Presentation
Presents with acute onset of anorexia and lethargy.
Patient Data
The urinary bladder is markedly enlarged. The right kidney is enlarged, and the left kidney is poorly visualized. There is mineralization within the right kidney. There is decreased serosal detail in the retroperitoneal space with a striated soft tissue opacity within the retroperitoneal fat. There are faint mineralizations within the bladder that may represent calculi.
Chronic renal disease with probable right ureteral obstruction.
The left kidney is small measuring approximately 2.2 cm in length. The right kidney is enlarged, measuring 6 cm in length. The right renal pelvis is mildly dilated. There is poor corticomedullary distinction. The proximal right ureter is dilated to 2 mm but tapers rapidly within 2 cm of the kidney to a normal size. There is no evidence of a ureterolith. There are no cystic calculi visible.
Chronic renal disease with atrophied left kidney and hypertrophied right kidney. Mild hydronephrosis. Current or resolving obstruction due to debris or mucous plugs. No calculi identified.
Case Discussion
Differential diagnoses for the findings include:
Enlarged right kidney - compensatory hypertrophy, hydronephrosis, pyelonephritis, (lymphoma)
Small left kidney - chronic renal disease
Retroperitoneal effusion - edema (inflammation, fluid overload), urine
Surgery was performed to remove a small calculus from the right ureter.
In cats with chronic renal disease, an obstructed functioning kidney leads to rapid decompensation with increased BUN and creatinine. Appropriate imaging tests to confirm this are abdominal ultrasound and contrast CT scanning.
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