This is a 4 yr old lab. Is profoundly pd. also pu. urine sg 1011. normal bloodwork. lean body condition. the owner reports always pd. has been treated by referring vet with desmopressin with little effect.I would like opinion on the renal medulla . It appears to have some echogenicity. could this be consistent with tublar disease? thanks
This is a 4 yr old lab. Is profoundly pd. also pu. urine sg 1011. normal bloodwork. lean body condition. the owner reports always pd. has been treated by referring vet with desmopressin with little effect.I would like opinion on the renal medulla . It appears to have some echogenicity. could this be consistent with tublar disease? thanks
Comments
structurally unremarkable
structurally unremarkable consider psychogenic pdpu or medullary washout
structurally unremarkable
structurally unremarkable consider psychogenic pdpu or medullary washout
Thanks .One more question,
Thanks .One more question, it’s nagging me, I thought I saw in the forum a case with a hazy medullary space. Do we equate that with tubular diseases? I can’t find specific reference can you direct me to a good one?
Thanks .One more question,
Thanks .One more question, it’s nagging me, I thought I saw in the forum a case with a hazy medullary space. Do we equate that with tubular diseases? I can’t find specific reference can you direct me to a good one?
unfortunately its a non
unfortunately its a non specific finding. I don’t kow of any literature correlating proteinuria with ill defined cm junction… maybe Remo has something up his sleeve:)..I would love to do a study on the frequency of pyuria and ill-defined renal pelvic fat and do the same with pyelectasia. Could likely do it right off our on line and back room archive in the 100s of cases:)
When the structural lines of any organ are disrupted or nebulous look for inflammation or neoplasia (when dramatic) associated with it… in this case if the CM junction is ill defined run a UA (if not already done) looking for proteinuria and inflammatory sediment to support the suspicion of pathology whether nephritis… if the deviation from curvilinear patterns is dramatic then needs an FNA to start… i.e. renal lymphoma or carcinoma.
Thanks as always! Good info .
Thanks as always! Good info . Have a great hands on lab weekend wish I could have fit it in.
unfortunately its a non
unfortunately its a non specific finding. I don’t kow of any literature correlating proteinuria with ill defined cm junction… maybe Remo has something up his sleeve:)..I would love to do a study on the frequency of pyuria and ill-defined renal pelvic fat and do the same with pyelectasia. Could likely do it right off our on line and back room archive in the 100s of cases:)
When the structural lines of any organ are disrupted or nebulous look for inflammation or neoplasia (when dramatic) associated with it… in this case if the CM junction is ill defined run a UA (if not already done) looking for proteinuria and inflammatory sediment to support the suspicion of pathology whether nephritis… if the deviation from curvilinear patterns is dramatic then needs an FNA to start… i.e. renal lymphoma or carcinoma.
Thanks as always! Good info .
Thanks as always! Good info . Have a great hands on lab weekend wish I could have fit it in.
Would recommend a modified
Would recommend a modified water deprivation test as the PuPd has been going on for a long time. Basically need to gradually restrict the water intake over a number of days before withdrawing it completeley and if the SG does not increase the use desmopressin.
Basic protocol:
100 mls water/kg per day for 2-3 days, then 80 mls/kg per day for 2-3 days, then 60 mls water/kg per day for 2-3 days. Increasing the protein and salt content of the diet helps in re-establishing the medullary solute. After the the couple of days of restricted water, remove all water (and food) and monitor body weight, PCV, and urine SG. If psychogenic/medullary solute wash-out then SG will increase. If not the use desmopressin and if SG increases then have a diabetes insipidus.
Thank you very much. This was
Thank you very much. This was a referral for imaging but I will talk with the RDVM about this I am sure they will appreciate the information.
Would recommend a modified
Would recommend a modified water deprivation test as the PuPd has been going on for a long time. Basically need to gradually restrict the water intake over a number of days before withdrawing it completeley and if the SG does not increase the use desmopressin.
Basic protocol:
100 mls water/kg per day for 2-3 days, then 80 mls/kg per day for 2-3 days, then 60 mls water/kg per day for 2-3 days. Increasing the protein and salt content of the diet helps in re-establishing the medullary solute. After the the couple of days of restricted water, remove all water (and food) and monitor body weight, PCV, and urine SG. If psychogenic/medullary solute wash-out then SG will increase. If not the use desmopressin and if SG increases then have a diabetes insipidus.
Thank you very much. This was
Thank you very much. This was a referral for imaging but I will talk with the RDVM about this I am sure they will appreciate the information.