Sonopath Forum

Vomiting cat with renal failure and GI wall changes

10 year old male neutered DLH presented for vomiting 1 week ago
Bloodwork showed Glu=166mg/dL, Creat=3.1mg/dL, BUN=37mg/dL, Glob=5.5g/dL, and ALT=283 U/L.
Radiographs shows small, irregulary shaped kidneys.
The patient was treated with IV fluids and Cerenia.
The patient returned yesterday for recurrent vomiting.
Bloodwork performed yesterday showed Creat=3.7mg/dL, BUN=43mg/dL, Glob=5.7g/dL, ALT=219 U/L

10 year old male neutered DLH presented for vomiting 1 week ago
Bloodwork showed Glu=166mg/dL, Creat=3.1mg/dL, BUN=37mg/dL, Glob=5.5g/dL, and ALT=283 U/L.
Radiographs shows small, irregulary shaped kidneys.
The patient was treated with IV fluids and Cerenia.
The patient returned yesterday for recurrent vomiting.
Bloodwork performed yesterday showed Creat=3.7mg/dL, BUN=43mg/dL, Glob=5.7g/dL, ALT=219 U/L
Abdominal US shows an increased muscularis to mucosal ratio in the pyloric wall and small intestines, mildly reactive mesenteric lymph nodes, prominent adrenal glands (normal measurement but look rounded). Both kidneys show almost complete loss of corticomedullary definition, irregular capsule contour, and slightly decreased size. Ih some views the renal corticies appear nodular.
Urinalysis, UPC ratio, urine culture, and blood pressure measurements are pending.
Rule out for the renal changes include chronic glomerulonephritis, chronic interstitial nephritis, pre-existing renal dysplasia.
Primary differentials for the small intestinal wall changes include IBD and emerging LSA.
Just wondering if I should have renal lymphoma on the differential diagnosis list here even though the kidneys show decreased size. What do you think?
Suspect vomiting here may be due to crf and or GI disease.