Case Study

Left ureteral mass with hydronephrosis and hydroureter in a 11 year old MN German Shepherd dog with suspected neoplasia

An 11-year-old MN German shepherd cross was presented for evaluation of acute onset hematuria and anorexia. Additional history was weight loss over a 4-week period. Urinalysis showed SG of 1.030, 3+ blood, and 4+ protein. Mild hyperglobulinemia (4.2) and elevated creatinine was present on serum biochemistry. Survey radiographs were normal.

Sonographic Differential Diagnosis

Left ureteral mass, hydronephrosis, hydroureter. Possible metastatic disease.

Image Interpretation

Left ureteral mass was noted in this patient measuring approximately 3 x 2 cm obstructing the left ureter causing moderate hydronephrosis. Left kidney measured approximately 6 cm. Right kidney normal size and contour measuring 7 cm. Urinary bladder presented minor polypoid changes at the dorsal wall.

DX

Left ureteral mass, hydronephrosis, hydroureter. Possible metastatic disease.

Outcome

FNA of the liver is recommended followed by potential left ureterectomy, nephrectomy. No other evidence of neoplasia was noted. 3-view chest radiographs also recommended. If no evidence of metastatic disease, then complete left nephrectomy and left ureterectomy are recommended and inspection of the dorsal bladder for the origin of the polyps that may need to be resected as well. Strong suspicion for ureteral sarcoma or carcinoma.

Clinical Differential Diagnosis

Bladder – neoplasia, urolith, bacterial cystitis, polyploid cystitis
Prostate – neoplasia
Kidney – renolith, neoplasia
Systemic – hypertension, bleeding tendency