Characterization of normal feline renal vascular anatomy with dual-phase CT angiography

Helical computed tomography angiography was used to evaluate the renal vascular anatomy of potential feline renal donors. One hundred and fourteen computed tomography angiograms were reviewed. The vessels were characterized as single without bifurcation, single with bifurcation, double, or triple. Multiplicity was most commonly seen for the right renal vein (45/114 vs. 3/114 multiple left renal veins, 0/114 multiple right renal arteries, and 8/114 multiple left renal arteries). The right kidney was 13.3 times more likely than the left to have multiple renal veins. Additional vascular variants included double caudal vena cava and an accessory renal artery. For the left kidney, surgery and computed tomography angiography findings were in agreement in 92% of 74 cats. For the right kidney, surgery and computed tomography angiography findings were in agreement in 6/6 cats. Our findings of renal vascular anatomy variations in cats were similar to previous reports in humans. Identifying and recognizing the pattern of distribution of these vessels is important when performing renal transplantation.     

Clinicopathologic findings associated with chronic renal disease in cats: 74 cases (1973-1984)

The historic, physical, laboratory, and histologic findings for 74 cats with chronic renal disease were reviewed. Most cats were older, and no breed or sex predilection was detected. This most common clinical signs detected by owners were lethargy, anorexia, and weight loss. Dehydration and emaciation were common physical examination findings. Common laboratory findings were nonregenerative anemia, lymphopenia, azotemia, hypercholesterolemia, metabolic acidosis, hyperphosphatemia, and isosthenuria. The most common morphologic diagnosis was chronic tubulointerstitial nephritis of unknown cause. The other pathologic diagnoses were renal lymphosarcoma, renal amyloidosis, chronic pyelonephritis, chronic glomerulonephritis, polycystic renal disease, and pyogranulomatous nephritis secondary to feline infectious peritonitis.     

Putative uremic encephalopathy in horses: five cases (1978-1998)

OBJECTIVE: To determine historical, physical examination, clinicopathologic, and postmortem findings in horses with putative uremic encephalopathy. Design-Retrospective study. Animals-5 horses with renal failure and neurologic disease not attributable to abnormalities in any other organ system. PROCEDURE: Medical records from 1978 to 1998 were examined for horses with renal disease and neurologic signs not attributable to primary neurologic, hepatic, or other diseases. Signalment, history, physical examination findings, clinicopathologic data, renal ultrasonographic findings, and postmortem data were reviewed. RESULTS: Of 332 horses with renal disease, 5 met selection criteria. Historical findings, physical examination findings, clinicopathologic data, ultrasonographic data, and postmortem findings were consistent with chronic renal failure. Swollen astrocytes were detected in all 4 horses examined at necropsy. CONCLUSIONS AND CLINICAL RELEVANCE: A single criterion was not determined to be pathognomonic for uremic encephalopathy in horses. Uremic encephalopathy should be considered as a differential diagnosis in horses with evidence of chronic renal failure and encephalopathic neurologic sign not attributable to other causes. Astrocyte swelling, which was common to all 4 horses examined at necropsy, may serve as a microscopic indicator of uremic encephalopathy in horses.     

Renal failure and hyperparathyroidism in an Alaskan Malamute pup

In a 5-month-old male Alaskan Malamute, clinicopathologic and radiographic findings supported a diagnosis of renal failure and hyperparathyroidism. At necropsy, the parathyroid glands were enlarged and the kidneys were shrunken and irregular. The histopathologic findings were consistent with the diagnosis of logic findings were consistent with the diagnosis of terminal renal failure and hyperparathyroidism. Based on the history, a heritable disorder was suspected.     

EQUINE RENAL ULTRASONOGRAPHY: NORMAL AND ABNORMAL

The kidneys of three clinically normal horses were evaluated ultrasonographically, utilizing a standardized approach. The normal renal architecture, including cortex, medulla, pyramids, renal sinus fat, collecting system, and intrarenal vessels, was evaluated.
A horse with hematuria was examined in the same manner and a mass was found in the right renal pelvis.
Ultrasonographic determinations were correlated with gross anatomy, clinical signs, and pathologic findings of a renal pelvic adenoma.     

