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Medullary rim kidneys in a 6 month old Persian

Case Study

Medullary rim kidneys in a 6 month old Persian

A 6-month-old NM Persian was presented for evaluation of failing to gain weight and chronic pyrexia. PCV was low (19%), total proteins elevated (10), and negative for FeLV, FIV, and Mycoplasma.

A 6-month-old NM Persian was presented for evaluation of failing to gain weight and chronic pyrexia. PCV was low (19%), total proteins elevated (10), and negative for FeLV, FIV, and Mycoplasma.

DX

Medullary Rim Kidney

Sonographic Differential Diagnosis

Multi centric lymphoma or dry form FIP

Image Interpretation

The kidneys presented medullary rim sign with expansive nodular cortical changes and generalized renomegaly. The right kidney measured 4.48 cm. The left kidney measured 3.8 cm. Regional inflammation was noted around both kidneys.

The mesenteric lymph node was enlarged and hypoechoic with irregular disrupted architecture measuring 2.8 x 2.0 cm. A cluster of lymph nodes measured 3.2 cm at the mesenteric root.

Outcome

Medullary rim kidney with disrupted architecture. Subcapsular halo noted around both kidneys with pericapsular inflammation. Multi centric lymphoma or dry form FIP are the primary differentials in this case. Ultrasound-guided FNA of the kidneys primarily the caudal aspect of the right kidney as well as mesenteric lymph nodes would be recommended. Very guarded prognosis depending on cytology results.
The cranial mediastinum revealed a slight, hypoechoic consolidation as well. This is suggestive for metastatic disease.

Clinical Differential Diagnosis

FIP, Chronic bacterial infection – peritonitis, pyothorax, Abscess/granuloma

Patient Information

Patient Name : Chaucer Scharpf
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Code : 06_00369

Clinical Signs

  • Failure to gain weight
  • Fever

Exam Finding

  • Fever

Images

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Blood Chemistry

  • BUN low
  • Total Protein, High

CBC

  • Hematocrit, Low

Clinical Signs

  • Failure to gain weight
  • Fever