Splenic nodule. End stage renal dystrophy in the right kidney with ureteral calculi, slight pyelectasia and pelvic calculi in the left kidney with cortical infarcts, collapse and compensatory hypertrophy.
The renal pelvis in the left kidney in this patient is not dilated enough for potential ureteral bypass procedure with SUB device, as typically 0.5 cm of dilation is necessary for placement of SUB or stents. However, surgical intervention in order to liberate the ureteral stones would likely be in the patient’s best interest as the right kidney is likely not functional and the calculi appear to be embedded in the proximal ureter. Minor inflammatory/fibrotic pattern is noted around the left ureter. The calculi are obstructed approximately 2.5 cm caudal from the left renal pelvis. Nephrotomy to liberate the pelvic calculi may be in the patient’s best interest as well from a surgical standpoint as the largest calculus is nearly 1.0 cm. Other calculi are greater than 0.4-0.5 cm, which are typically too large to pass into the ureters. Perinephric inflammatory pattern was noted around the left kidney as well. Ideally the splenic nodule would be sampled.
Nodular hyperplasia is possible, yet relatively rare in cats. Abscessation or possible
round cell neoplasia are all possibilities.