Acute renal failure in six horses resulting from haemodynamic causes

Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses that had kidney sections submitted for microscopic examination. Renal cortical necrosis occurred in one horse. Intravenous fluid and electrolyte replacement was the most important therapy in those cases that were non-oliguric. Furosemide, mannitol and dopamine were used in horses with oliguria. The prognosis was generally good if the predisposing cause could be corrected and the acute renal failure was not oliguric.     

COMPUTED TOMOGRAPHY OF HEREDITARY MULTIFOCAL RENAL CYSTADENOCARCINOMAS IN GERMAN SHEPHERD DOGS

the purpose of the study was to characterize the renal lesions of hereditary renal cystadenocarcinomas in the German shepherd dog using computed tomography (CT), Fourteen dogs with renal cystadenocarcinomas and nodular dermatofibrosis, and two unaffected dogs were studied. There were nine dogs with spontaneous disease and seven dogs from a test mating. The characteristic renal CT findings of renal cystadenocarcinomas were bilateral multiple cysts and tumor masses of various sizes. The earliest change were detected between 4 and 5 years of age and the smallest cysts measured 2-3 mm in diameter. Abdominal CT examination gives a wide field view and excellent anatomic images of the kidneys. It is easy to differentiate between cysts and solid tumors. CT examination is useful for the early detection of renal cystadenocarcinomas and for screening suspected carrier dogs before breeding.     

Urinary gamma-glutamyl transferase and the degree of renal dysfunction in 75 bitches with pyometra

In 75 bitches with pyometra single urine samples were examined for gamma-glutamyl transferase (gamma-GT), protein, glucose, specific gravity, bacteria, red blood cells and white blood cells. Serum samples were examined for urea, creatinine, inorganic phosphate and gamma-GT. Biochemical findings were compared with the degree of illness (clinical signs). Twenty one bitches had no signs of renal disease. Seventeen showed only glomerular damage indicated by proteinuria without signs of proximal tubular damage. Thirty seven bitches had increased urinary gamma-GT levels, indicating proximal tubular lesions, which were associated with proteinuria in 35 and renal failure in 16 of them, and worse clinical findings. In all bitches with pyometra serum levels of gamma-GT were comparable to values in control bitches. Glomerular dysfunction seemed to precede proximal tubular lesions, so that gamma-GT-uria in bitches with pyometra was not an early but rather a late indication of a more profound degree of renal dysfunction, that is, proximal tubular renal damage developed after glomerular dysfunction and preceding renal failure.     

LESIONS OF THE RENAL PELVIS AND PROXIMAL URETER IN VARIOUS NEPHRO-UROLOGICAL CONDITIONS: AN ULTRASONOGRAPHIC STUDY

The applicability of ultrasonography was studied in the diagnosis of lesions of the renal pelvis and ureter in 10 dogs. Ultrasonographic findings of processes associated with dilatation and concretion formation in the renal pelvis were described and the differential diagnosis of the lesions was discussed. The authors propose a new classification system for judging processes characterized by dilatation of the renal pelvis. Experience suggests that ultrasonography is an effective procedure in the diagnosis of certain diseases of the upper urinary tract in dogs.     

Ultrasonographic evaluation of renal parenchymal diseases in dogs: 32 cases (1981-1986)

The medical records of 32 dogs with microscopically proven renal parenchymal disease were evaluated to characterize the associated ultrasonographic patterns and to assess the contribution of ultrasonography to the diagnosis and management in each case. Ultrasonography provided additional information on internal renal architecture in 18 dogs with radiographic evidence of structural abnormality. Ultrasonography determined the renal origin of 2 abdominal masses, defined the extent and distribution of neoplastic disease in 6 dogs, and identified kidneys not seen on survey radiographs or excretory urograms in 5 dogs because of decreased abdominal contrast or poor function. The ultrasonographic patterns were most specific for focal and multifocal or diffuse neoplasia. Ultrasonographic findings were least specific for diffuse parenchymal disease without architectural disruption such as glomerulo/interstitial nephritis, renal tubular necrosis, and nephrocalcinosis. In these cases, biopsy was recommended. Six interpretive errors were made. Four of these errors were related to the overestimation of renal pelvic and diverticular size because of confusion with medullary papilla. Two errors occurred in the diagnosis of renal lymphosarcoma, one of which was interpreted to be pyelonephritis. The other was an interpretive dilemma because of absence of hypoechoic multifocal nodules. Renal tubular necrosis was confirmed in this case.     

