- A 2 year old cat presented in renal failure in March of 2014 with a BUN of 180mg/dl and creatinine of 6.5 mg/dl. He is an indoor cat with no known exposure to toxins. ALB was normal at 4.2 g/dl. He responded to aggressive treatment with hospitalization. He is currently asymptomatic (other than being slightly thin) but remains azotemic today with a BUN of 67mg/dl and a creatinine of 2.0mg/dl. USG was 1.016 and urinalysis was negative on dipstick for proteinuria. A UPC done showed a ratio of 0.3.
- A 2 year old cat presented in renal failure in March of 2014 with a BUN of 180mg/dl and creatinine of 6.5 mg/dl. He is an indoor cat with no known exposure to toxins. ALB was normal at 4.2 g/dl. He responded to aggressive treatment with hospitalization. He is currently asymptomatic (other than being slightly thin) but remains azotemic today with a BUN of 67mg/dl and a creatinine of 2.0mg/dl. USG was 1.016 and urinalysis was negative on dipstick for proteinuria. A UPC done showed a ratio of 0.3.
- The cat was originally a barn kitten. He had an elevated BUN at the time of his castration (50’s) but this was not worked up at that time. He was adopted by a vet tech after he became ill.
- He is not on any medications or prescription diet at this time. BP was measured at 150mmHg.
- My primary differentials are renal dysplasia or chronic renal failure due to some prior unknown insult. Dry FIP and LSA seem less likely due to the small normal size of the kidneys and the chronic nature of his disease.
- Any other thoughts?
Comments
This is an interstitial
This is an interstitial nephrosis pattern and those echogenic cortical wedge lesions are small infarcts with capsular retraction adjacent to them. Lots of things can cause this from FIP/other infectious to toxin to idiopathic LP nephritis. I doubt renal dyscplasia as its relatively rare in cats wiht normal renal size but possible and dsplasia can look like anything. Most renal dysplasia cases have significant disruption of architecture small size or loss of CM structure all together. These kidneys look like they started ok then got “lumped up” by some chronic insidious process hence the diffs above.
Check out the renal dysplasia cases in the archive under the basic search
http://sonopath.com/members/case-studies/search?text=renal+dysplasia&species=All
This one needs a renal bx to know what is truly going on.
This is an interstitial
This is an interstitial nephrosis pattern and those echogenic cortical wedge lesions are small infarcts with capsular retraction adjacent to them. Lots of things can cause this from FIP/other infectious to toxin to idiopathic LP nephritis. I doubt renal dyscplasia as its relatively rare in cats wiht normal renal size but possible and dsplasia can look like anything. Most renal dysplasia cases have significant disruption of architecture small size or loss of CM structure all together. These kidneys look like they started ok then got “lumped up” by some chronic insidious process hence the diffs above.
Check out the renal dysplasia cases in the archive under the basic search
http://sonopath.com/members/case-studies/search?text=renal+dysplasia&species=All
This one needs a renal bx to know what is truly going on.