Big kidney little kidney

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Big kidney little kidney

  • Adult cat  in poor condition with right forelimb and left hindlimb neuropathy
  • Bloods: anaemia, hyperglobulinaemia, azotaemic, fiv+, toxo and coronavirus pending, SPE polyclonal gammopathy
  • Moderate HCM and main abdominal findings were kidenys with large nodular right kidney and smaller left kidney
  • Sampling declined pending remainder of blood results
    • Adult cat  in poor condition with right forelimb and left hindlimb neuropathy
    • Bloods: anaemia, hyperglobulinaemia, azotaemic, fiv+, toxo and coronavirus pending, SPE polyclonal gammopathy
    • Moderate HCM and main abdominal findings were kidenys with large nodular right kidney and smaller left kidney
    • Sampling declined pending remainder of blood results
    • Chronic left kidney with hypertrophied right. I had a case of nodules in cortex before that came back as iterstitial nephritis but could this be FIP? What changes does toxoplasma have on the kidneys?

Comments

DrMac

The right kidney is

The right kidney is definitely enlarged while the left kidney looks normal in size. Both kidneys are heterogenous with some loss of architecture in the left kidney. The enlarged right kidney has basically maintained architecture with ill defined hypoechoic nodules. 

The polycloncal gammopathy may indicate infection or immune mediated disease or FIP if an infection or imune mediated disease is not identified. FIP is not as common in adult cats but surely its possible. You can also see polyclonal gammopathy with neoplasia so neoplasia cant be ruled out. 

I don’t think Toxo really has an effect on the kidneys, maybe except for possible cyst formation in visceral disease? I cant think of an effect Toxo has on the kidneys…I think more CNS and maybe acute liver disease with Toxo. 

It looks like there is thickened SI and maybe pancreatic inflammation in the clip of the LK. 

I think I would put neoplasia / Lymphoma, FIP and nonspecific nephritis at the top of the list with the enlaged RK with nodular changes. FNA of the RK cortex using 25 ga needle and with normal coag panel would be the next move pending the testing. 

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