COMPARISON OF THE RESISTIVE INDEX TO CLINICAL PARAMETERS IN DOGS WITH RENAL DISEASE

The resistive index (RI) is a measurement of arteriole vascular resistance and is obtained by pulsed-wave Doppler interrogation. The diagnostic potential of the renal resistive index (RI) was retrospectively investigated in 142 kidneys from 81 dogs. The resistive index of each kidney was compared to clinical laboratory parameters, clinical diagnoses, and sonographic findings. The mean renal resistive index (RI) for 22 normal kidneys was 0.61 (standard deviation = 0.06). An elevation in the mean renal RI (>0.70) was found for the clinical diagnoses of acute renal failure and congenital dysplasia. When a RI of greater than 0.70 was considered abnormal, the sensitivity and specificity of the RI in determining normal vs, abnormal kidneys were 38% and 96% respectively.     

Feline chronic renal failure: clinical findings in 80 cases diagnosed between 1992 and 1995

Clinical and laboratory findings at the time of first diagnosis in 80 cats with chronic renal failure (CRF) were examined in a prospective study to determine the survival time of these animals and identify possible factors contributing to the progression of feline CRF. On the basis of clinical presentation, animals were assigned to one of three groups; compensated (n=15), uraemic (n=39) and end-stage (n=26) CRF. Loss of renal concentrating ability was a common finding, even before clinical signs of renal disease were evident. The plasma creatinine concentration at initial presentation was a poor predictor of survival time and the presence of significant anaemia was indicative of a poor prognosis. The study demonstrated the highly variable degree of renal impairment present at the time of diagnosis and the potentially long survival time of many compensated and uraemic cases.     

ULTRASONOGRAPHIC FINDINGS IN CAIRN TERRIERS WITH PRECLINICAL RENAL DYSPLASIA

Renal dysplasia is a hereditary disease characterized by abnormal differentiation of renal tissue. The ultrasonographic appearance of dysplastic canine kidneys has been reported in the late stage of the disease where inflammatory and degenerative changes are already present and the dogs are in chronic renal failure. In this study, we describe the ultrasonographic appearance of the kidneys of five related Cairn Terriers affected with renal dysplasia before the onset of clinical or laboratory evidence of renal failure. Common findings included poor corticomedullary definition and multifocal hyperechoic speckles in the renal medulla, or a diffusely hyperechoic medulla. Severity of ultrasonographic changes was related to the severity of histopathologic findings. The ability to detect dysplastic changes before clinical signs develop makes ultrasound a potentially useful screening method for canine renal dysplasia.     

Evaluation of methods for localization of urinary tract infection in the female dog.

Urinary tract infection (UTI) was induced in the left kidney of seven female dogs and in the urinary bladder of eight female dogs. Several methods advocated for localization of UTI in other species were tested in the infected dogs. Although fever, renal pain, and leukocytosis were detected in some dogs with renal infection, findings were transient. Radiographic changes in the kidneys and ureters were detected in some dogs with renal infection, but were absent in others. Bladder washout studies were not reliable for differentiating renal infection from bladder infection. Antibody coating studies were positive in dogs with bladder infection and in dogs with renal infection. The positive results from dogs with bladder infection may have been because of nonspecific binding of immunoglobulins to Staphylococcus aureus after leakage of serum immunoglobulins into urine. Studies of six dogs of both sexes with naturally occurring UTI indicated that their serum contained antibody against common urinary pathogens and that this antibody gained access to the urine in some dogs. It was concluded that the antibody coating test was unreliable for localization of UTI in the dog.     

