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7 year old FS Shih-Tzu presented for weight loss
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Labwork shows BUN=42, Creat=2.3, and isothenuria
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Abdominal ultrasound shows a markedly enlarged right kidney with stones measuring up to 2.8cm in the renal pelvis. The left kidney appears small and degenerative with medullary rim sign. No ureteral stones or obstructions are seen.
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Rule outs for the renal failure include pyelonephritis, previous ureteral or renal pelvic obstruction, or current, early right renal pelvic obstruction.
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7 year old FS Shih-Tzu presented for weight loss
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Labwork shows BUN=42, Creat=2.3, and isothenuria
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Abdominal ultrasound shows a markedly enlarged right kidney with stones measuring up to 2.8cm in the renal pelvis. The left kidney appears small and degenerative with medullary rim sign. No ureteral stones or obstructions are seen.
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Rule outs for the renal failure include pyelonephritis, previous ureteral or renal pelvic obstruction, or current, early right renal pelvic obstruction.
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The referring veterinarian is going to attempt stone dissolution with dietary therapy and concurrent antibiotics.
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If unsuccessful, would you pursue right renal nephrotomy next as the right kidney appear more normal in structure than the left kidney?
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Any thoughts on lithotripsy in a 15 lb dog?
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Comments
Big rocks:) If the kidney
Big rocks:) If the kidney is still functioning I wouldn’t remove it.. chick weiss & allyson berent at AMC can lithotripsy this extracorporeal would be the way to go or they would do it directly. I doubt this will dissolve at all medically looks like oxalate.. I saw a Jodi Lulich lecture took them 6 months to dissolve one half that size with the most strict regimen and super compliant owner. But if he can do it he should get an award 🙂 nephrotomies are problematic especially in renal failure patients but surgeon/internist dependent on success.
if this is a motivated owner and has a solid $ backing I would send her to amc and let chick and allyson play with it especially with the renal failure. Any systemic hypertension? Culture?? Owner can do a 4 day NYC vacation same time:)
Thanks Eric. I will pass on
Thanks Eric. I will pass on the info. I loaded up on feline renolithiasis treatment info at ACVIM, but not so much on canine. I did see proceedings on a combo lithotripsy/endoscopy procedure out of Japan.
Here is her radiograph
Here is her radiograph
Big rocks:) If the kidney
Big rocks:) If the kidney is still functioning I wouldn’t remove it.. chick weiss & allyson berent at AMC can lithotripsy this extracorporeal would be the way to go or they would do it directly. I doubt this will dissolve at all medically looks like oxalate.. I saw a Jodi Lulich lecture took them 6 months to dissolve one half that size with the most strict regimen and super compliant owner. But if he can do it he should get an award 🙂 nephrotomies are problematic especially in renal failure patients but surgeon/internist dependent on success.
if this is a motivated owner and has a solid $ backing I would send her to amc and let chick and allyson play with it especially with the renal failure. Any systemic hypertension? Culture?? Owner can do a 4 day NYC vacation same time:)
Thanks Eric. I will pass on
Thanks Eric. I will pass on the info. I loaded up on feline renolithiasis treatment info at ACVIM, but not so much on canine. I did see proceedings on a combo lithotripsy/endoscopy procedure out of Japan.
Here is her radiograph
Here is her radiograph
I am no expert for sure, but
I am no expert for sure, but lithotripsy could possibly lead to much smaller stones obstructing the ureter and making the situation worse. Bad situation for this dog.
I am no expert for sure, but
I am no expert for sure, but lithotripsy could possibly lead to much smaller stones obstructing the ureter and making the situation worse. Bad situation for this dog.
With direct laser lithotripsy
With direct laser lithotripsy they suction out the stones at the same time… its a “non invasive” nephrotomy essentially….. they have different techniques for different presentations
With direct laser lithotripsy
With direct laser lithotripsy they suction out the stones at the same time… its a “non invasive” nephrotomy essentially….. they have different techniques for different presentations
I have an entire case series
I have an entire case series of images on a Pug that had nephroliths this size and uroliths. They did a cystotomy and the stones were struvites (rare around here – almost all are CaOx) and we put the dog on Royal Canin SO and within 3 months they were gone! The renal pelvises were all stretched out and stayed that way for the rest of the dog’s life, but the stones disappeared and never came back on SO. I’ve scanned that dog many times. I showed it to one of Royal Canin’s technical services DVM’s at a meeting and they begged me for the images. But what are the odds these are struvites?
I have an entire case series
I have an entire case series of images on a Pug that had nephroliths this size and uroliths. They did a cystotomy and the stones were struvites (rare around here – almost all are CaOx) and we put the dog on Royal Canin SO and within 3 months they were gone! The renal pelvises were all stretched out and stayed that way for the rest of the dog’s life, but the stones disappeared and never came back on SO. I’ve scanned that dog many times. I showed it to one of Royal Canin’s technical services DVM’s at a meeting and they begged me for the images. But what are the odds these are struvites?
Thanks for the info. I will
Thanks for the info. I will pass it along to the primary DVM.
Thanks for the info. I will
Thanks for the info. I will pass it along to the primary DVM.
cool info marty yes great if
cool info marty yes great if struvite med tx may work.
cool info marty yes great if
cool info marty yes great if struvite med tx may work.
Nick
Nick
Nick
Nick