Today’s case is a 13-year-old female neutered domestic short haired cat with history of hematuria.
Case originally posted on March 2, 2007
Teaching and learning about veterinary diagnostic imaging.
Today’s case is a 13-year-old female neutered domestic short haired cat with history of hematuria.
The right kidney is markedly enlarged, with a rounded shape. It is distorting the abdominal wall on the v/d projection and displacing the ascending and transverse colon medially and ventrally. The left kidney also has an abnormal shape, with reduced length and increased width.
There is also spondylosis deformans at the L5-6 intervertebral disc space, which is an incidental finding.
On ultrasound images, both kidneys were surrounded by large cystic structures filled with echogenic fluid. There are fine septae visible in the pseudocyst surrounding the left kidney. Drainage of both collections of fluid were clear and colorless except for the last 15 ml from the right kidney, which was hemorrhagic. Both kidneys were small and irregular with poor corticomedullary distinction.
Bilateral perinephric pseudocysts and chronic renal disease.
Perinephric pseudocysts are associated with chronic renal disease, but are often asymptomatic. The association between the pseudocysts and this cat’s hematuria is unclear. The hematuria may have been due to pressure from the pseudocysts, or idiopathic in nature.
TorontoVet says
There is severe rt renomegaly. The L kidney also appears more plump/round than normal.
DDx for renomegaly include neoplasia, hydronephrosis, and pyelonephritis. Pyelo would NOT cause such severe enlargment. I think it’s either of the two first ddx.
Clifford
Allison Zwingenberger says
Yes, it is severe renomegaly, and unlikely to be caused solely by pyelonephritis. I agree that the left kidney is abnormal in shape as well, though it doesn’t appear enlarged in length. Check the MIRC site for the answer.