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Ureterolith with hydronephrosis in a 13 year old FS Dachshund

Case Study

Ureterolith with hydronephrosis in a 13 year old FS Dachshund

A 13-year-old female spayed Dachshund was presented for evaluation of weight loss, inappetence, and frequent urination. Urinalysis showed inappropriate SG (1.020), proteinuria, and hematuria. Abnormalities on CBC and serum biochemistry included leukocytosis, mild anemia, and hypoalbuminemia.

A 13-year-old female spayed Dachshund was presented for evaluation of weight loss, inappetence, and frequent urination. Urinalysis showed inappropriate SG (1.020), proteinuria, and hematuria. Abnormalities on CBC and serum biochemistry included leukocytosis, mild anemia, and hypoalbuminemia.

DX

Severe hydronephrosis and blood clot of the right kidney with ureteral calculi

Sonographic Differential Diagnosis

Severe hydronephrosis and blood clot of the right kidney with ureteral calculi. Mild degenerative changes in the left kidney with non-obstructive calculi. The left kidney appears structurally viable and should be able to maintain metabolic homeostasis in this patient without the presence of the right kidney.

Image Interpretation

The urinary bladder, trigone and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. A large amount of dependent debris was noted in the urinary bladder. This is consistent with clotted blood. No evidence of inflammatory or neoplastic changes were noted. The right ureter was dilated at 0.3 cm with two separate calculi within the right ureter at the level of the mid bladder. The larger calculus measured 0.63 cm in length. The right kidney in this patient was composed of a mixed, hypoechoic mass or large blood clot due to hydronephrosis measuring 4.82 x 3.8 cm. Generalized renomegaly was noted that measured 6.35 cm. It demonstrated cortical blood flow, however, no blood flow was noted in the medulla which would suggest hydronephrosis and blood clot. The left kidney appeared structurally unremarkable with minor degenerative changes and corticomedullary calculi that were non obstructive. The left kidney measured 5.01 cm. A slight amount of pyelectasia was noted in the left kidney.

Outcome

None

Comments

Recommend right nephrectomy and ureterectomy.

Clinical Differential Diagnosis

Renal disease – pyelonephritis, neoplasia, renoliths. Bladder disease – uroliths, chronic cystitis, neoplasia. Blood loss – GIT (neoplasia, foreign body, ulcer), splenic/hepatic neoplasia.

Sampling

None

UA Specific Gravity Range

1.020

Patient Information

Patient Name : Anna G
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 06_00174

Clinical Signs

  • Anorexia
  • Polyuria
  • Weight loss

Images

anna_gray_rk_hydronephrosis_blood_clot_ubanna_gray_rk_hydronephrosis_blood_clot_rt_ureteral_stonesanna_gray_rk_hydronephrosis_blood_clotanna_gray_rk_hydronephrosis_blood_clot_rk_no_flowanna_gray_rk_hydronephrosis_blood_clot_lk_2anna_gray_rk_hydronephrosis_blood_clot_lk

Blood Chemistry

  • Albumin, Low

CBC

  • RBC, Low
  • WBC, High

Clinical Signs

  • Anorexia
  • Polyuria
  • Weight loss

Urinalysi

  • Blood Present
  • Protein Present
  • Specific Gravity Low