Case Study

Ureteral stones (calculi) with ureteral obstruction and hydronephrosis in a 5 year old FS Shih-tzu dog

A 5-year-old FS Shih-tzu dog presented for intermittent vomiting one week duration, inappetance. The clinical exam revealed upper abdominal discomfort. The bloodwork revealed elevated white blood cell count and normal blood chemistry. Two radiopaque marble size structures noted on abdominal radiographs suspected to be nephroliths or intestinal foreign body. Urinalysis was pending at the time of the sonogram.

DX

Ureterolithiasis with hydronephrosis and bladder calculi

Sonographic Differential Diagnosis

Ureterolithiasis with hydronephrosis and bladder calculi.

Image Interpretation

The left kidney measured 4.11 cm and the right kidney measured 3.68 cm, both were normal in size. Renal cortical echogenicity was normal as is corticomedullary distinction specifically in the right kidney. The left kidney was markedly distended with fluids with severe hydronephrosis. The left ureter was dilated to 1.34cm and there were two ureteroliths noted within the ureter. The more proximal one measured 1.21cm and was non obstructive and the second one was located in close proximity measuring 1.16cm and was definitively obstructive. There were a few tiny nephroliths noted in the right kidney but they were non obstructive and there was no evidence of pelvic dilation in the right kidney. The urinary bladder was normal in appearance and there was no evidence of any masses within the bladder. Several small uroliths were noted to be gravity dependent in the bladder. The trigone area was visualized and was normal. Wall thickness was appropriate.