels Griffon presented for 2 day history of vomiting, anorexia, depression
- No known exposure to toxins
- PE shows profound depression and moderate dehydration
- Chem prof showed BUN>180, Creat=9.3, glu=170, TP=8.1, ALB=2.7, Ca=10.9, Na=144, K=5.9, Glob=5.4, P=21.9.
- Both kidneys show increased cortical thickness and echogenicity-size appears low normal for this size dog in the 3.5cm range. There is moderate loss of corticomedullary definition. Mineralization is present in the right kidney.
- 6 year old fs Brussels Griffon presented for 2 day history of vomiting, anorexia, depression
- No known exposure to toxins
- PE shows profound depression and moderate dehydration
- Chem prof showed BUN>180, Creat=9.3, glu=170, TP=8.1, ALB=2.7, Ca=10.9, Na=144, K=5.9, Glob=5.4, P=21.9.
- Both kidneys show increased cortical thickness and echogenicity-size appears low normal for this size dog in the 3.5cm range. There is moderate loss of corticomedullary definition. Mineralization is present in the right kidney.
- U/A obtained by US guided cysto post IV fluid administration showed 4+ bacteruria with no evidence of inflammation and no crystalluria. USG=1.015. 1+proteinuria.
- R/O’s include toxin, Lepto (wrong time of year up here), acute dehydration? acute on top of chronic?
Comments
Looks like a chronic
Looks like a chronic interstitial nephrosis. Check chronic lepto here. Stone in the renal pelvis so may be moving stones adding to insult along with the UTI. Mixed bag here acute on chronic RF so Tx the acuite issues otherwise renal Bx.
Looks like a chronic
Looks like a chronic interstitial nephrosis. Check chronic lepto here. Stone in the renal pelvis so may be moving stones adding to insult along with the UTI. Mixed bag here acute on chronic RF so Tx the acuite issues otherwise renal Bx.
Should consider Addison’s as
Should consider Addison’s as well – clinical signs, low-normal sodium, elevated potassium, Na:K ratio 24:1
Should consider Addison’s as
Should consider Addison’s as well – clinical signs, low-normal sodium, elevated potassium, Na:K ratio 24:1
Thx Remo yes … renal
Thx Remo yes … renal failure always check that the “great pretender” isn’t a player:)
Any time I have unexplained renal failure especially in a patient between 3-9 years of age and especially if flat adrenals ruling out Addison’s is essential. These kidneys look pretty lumped up though but other factors sending him over the edge… addisons as Remo pointed out, hypertension, infection, infarcts, toxins, acute phase disease of any sort is usually the scenario in the end…acute on chronic disease smoldering til 60-70% of function is compromised and then they go into true IRIS stages of RF.
Thx Remo yes … renal
Thx Remo yes … renal failure always check that the “great pretender” isn’t a player:)
Any time I have unexplained renal failure especially in a patient between 3-9 years of age and especially if flat adrenals ruling out Addison’s is essential. These kidneys look pretty lumped up though but other factors sending him over the edge… addisons as Remo pointed out, hypertension, infection, infarcts, toxins, acute phase disease of any sort is usually the scenario in the end…acute on chronic disease smoldering til 60-70% of function is compromised and then they go into true IRIS stages of RF.
Thank you for your input.
Thank you for your input. This case is especially challenging because it presented as a new client with no documented history, no previous labs to compare to, etc.
Thank you for your input.
Thank you for your input. This case is especially challenging because it presented as a new client with no documented history, no previous labs to compare to, etc.