Assessment of the use of gross lesions at post-mortem to detect outbreaks of classical swine fever

The performance of pathological findings as a diagnostic tool for the detection of classical swine fever (CSF) outbreaks during the 1997/1998 CSF-epidemic in The Netherlands was evaluated by constructing and analysing receiver operating characteristic (ROC) curves. This was done at the individual pig level and at the submission level (a group of pigs from the same herd submitted together for post-mortem investigation). At post-mortem examination, the tonsils, spleen, ileo-caecal valve and renal pelvis were sampled, sent to the reference laboratory, and tested by means of a CSF-specific fluorescent antibody test in combination with a confirmatory test. This resulted in an infection status at the individual pig level. The infection status and pathological findings of 1072 individual pigs from a total of 230 infected herds were included in this analysis. We also included submissions of pigs from herds that were sent to post-mortem examination because of a clinically CSF-suspect situation but afterwards were concluded to be from non-infected herds. Infection status and pathological findings of 1224 individual pigs from a total of 241 non-infected herds were included in the analysis. Pneumonia, pleuritis, chronic bronchitis, pulmonary oedema, chronic gastric ulceration, dry faecal contents in the colon, conjunctivitis, haemorrhages in the renal pelvis, renal haemorrhages, splenic enlargement, haemorrhages in the urinary bladder, haemorrhagic and enlarged lymph nodes were the most frequently recorded pathological findings during a post-mortem examination of pigs submitted in a CSF-suspect clinical situation. However, some of these pathological findings (e.g. pneumonia, pleuritis) were almost evenly distributed in infected and in non-infected pigs, resulting in a high sensitivity combined with a low specificity. The area under the ROC curve of pathological findings at the individual pig level and at the submission level was 0.720 and 0.782, respectively, which was significantly (P<0.0001) larger than the area under the random ROC curve. It was concluded that, although gross pathology is a legitimate test, its quantitative contribution to the detection of CSF is limited.     

Hypercalcemia in cats: a retrospective study of 71 cases (1991-1997)

A retrospective study was conducted to characterize the diseases, clinical findings, and clinicopathologic and ultrasonographic findings associated with hypercalcemia (serum calcium concentration >11 mg/dL) in 71 cats presented to North Carolina State University Veterinary Teaching Hospital. The 3 most common diagnoses were neoplasia (n = 21), renal failure (n = 18), and urolithiasis (n = 11). Primary hyperparathyroidism was diagnosed in 4 cats. Lymphoma and squamous cell carcinoma were the most frequently diagnosed tumors. Calcium oxalate uroliths were diagnosed in 8 of 11 cats with urolithiasis. Cats with neoplasia had a higher serum calcium concentration (13.5 ± 2.5 mg/dL) than cats with renal failure or urolithiasis and renal failure (11.5 ± 0.4 mg/dL; P <.03). Serum phosphorus concentration was higher in cats with renal failure than in cats with neoplasia ( P < .004). Despite the fact that the majority of cats with uroliths were azotemic, their serum urea nitrogen and creatinine concentrations and urine specific gravity differed from that of cats with renal failure. Additional studies are warranted to determine the underlying disease mechanism in the cats we identified with hypercalcemia and urolithiasis. We also identified a small number of cats with diseases that are not commonly reported with hypercalcemia. Further studies are needed to determine whether an association exists between these diseases and hypercalcemia, as well as to characterize the underlying pathophysiologic mechanism for each disease process.     

