– 14 year old lab presented for weakenss, hyporexia, weight loss and vomiting, pu/pd, urinary incontinence
– bloodwork consistent with IRIS stage 3 renal failure(urine SG 1.017) and moderate elevations in ALP,ALT, non-regenerative anemia
– rDVM was concerned about a possible mass in the abdomen on x-ray
– u/s showed a slightly small liver with a nodular left liver lobe ( DDx: CAH with possible fibrosis, nodular hyperplasia, neoplasia (less likely))
– 1cm hypoechoic mass in the right adrenal gland (DDx: benign vs emerging neoplastic disease)
– 14 year old lab presented for weakenss, hyporexia, weight loss and vomiting, pu/pd, urinary incontinence
– bloodwork consistent with IRIS stage 3 renal failure(urine SG 1.017) and moderate elevations in ALP,ALT, non-regenerative anemia
– rDVM was concerned about a possible mass in the abdomen on x-ray
– u/s showed a slightly small liver with a nodular left liver lobe ( DDx: CAH with possible fibrosis, nodular hyperplasia, neoplasia (less likely))
– 1cm hypoechoic mass in the right adrenal gland (DDx: benign vs emerging neoplastic disease)
– both kidneys irregular capsular margins, decreased CM distinction, mild pylectasia, heteroechoic cortices with mineral foci and renal cyst in the right kidney
So to me the most concerning finding would be these kidneys as they look like chronic changes ( and bloodwork goes along with this) A urine pro:crea, BP and urine culture is recommended.
Late-stage kidney disease? If so, is there any point in working up the liver?
Comments
Very indicative of chronic
Very indicative of chronic kidney disease, heading towards end-stage. Liver most likely an incidental finding. Would add reactive and vacuolar hepatopathy as differentials.
Very indicative of chronic
Very indicative of chronic kidney disease, heading towards end-stage. Liver most likely an incidental finding. Would add reactive and vacuolar hepatopathy as differentials.
Note the cortical infarct in
Note the cortical infarct in the dorsal cortex…look for causes of hypercogulative state. This kidney subjectively looks degenerative but not a shriveled up end stage kidney though there are degenerative changes. Look for acute on chronic causes… uti, hypertension, maybe the adrenal is a pheo and driving the kidneys??? Unfortunately renal Bx is th eonlytthing that will tell for sure what is going on in the kidney itself.
Note the cortical infarct in
Note the cortical infarct in the dorsal cortex…look for causes of hypercogulative state. This kidney subjectively looks degenerative but not a shriveled up end stage kidney though there are degenerative changes. Look for acute on chronic causes… uti, hypertension, maybe the adrenal is a pheo and driving the kidneys??? Unfortunately renal Bx is th eonlytthing that will tell for sure what is going on in the kidney itself.
Negative for Borrelia and
Negative for Borrelia and Lepto?
Negative for Borrelia and
Negative for Borrelia and Lepto?
Thanks everyone. I dicussed
Thanks everyone. I dicussed Lepto titres and 4DX testing with rDVM but not sure further testing is in the budget for this one. The dog was vaccinated for Lepto. I too was wondering about a pheo esp. with the weakness episodes. I guess it wouldn’t hurt to try empirical antibitoics if further testing not in the plan.
Thanks everyone. I dicussed
Thanks everyone. I dicussed Lepto titres and 4DX testing with rDVM but not sure further testing is in the budget for this one. The dog was vaccinated for Lepto. I too was wondering about a pheo esp. with the weakness episodes. I guess it wouldn’t hurt to try empirical antibitoics if further testing not in the plan.