Case Study
A young (< 1 year) intact female was presented for evaluation of PU/PD and a hematocrit of 26.
Sonographic Differential Diagnosis
-The urinary bladder, trigone and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. No uroliths or sediment were visualized. No evidence of inflammatory or neoplastic changes were noted.
-The uterus was uniform and measured 1.05 cm.
-The kidneys presented thickened, irregular cortices with nodular, expansion and disruption of architecture. Corticomedullary and pelvic infrastructure was completely disrupted. This is strongly consistent with primary renal dysplasia. Pyelectasia in both kidneys would suggest concurrent pyelonephritis. Cortical infarcts were noted in both kidneys. The left kidney revealed slight pyelectasia that measured 0.55 cm and 5.15 cm in length. The right kidney revealed pyelectasia that measured 0.54 cm and 5.03 cm in length. The right and left ureters were dilated in this patient.
DX
Outcome
Urine culture and sensitivity would be warranted as well as blood pressure measurements. Treatment for chronic renal failure would be recommended. Renal biopsy would be indicated. This is strongly suggestive for primary renal dysplasia. Prognosis is very guarded.
Clinical Differential Diagnosis
-Renal – congenital renal disease, pyelonephritis, chronic kidney disease from prior renal insult, obstructive uropathy, renoliths
-Addison’s disease
-Lymphoma
Patient Information
Clinical Signs
- Abdominal Pain
- Lethargy
- Polydipsia
- Polyuria
Exam Finding
- Abdominal Pain
Images
CBC
- Hematocrit, Low
Clinical Signs
- Abdominal Pain
- Lethargy
- Polydipsia
- Polyuria