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FELINE HYDRONEPHROSIS. Christina Copple Class of 2007 Block 15. 10 yr old MC Bengal Weakness and anorexia of 1 day duration Significant weight loss over past few months One month ago was seen for constipation, anorexia, and vomiting Continued poor appetite for last month. Diagnostics CBC
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FELINE HYDRONEPHROSIS Christina Copple Class of 2007 Block 15
10 yr old MC Bengal • Weakness and anorexia of 1 day duration • Significant weight loss over past few months • One month ago was seen for constipation, anorexia, and vomiting • Continued poor appetite for last month
Diagnostics • CBC • Anemia • Urinalysis • USG-1.009 • Proteinuria • hematuria • Chemistry Panel • Azotemia • Hypokalemia • Physical Examination: • 10% dehydrated • Depressed • BCS-2/9 • T-97F, P-160, R-18, CRT-2sec, MM-pale pink • On palpation abdomen is soft, left kidney is irregular/enlarged, right kidney is small • Marked ventroflexion of neck • Pronounced muscle wasting
Abdominal Radiographs from referring DVM VD-bilateral renal mineralization (nephroliths) and left renomegaly
Abdominal Radiographs from referring DVM Right Lateral-bilateral renal mineralization
Ultrasound Images Left Kidney-4.39cm (normal measurement is 3.8-4.4cm) severe hydronephrosis
Ultrasound Images Left kidney-severe hydronephrosis
Ultrasound Images Left ureter-hydroureter due to obstruction from ureterolith
Ultrasound Images Right Kidney- 3.52cm with renal cyst, the kidney is hyperechoic and there is decrease in corticomedullary distinction, a nephrolith is also noted that measures 3.5mm
Outcome of Case • This cat had his left kidney removed after 3 days of medical management (IV fluids, potassium supplementation and amitriptyline) were unsuccessful in treating the ureterolith and relieving his obstruction. • He also had a gastrotomy tube placed at the time of surgery to provide post-op nuturition. • The cat was discharged four days following his nephrectomy.