renal changes

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10 year old FS Bouvier w/ hyporexia and intermittent vomiting.  Renal azotemia – BUN 147, creat 7.9, phos 16, K WNL, HCT 40, SpG 1.016, 3+ protein and 10-20 WBCs w/o bacteria seen on urine cytology.  Culture pending.  With the mineralization, thinking chronic renal failure most likely, but with the relatively normal size for 65 lb dog and smooth capsule + proteinuria, would glomerulonephritis be high on your list? Dog is current on Lepto vaccine.  

10 year old FS Bouvier w/ hyporexia and intermittent vomiting.  Renal azotemia – BUN 147, creat 7.9, phos 16, K WNL, HCT 40, SpG 1.016, 3+ protein and 10-20 WBCs w/o bacteria seen on urine cytology.  Culture pending.  With the mineralization, thinking chronic renal failure most likely, but with the relatively normal size for 65 lb dog and smooth capsule + proteinuria, would glomerulonephritis be high on your list? Dog is current on Lepto vaccine.  

I also included pics of gall bladder – would you consider this an emerging mucocele without any liver enzyme elevation and no inflammation noted on ultrasound?

Comments

rlobetti

Renal changes typical for

Renal changes typical for chronic kidney diseae, which may have been trigerred by glomerulonephritis. However the proteinuria may be secondary to the CKD (tublar/interstitial pathology) so would need to run a UPC and if extremely high then most likley primary glomerulonephritis. Would also do blood pressures as this will impact on further management.

Gall bladder just looks like sludge accumulation.

kromero

Thank you for the input.  We

Thank you for the input.  We started amlodipine because pressures were high and they came down.  I am always perplexed when to reach for an ace inhibitor.  I lean away from them because as an ER vet, I usually see acute on chronic, but I realize if our UPC comes back high, the ace inhibitor would be helpful.  I’m just never sure when to do it.  

EL

I agree with Remo on this

I agree with Remo on this one. Consider chronic lepto as well if present in your region.

kromero

thanks, Eric – I did talk the

thanks, Eric – I did talk the owner into running Lepto PCR – she resisted initially since the dog is current on her lepto vaccine

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