Post By Pam Schott This 10 year old MN DSH cat has an elevated Calcium (12.2, ionized calcium pending) and weight loss (16 down to 14), remainder of bloodwork normal. 
Both kidneys looked similar.
Post By Pam Schott This 10 year old MN DSH cat has an elevated Calcium (12.2, ionized calcium pending) and weight loss (16 down to 14), remainder of bloodwork normal. Both kidneys looked similar. To me the kidneys look very abnormal; the remainder of the abdominal organs looked normal to me; I performed FNA of each kidney and the spleen. I am thinking this is lymphosarcoma and of course cat belongs to a staff member…
Comments
Pam this is a chronic
Pam this is a chronic interstitial nephrosis pattern with a medullary rim and unfortunately its subjectively end stage from a structural standpoint. You may just be getting a calcium spike before the phosphorus so watch the usg then bun and then creat but they dont always follow that order.BP as well. I doubt this is lsa because the capsule is in tact and no distortion like lsa.. Needs a bx to be sure but prognosis is poor long term.
Attached are typical lsa kidneys not the subcapsular capping and the hypoechoic mass distorting the cm junction. Fna will suffice in these images but given that interstitial nephrosis in your image is a structural disease you need bx for the dx. Sometimes with that medullary rim dry fip comes back as well.
Pam this is a chronic
Pam this is a chronic interstitial nephrosis pattern with a medullary rim and unfortunately its subjectively end stage from a structural standpoint. You may just be getting a calcium spike before the phosphorus so watch the usg then bun and then creat but they dont always follow that order.BP as well. I doubt this is lsa because the capsule is in tact and no distortion like lsa.. Needs a bx to be sure but prognosis is poor long term.
Attached are typical lsa kidneys not the subcapsular capping and the hypoechoic mass distorting the cm junction. Fna will suffice in these images but given that interstitial nephrosis in your image is a structural disease you need bx for the dx. Sometimes with that medullary rim dry fip comes back as well.
renal lsa for example 1
renal lsa for example 1
renal lsa for example 1
renal lsa for example 1
lsa image 1
lsa image 1
lsa image 1
lsa image 1
lsa image 2
lsa image 2
lsa image 2
lsa image 2
Ideally need USG, urine
Ideally need USG, urine protein, BUN/creatinine, and phosphate to get an idea of renal function as kidneys may appear very abnormal on US but still have reasonable function and thus weight loss may not be of renal origin.
Ideally need USG, urine
Ideally need USG, urine protein, BUN/creatinine, and phosphate to get an idea of renal function as kidneys may appear very abnormal on US but still have reasonable function and thus weight loss may not be of renal origin.
Thank you very much for
Thank you very much for managing my crazy file and for the comments. Creatinine is 2.1, BUN normal, phosphorus normal, USG 1.036 so no renal function prob yet. Ionized calcium is pending. I’m glad you guys don’t think it’s LSA and thanks for the examples. I am still concerned because owner has been trying to get this cat to lose weight forever, and then he dropped 2 lbs in 3 months…will post cytology result when available.
Pam
Thank you very much for
Thank you very much for managing my crazy file and for the comments. Creatinine is 2.1, BUN normal, phosphorus normal, USG 1.036 so no renal function prob yet. Ionized calcium is pending. I’m glad you guys don’t think it’s LSA and thanks for the examples. I am still concerned because owner has been trying to get this cat to lose weight forever, and then he dropped 2 lbs in 3 months…will post cytology result when available.
Pam