Feb 11/16 – 14 y M/N Boxer presented for hematuria x several days. Colleague did cbc/chem/ua – only abnormal findings was UTI (TNTC RBCs, 3+ WBCs). Rx Amoxil q12hrs x 10 days.
Feb 27/16 – recheck UA – owner feels hematuria has cleared up, dog is better. BUT UA – persistant 3+ WBCs and 2+ RBCs and now rods and cocci seen. Rx Veraflox q24hrs x 7 days.
March 14/16 – recheck UA – dog continues to do well. BUT UA – persistant hematuria – 2+.
Feb 11/16 – 14 y M/N Boxer presented for hematuria x several days. Colleague did cbc/chem/ua – only abnormal findings was UTI (TNTC RBCs, 3+ WBCs). Rx Amoxil q12hrs x 10 days.
Feb 27/16 – recheck UA – owner feels hematuria has cleared up, dog is better. BUT UA – persistant 3+ WBCs and 2+ RBCs and now rods and cocci seen. Rx Veraflox q24hrs x 7 days.
March 14/16 – recheck UA – dog continues to do well. BUT UA – persistant hematuria – 2+.
March 16/16 – ultrasounded – bladder WNLs, prostate WNLs, kidneys (see attached) – RK unremarkable, LK – caudal pole contains what I would describe as a lobulated round structure with a thin, well demarcated, hyperechoic rim. I would have interpreted this as a cystic structure, but have never seen a cyst present in such a manner – I usually just see a single or multifocal circular or oval anechoic structure with similar rim. Again, the dog is otherwise healthy and bloodwork WNLs. Urine culture is pending.
My questions:
– could this just be a multilobulated cyst? or similar aging change?
– if the culture is negative, should I be looking into FNA the area to rule out neoplasia?
Thanks
Jennifer
Comments
Renal cysts should not cause
Renal cysts should not cause hematuria so I would be worried about possible neoplasia – renal hemangioma/hemagiosarcoma, and possibly carcinoma althought those generally are solid tumors. Focal abscessation/granuloma also possible. FNA would be indicated, however, hemangioma/hemagiosarcoma are difficult to diagnosis on FNA.
Ok thanks! I had heard (from
Ok thanks! I had heard (from a radiologist) in the past that if a dog had renal cysts and hematuria only, the renal cysts could be responsible for intermittent mild hematuria.
I wasn’t thinking abscessation given I didn’t really see any echogenic material within the lesion but I guess that’s possible and might tie into the suspected UTI – looks like we are going to grow some bacteria based on initial UA results (culture pending).
I guess we will treat the UTI/possible abscessation x 4-6 weeks then recheck lesion to see whether it has grown/changed (or I guess offer FNA to rule out carcinoma as well once ABs finished).
Thanks
Jennifer
This looks like a typical
This looks like a typical renal cyst but when they get echogenic i worry of infection or bleeding. 25g drainage and culture and see if hemorrhagic should shed some light