Dear all, this is the second case of potentially PKD I see in the past 10 days. Just a bit of reassurance on the correct diagnosis and next step forward.

– 5 years 7 months old FN British shorthair  cat. presented for sudden onset of loss of apetite and a 1 time green vomitus.

-CBC: mild lymphopenia (1.2, min 1.5). Marginal Ca elevation (12, max 11.8), low Phosphorus (2.8, range 3.4-8.5). NO AZOTEMIA. Normal liver enzymes and TBIL.

Dear all, this is the second case of potentially PKD I see in the past 10 days. Just a bit of reassurance on the correct diagnosis and next step forward.

– 5 years 7 months old FN British shorthair  cat. presented for sudden onset of loss of apetite and a 1 time green vomitus.

-CBC: mild lymphopenia (1.2, min 1.5). Marginal Ca elevation (12, max 11.8), low Phosphorus (2.8, range 3.4-8.5). NO AZOTEMIA. Normal liver enzymes and TBIL.

-ULTRASOUND: marked polycystic kidneys. Cysts appear somewhat irregular and cavernous with trabeculas rather than empty.  Numerous focci of distrophic mineralization inside and outside cystic lesions (in parenchyma). Both kidneys afected. Size is mildly enlarged (4.5cm kidneys, approx). Liver: 2 cystic structures; one in left lobes parenchyma of approx 2cm diameter (kind of irregular in size), one very round cystic structure beside or originating from CBD. GB appears mildly distended. Patient is very painful in the area. Reactive surrounding mesentery. No free fluid. To me…the cyst is actually not linked to CBD, but i cannot be sure.

-Questions: with the (to me) irregular cystic appearance, high calcium and low phosphorus and lack of Azotemia…can this be neoplasia rather than purely PKD? Are FNA/biopsy needed or contraindicated? What about the cystic lesion in CBD? I think considering the extent of lesions, and being bilateral, prognosis is poor regardless of whether PKD or neoplasia…Im just trying to decide whether we should do anything about the cystic area in CBD.

Thanks for any input.