Radiology Packet 35

Urinary tract 1

6-year old FS German Shepherd

• Hx: Presented for lethargy. She is febrile.

6-year old FS German Shepherd

• RF– Both kidneys are large.– The bladder is not really seen with confidence, may be very small near the pelvic inlet.– The liver is mildly enlarged but has maintained a sharp margin.– Mild to moderate spondylosis of the lumbar spine is noted.

• RD– Bilateral renal enlargement.– Non-visualization of the urinary bladder.– Mild hepatomegaly.

• R/O– Bilateral renomegaly

• Acute nephritis/pyelonephritis – bacterial• Toxicities (eg. ethylene glycol)• Lymphosarcoma• Hydronephosis• Pericapsular hemorrhage

– Non-visualization of the urinary bladder• Anuria• Recent voiding• Rupture (unlikely since there is good abdominal detail)

• Next– Urinalysis– Ultrasound

9-year old F DSH“Missy”

• Hx: The patient was presented for evaluation of neurologic deficits to the hind limbs. The signs are reported to be upper motor neuron with the right hindlimb more affected than the left. On PE a large mid-abdominal mass was palpated.

9-year old F DSH“Missy”

• RF– The right kidney is mildly enlarged. The left kidney is massively enlarged.– Enlargement of the kidneys has resulted in displacement of the gastrointestinal

structures.

• RD– Bilateral renomegaly –the left kidney is much larger than the right

• R/O– Hydronephrosis– Infiltrative disease (amyloidosis, lymphosarcoma)– Inflammatory disease (acute pyelonephritis, acute nephritis)

• Next– Ultrasound examination

14 year old FS Mixed Breed dog“Jessie”

• Hx: Presented for evaluation of weight loss and hind limb ataxia. On PE a large mass was palpated in the left cranial abdominal quadrant.

14 year old FS Mixed Breed dog“Jessie”

• RF– The right kidney is normal in size and shape. The left kidney is enlarged and

abnormally shaped.– Enlargement of the left kidney has caused displacement of the descending colon

ventrally and medially.– There is an incidental finding of a metallic object (pellet) at the lateral margin of the

right ilial wing.

• RD– Unilateral (left) renomegaly

• R/O– Hydronephrosis– Neoplasia– Inflammatory disease

• Next– Ultrasound

4-year old FS Mixed Breed dog“Maple”

• Hx: Hit by car. This patient has multiple pelvic fractures. A lateral view of the abdomen was obtained to assess the urinary bladder.

4-year old FS Mixed Breed dog“Maple”

• RF– The urinary bladder is visible and is of moderate size.– There is an ill-defined subtle increase in opacity of tissue overlying the dorsal part

of the bladder.– There is an increase in opacity present in the retroperitoneal space.– There are fractures of one ilial body and the pelvic floor.

• RD– Loss of retroperitoneal detail as a result of fluid within the space

• R/O– Hemorrhage due to trauma– Urine due to ureteral rupture

• Next– An intravenous urogram (IVU)

9-year old MC Burmese“Trouble”

• Hx: One-week history of vomiting and anorexia.

9-year old MC Burmese“Trouble”

• RF– The stomach is displaced cranially by a gas-filled viscus which is the colon.– The right kidney is small (1.75 times the length of L2). – There is an area of increased opacity in the hilus of the right kidney.

• RD– Renal mineralization or renal pelvic calculus– Decreased size of right kidney

• R/O– Chronic renal disease

7-year old MN cat“Dusty”

• Hx: Presented for anorexia and severe dehydration. Blood work is pending.

7-year old MN cat“Dusty”

• RF– Both kidneys are small and irregularly shaped. The left kidney is much

smaller than the right.

• RD– Bilaterally small and irregular kidneys

• R/O– Chronic interstitial nephritis

• Next– Ultrasound

10-year old cat“Rocky”

• Hx: Presented for lethargy.

10-year old cat“Rocky”

• RF– Enlargement of the left kidney, with a slightly misshappen appearance.– Overlying the left kidney are 3 tiny foci of mineralization. There are also 2 noted outside

the confines of the kidney, both overlying the urinary bladder to the left of the spine.– Right kidney is not easily seen.– The bladder is very large.

• RD– Enlarged left kidney– Multiple tiny mineralized foci may be within the kidney and perhaps the urinary bladder or

ureter

• R/O– Kidney calculi– Ureteral calculi

• Next– Ultasound

4-year old FS Ferret

• Hx: Presented for evaluation and polyuria/polydipsia and increased appetite.

4-year old FS Ferret• RF

– In the VD view there is a mass of soft tissue opacity in the right cranial abdominal cavity craniomedial to the right kidney.

– In the lateral view this is seen as a rounded area of increased soft tissue opacity at the cranial pole of the right kidney.

– The margin of the mass is visible indicating that it is not in direct contact with the kidney.

• RD– Mass in the right cranio-dorsal abdominal quadrant

• R/O– Mass arising from the adrenal gland.– Hyperadrenocorticism

• Next– Abdominal ultrasound

Middle age M Boston Terrier“Freckles”

• Hx: Presented for non-specific “abdominal pain”.

Middle age M Boston Terrier“Freckles”

• RF– Multifocal mineralization of the diverticula of the kidneys.– Normal size and shape of kidneys.– Total collapse of the T13-L1 IV disc space with spondylosis.

• RD– Mineralization of the collecting system of the kidneys, which may extend into the renal

parenchyma– Collapse of the T13-L1 IV disc space

• R/O– Hyperadrenocorticism– Hypercalcemia– Hyperparathyroidism

• Next– Urinalysis– Blood work

3-year old FS cocker Spaniel“Loni”

• Hx: Presented for PU/PD.

3-year old FS cocker Spaniel“Loni”

• RF– Both renal silhouettes are enlarged.

• RD– Bilateral renomegaly

• R/O– Hydronephrosis

– Neoplasia

– Inflammatory disease

• Next– Ultrasound