Attenuation of ischemia-reperfusion injury by ascorbic acid in the canine renal transplantation

This study examined the effects of ascorbic acid on the attenuation of an ischemia-reperfusion (I/R) injury after a canine renal transplantation. Eight beagle dogs were subjected to a renal auto-transplantation followed by the administration of ascorbic acid (treatment group) and the same amount of vehicle (physiological saline, control group). Blood samples were collected from these dogs to perform the kidney function tests and the invasive blood pressure was measured in the renal artery at pre- and post- anastomosis. The antioxidant enzymes of level 72 h after the transplant were measured. The kidneys were taken for a histopathology evaluation at day 21. The kidney function tests showed a significant difference between the control and treatment group. The invasive blood pressure in the renal artery was similar in the groups. The activity of the antioxidant enzymes in the blood plasma was significant lower in the control group than in the treatment group. The histopathology findings revealed the treatment group to have less damage than the control group. The results of this study suggest that ascorbic acid alone might play a role in attenuating I/R injury and assist in the recovery of the renal function in a renal transplantation model.     

Extensive caudal vena cava thrombosis secondary to unilateral renal tubular cell carcinoma in a dog

A nine-year-old German shorthaired pointer cross was admitted because of partial anorexia, exercise intolerance and haematuria. On clinical examination, subcutaneous oedema, purpura and ascites were detected along with a palpable mass in the right craniodorsal abdomen. Laboratory findings included regenerative anaemia, leucocytosis, thrombocytopenia, azotaemia, increased blood serum alkaline phosphatase and proteinuria. Radiographic and ultrasonographic examinations revealed a large neoplasm involving the right kidney. Computed tomography further showed that the neoplastic tissue had spread into the lymph nodes, the wall of the caudal vena cava, the liver and lungs. The right renal vein, caudal vena cava and iliac veins appeared enlarged and secondarily thrombosed. A diagnosis was made of renal tubular cell carcinoma with secondary venous thrombosis. Gross postmortem examination confirmed the imaging findings, while light and electron microscopic examination revealed that the neoplasm was a solid carcinoma originating from the proximal convoluted renal tubules.     

N-acetyl-beta-D-glucosaminidase activity in urine of cows with renal parenchymal lesions

OBJECTIVE: To measure N-acetyl-beta-D-glucosaminidase (NAG) activity in urine of cows with renal diseases and to correlate values for NAG activity with renal lesions. ANIMALS: 8 lactating Holstein cows and a Japanese Shorthorn cow, all of which had renal disease. PROCEDURE: Urine samples were collected, and urinary NAG activity and creatinine concentration were measured. The NAG activity was expressed as units per gram of creatinine (NAG index). Cows were euthanatized, necropsy was performed, and correlations between results for urinary NAG index and histopathologic findings for the kidneys were evaluated. RESULTS: The NAG activity and NAG index in urine samples obtained from cows with interstitial nephritis were high, ranging from 4.2 to 13.6 U/L and 3.5 to 23.0 U/g, respectively. A cow with renal amyloidosis also had high values for urinary NAG activity and NAG index. Histologic examination of the kidneys revealed various kinds of parenchymal lesions. However, urinary NAG index in cows with enzootic bovine leukosis was low. CONCLUSIONS AND CLINICAL RELEVANCE: Cows with renal diseases had high urinary NAG indexes that correlated well with their renal lesions, except for cows with enzootic bovine leukosis. Therefore, measurement of NAG index in urine samples has the potential to provide new perspectives on clinical diagnosis of renal disease in cattle.     

Renal tubular necrosis and interstitial hemorrhage ("turkey-egg kidney") in a circovirus-infected Yorkshire cross pig.

A juvenile Yorkshire cross pig with rapidly progressive acute renal failure was submitted for necropsy. There was marked edema and disseminated petechiation of both kidneys, producing the "turkey-egg" appearance that is characteristic of exotic diseases such as African and classical swine fever. Microscopic findings included renal tubular epithelial necrosis with extensive interstitial edema and hemorrhage; lymphoplasmacytic, eosinophilic, and histiocytic tubulointerstitial nephritis; and numerous botryoid intracytoplasmic inclusions within the renal tubular epithelium and interstitial macrophages. Porcine circovirus 2 (PCV2) was readily identified within these lesions by both PCV2-specific immunohistochemistical staining and electron microscopy. Tests for African and classical swine fever viruses, as well as bacterial cultures, were negative. The striking renal lesions in this pig were attributed to PCV2 infection and are distinct from those that are typical of other PCV2-associated diseases.