Can someone help me interpret at these images? I find the subtle changes in kidneys difficult to parse out between normal aging variation and disease processes. First:
Can someone help me interpret at these images? I find the subtle changes in kidneys difficult to parse out between normal aging variation and disease processes. First:
- 6 year old mn DSH cat
- History of relinquishing to vet hospital due to bladder stones chronic urinary issues
- Stones disappeared on SO while in hospital
- Recent onset of acute bladder pain about 1 week after rehoming
- Radiograph post u/s was negative for stones in urethra, cat is not blocked but does not empty bladder fully
- I am worried about the marked medullary rim sign and mild pyelectasia (I think visible in the video that I can’t get to post) in a cat that has had no fluids. Bladder now appears normal on u/s with no sand or sediment.
Second:
- 4 year old FI Coton de Tulear.
- Owner (my boss – another veterinarian) has noticed consistently dilute urine. The dog was difficult to housetrain.
- These kidneys also showed a hyperechoic corticomedullary junction and thin cortex. I’m not sure if there is any significance. Left measured 3.69 and right 4.17 cm.
Thanks for all thoughts and teaching. 
Liz
Comments
Medullary rim can be
Medullary rim can be idiopathic and have nothing to do wit the clinical issue or more significant if PLN is the case. Pyelectasia can occur from diuresis, uti, scarring and potentially age related like an old cat with dilated duct but no study has said this yet that i know of. Bottom line is when the kidneys have minor changes such as these I just back of the sonogram and look at the clinical scenario and ask what does this? Trial tx for uti? partial water dep test?, acth stim? usually at that point the case is resolved. A negative or bland sonogram is as important as a + find and its important to relay this to the client. Rule out the obvious badness and tx the reality of what is left.
Medullary rim can be
Medullary rim can be idiopathic and have nothing to do wit the clinical issue or more significant if PLN is the case. Pyelectasia can occur from diuresis, uti, scarring and potentially age related like an old cat with dilated duct but no study has said this yet that i know of. Bottom line is when the kidneys have minor changes such as these I just back of the sonogram and look at the clinical scenario and ask what does this? Trial tx for uti? partial water dep test?, acth stim? usually at that point the case is resolved. A negative or bland sonogram is as important as a + find and its important to relay this to the client. Rule out the obvious badness and tx the reality of what is left.
Hey Eric –
Have we figured
Hey Eric –
Have we figured out what’s going on with the video? I still can’t seem to post it…
So, with a cat with a history of bladder stones and significant pain on palpation of the urinary bladder, would you not worry about the images above due to the subtlety of the sonographic changes?
And in the second set of images, is the cortex actually thin or is that a nonsignificant finding?
Thanks for your help,
Liz
Hey Eric –
Have we figured
Hey Eric –
Have we figured out what’s going on with the video? I still can’t seem to post it…
So, with a cat with a history of bladder stones and significant pain on palpation of the urinary bladder, would you not worry about the images above due to the subtlety of the sonographic changes?
And in the second set of images, is the cortex actually thin or is that a nonsignificant finding?
Thanks for your help,
Liz
The changes are both
The changes are both aspecific. I see them all the time in normal animals with uneventful urine. Really depends on the case.
Tech support was working on the video upload. It was a video press issue and not a sonopath issue.
The changes are both
The changes are both aspecific. I see them all the time in normal animals with uneventful urine. Really depends on the case.
Tech support was working on the video upload. It was a video press issue and not a sonopath issue.