2 year old M/N Cairn Terrier, 11.5kg
Presented to rDVM Oct 1, 2014 for inappropriate urination. Normal on PE. Catheterized urine sample cultured negative but put on short course of ABs while waiting for results. USG 1.026, pH 7.5, trace protein, 3+ WBC/2+ RBC/fat droplets on sediment.
2 year old M/N Cairn Terrier, 11.5kg
Presented to rDVM Oct 1, 2014 for inappropriate urination. Normal on PE. Catheterized urine sample cultured negative but put on short course of ABs while waiting for results. USG 1.026, pH 7.5, trace protein, 3+ WBC/2+ RBC/fat droplets on sediment.
Presented to rDVM March 10, 2015 for lethargy with small burst of energy and still inappropriate urination. Dog is not pu/pd (actually hardly drinks at all, which drives the owners crazy!). Normal on PE. Catheterized urine sample cultured negative, USG 1.015, pH 7, sediment quiet. 4DX negative. CBC/CHEM/T4 – CREA 144 (44-133), otherwise WNLs.
Full abdominal ultrasound – no abnormalities noted other than both kidneys have focal hyperechoic area in cranial pole (in both LA and SA views). No pyelectasia seen (<1mm), no “streaking” in cortex , renal size normal (4.5cm), CM distinction normal.
Initially wondered about acute pyelonephritis (as I understand kidneys can appear “normal”), but would have expected to see renomegaly, right? Could this be infarcts or am I being caught be a “normal variation”?
Essentially we have a breeder who is arguing it is behavioral, and a owner who wants to make sure it’s not medical, and the rDVM is caught between the two! So far the only plan they have is repeating the bloodwork/UA next month.
Thanks
Jennifer
Comments
There is a trace amount of
There is a trace amount of pyelectasia in the kidney (arrow) but this is aspecific and the rest of the kidney looks unremarkable. Trace pyelectasia up to 0.3 cm can be from diuresis but of course pyelo possible and I have seen it in PUPD dogs with no other pathology. The renal pelvic fat is not ill-defined either so if pyelo its very minor or resolving. I see this in older animals as well in idiopathic scenarios and believe it to be an age related change in many older patients but this issue is not really well defined. Have to place it with the case and follow-up after treating UTI at times.
The focal hyperechoic areas are normal and idiopathic cortical presentation.
Pyelonephritis has a variety of presentations whether acute vs chronic vs acute-on-chronic… Try a basic search and see what comes up… there are about 100+ cases in this search:)
http://sonopath.com/members/case-studies/search?text=Pyelonephritis&species=All
There is a trace amount of
There is a trace amount of pyelectasia in the kidney (arrow) but this is aspecific and the rest of the kidney looks unremarkable. Trace pyelectasia up to 0.3 cm can be from diuresis but of course pyelo possible and I have seen it in PUPD dogs with no other pathology. The renal pelvic fat is not ill-defined either so if pyelo its very minor or resolving. I see this in older animals as well in idiopathic scenarios and believe it to be an age related change in many older patients but this issue is not really well defined. Have to place it with the case and follow-up after treating UTI at times.
The focal hyperechoic areas are normal and idiopathic cortical presentation.
Pyelonephritis has a variety of presentations whether acute vs chronic vs acute-on-chronic… Try a basic search and see what comes up… there are about 100+ cases in this search:)
http://sonopath.com/members/case-studies/search?text=Pyelonephritis&species=All
The low SG is of concern and
The low SG is of concern and would be indicative of early renal disease, especaially with the mildly elevated creatinine, but should have PuPd. With behavioral issues would expect normal SG.
The low SG is of concern and
The low SG is of concern and would be indicative of early renal disease, especaially with the mildly elevated creatinine, but should have PuPd. With behavioral issues would expect normal SG.
Thank you both for your
Thank you both for your responses. The rDVM will be repeating the bloodwork (first am UA) and we plan on performing serial u/s rechecks.
Thanks again!
Jennifer
Thank you both for your
Thank you both for your responses. The rDVM will be repeating the bloodwork (first am UA) and we plan on performing serial u/s rechecks.
Thanks again!
Jennifer