2 year old FS DSH, more lethargic lately, some defecation outside the litter box. Did have a previous short episode of vomiting that resolve. Kidney values have been elevated – BUN 47, creat 3.3, phos 4.5, albumin 4.1 HCT 34, Urine SpG 1.047, 2+ protein on dipstick, but inactive sediment and UPC 0.1. Blood pressure today 115 systolic. No murmur. The left kidney looks to me like has either mineralization or a non-obstructive urolith and is small. The right kidney is normal in size, but has a very irregular capsule in two regions, including a hyperechoic wedge region suggesting infarction to me. No uroliths in urinary bladder and rest of ultrasound was WNL. Would love your input for this poor 2 year old nice cat.
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Bilateral chronic kidney disease with mineralization and a right sided infarction. Etiologies would be previous bacterial nephritis, previous obstructive uropathy, previous acute kidney injury (hypoxia, toxins), and with the cat’s age congenital renal disease. Needs to be managed as for chronic kidney disease – renal diet, enteric phosphate binders, either an ACE inhibitor or ACE receptor blocker.
Thank you so much Dr. Lobetti! Very helpful.