Zepplin is a 16 1/2 year old DSH with a history of Stage 3 CKD and Stranguria that responds to Buprenorphine – like an idiopathic cystitis. I did an ultrasound and the bladder and as much of the urethra I could see looked normal. The urinalysis had some hematuria but the urine MIC was negative
The Left kidney looked very abnormal with a large Peri-renal cyst.
I was hoping to get some feedback. Could the pathology of this kidney be the cuase of LUTD? Seems unlikely- although the cyst may be painful. How would you proceed with what you see in these cines?
Zepplin is a 16 1/2 year old DSH with a history of Stage 3 CKD and Stranguria that responds to Buprenorphine – like an idiopathic cystitis. I did an ultrasound and the bladder and as much of the urethra I could see looked normal. The urinalysis had some hematuria but the urine MIC was negative
The Left kidney looked very abnormal with a large Peri-renal cyst.
I was hoping to get some feedback. Could the pathology of this kidney be the cuase of LUTD? Seems unlikely- although the cyst may be painful. How would you proceed with what you see in these cines?
The R kidney looke more nomal with changes consistent interstitial nephritis and irregularity to the capsule most likely caused by infarcts.
Thanks for any feeback.
Comments
Very abnormal kidney with
Very abnormal kidney with hyperechoic material within the cyst – usually peri-nephric cysts contain anechoic fluid. Would be concerned about renal neoplasia/infected renal cyst. Stretching of the renal capusle can cause pain and hence the response to the buprenorphine. Would drain the cyst with cytology of the fluid as well as FNA the kidney.
wow thats ugly lots of
wow thats ugly lots of inflammation on the last clip. Fna culture and tx aggressive acute on chronci rf
Thanks all. I’ll keep you
Thanks all. I’ll keep you informed
You may even have had some
You may even have had some hemorrhage in that cavity. I also agree cytology is needed to look for the root problem. The last video seems to outline an area when some of the contents are attached to the renal capsule. Some of the renoliths may be influencing the pathology as well. When aspirating the lesion investigate these two considerations as well.
Thank you all for your
Thank you all for your insight. Unfortunatly the owners are going to euthanize Zepplin