Oxalate Nephrosis and Renal Sclerosis After Renal Transplantation in a Cat

A 10-year-old castrated domestic shorthair cat received two renal allografts, 14 days apart, for the treatment of chronic renal failure. Oxalate nephrosis developed in both allografts, and they became nonfunctional. During the transplantation period, the cat was not exposed to exogenous sources of oxalate, and there was no evidence of primary type 2 hyperoxaluria before surgery. Urologic surgery, in particular renal transplantation, has been identified as a factor that can precipitate renal failure in human patients with decompensated renal function and hyperoxaluria. If hyperoxaluria was present before surgery in this cat, it was most likely caused by increased absorption or decreased metabolism of dietary oxalate.     

Long-Term Survival of a Cat Receiving a Renal Allograft From an Unrelated Donor

A 6-year-old, spayed female Persian cat in terminal renal failure was referred to the Veterinary Medical Teaching Hospital for renal transplantation. An allograft from an unrelated donor was placed in the right iliac fossa and cyclosporine and prednisolone were administered as immunosuppressive agents. More than 18 months after surgery the cat was clinically normal and azotemia was absent.     

Distal renal tubular acidosis and hepatic lipidosis in a cat

Clinical and laboratory evidence of hepatic failure was found in a chronically anorectic cat. Simultaneous blood and urine pH determinations established a diagnosis of distal renal tubular acidosis. The cat did not respond to treatment. Necropsy revealed distal tubular nephrosis and hepatic lipidosis. The finding of distal renal tubular acidosis in a cat with hepatic lipidosis emphasizes the importance of complete evaluation of acid-base disorders in patients.     

Hypertensive retinopathy in a cat

A 12-year-old cat presented for sudden blindness was diagnosed with hypertensive retinopathy on the basis of ophthalmologic and ultrasonic examination. Renal failure due to a large intranephric cyst obstructing the right ureter and renal artery was the suggested cause of the systemic hypertension. The cat died 8 hours after unilateral nephrectomy.     

Primary aldosteronism (Conn's syndrome) in a cat; a case report and review of comparative aspects

An aged cat was presented with a history of chronic relapsing weakness and depression. Profound hypokalaemia was detected in association with increased serum aldosterone levels and marginally subnormal plasma renin activity. A diagnosis of primary aldosteronism (Conn's syndrome) was made and the cat was successfully treated for 2 ½ months with spironolactone. When renal failure developed, the cat was destroyed and at autopsy a large adrenal cortical adenocarcinoma was found.     

Histopathologic features of canine uremic gastropathy: a retrospective study

Uremic gastritis is a term commonly used to describe the gastrointestinal signs and histopathologic changes associated with renal failure in the dog. This retrospective study reviews the clinical, serum biochemical, and postmortem histopathologic data from 28 dogs with renal failure to determine the prevalence of gastric histopathology, characterize the gastric histopathology, and identify associations between gastric histopathology and serum concentrations of blood urea nitrogen (BUN), creatinine (Cr), calcium-phosphorus product (Ca x Phos), and hematocrit. Affected and control dogs with available renal and gastric tissue, serum biochemistry data, and urinalysis data were identified over a 10-year period (1992-2002) in the pathology department postmortem examination database at the Cornell University College of Veterinary Medicine. The serum biochemistry data and histopathologic findings were scored as normal, mild, moderate, and severe. All affected dogs had derangements of BUN, Cr, or Ca x Phos with gastric histopathology in 22 of 28 dogs (79%). Dogs with renal failure had a higher prevalence of gastric histopathologic changes compared with the control group. Associated histopathologic changes in the stomach were edema (P = .008), mineralization (P = .03), and vasculopathy (P = .03). Only 1 dog had evidence of gastric ulceration. Gastric necrosis was an uncommon finding (4/28, 14%). Gastric histopathology appears to be common in dogs with renal failure and is associated with increasing severity in the serum biochemistry data. Unlike humans with renal failure, in whom gastric ulceration predominates, gastric necrosis and ulceration appear to be uncommon in dogs with renal failure.     

Use of trilostane for the treatment of pituitary-dependent hyperadrenocorticism in a cat

Hyperadrenocorticism occurs much less frequently in cats than in dogs and, at present, is more difficult to manage successfully. This report documents the use of the steroid synthesis inhibitor trilostane for the treatment of hyperadrenocorticism in a domestic shorthaired cat with pituitary-dependent disease. Although trilostane was able to alleviate the severity of the clinical signs and was well tolerated, the cat subsequently died of renal failure secondary to a fungal infection of the urinary tract.     

CROSSED RENAL ECTOPIA WITH FUSION IN A CAT

In humans, crossed renal ectopia is a rare, usually asymptomatic, congenital malpositioning of the kidneys, involving wandering of one or both embryonic kidneys across the midline and usually fusion with its contralateral partner. This is the first report of crossed renal ectopia in the cat. A 7-year-old, neutered male cat was presented with polyuria, polydipsia, and a palpable abdominal mass. Diagnostic investigations, including clinical pathology, survey and contrast radiography, and ultrasonography, confirmed the presence of an ectopic left kidney fused with an orthotopic right kidney, with concurrent renal failure and hypertension. Many features of crossed renal ectopia in this cat are similar to those described in humans, however the vascular supply, the presence of renal failure, and the axial rotation of the fused kidney are atypical.     

Membranous nephropathy in the cat: a clinical and pathological study

A series of 13 cases of feline membranous nephropathy is presented. Two groups were distinguished clinically; eight cats had the nephrotic syndrome and five others were in renal failure but not nephrotic. The definitive diagnosis was based on histological, immunofluorescence and ultrastructural examinations of renal tissue obtained at renal biopsy or necropsy. Glomerular lesions were classified according to the degree of glomerular change into three distinct groups; mild, moderately severe and advanced. A relationship was established between the mild and moderately severe groups and cats with the nephrotic syndrome, and the advanced group and cats in renal failure. Diuretic therapy was satisfactory in initial control of oedema in the nephrotic cases. Monitoring of previously nephrotic cats for up to three years indicated that the disease is progressive, although in some cases it is sufficiently slow for a cat to live a relatively normal life without continuing treatment. The prognosis for cats presented in renal failure is hopeless.     

Polycystic kidney disease in a Persian cat

This case report is about a 9-year-old male castrated Persian cat with chronic renal failure. After physical examination and ultrasonography polycystic kidney disease (PKD) was diagnosed. Various aspects of etiology, pathophysiology and diagnosis of PKD are discussed.     

An isolated cryptococcal urinary tract infection in a cat

A male domestic shorthaired cat was presented for evaluation of stranguria and pollakiuria. A cryptococcal urinary tract infection (UTI) was diagnosed cytologically and via fungal culture. No evidence of systemic involvement was found. Chronic renal failure was a concurrent disease in this cat. Treatment consisted of oral fluconazole. Clinical signs resolved after 2 weeks of therapy, and fluconazole was discontinued after 6 months when negative urine culture results indicated resolution of the infection. This case demonstrates that correct identification of cryptococcal UTI allows for administration of therapy that can be associated with resolution of clinical signs.     

Possible Hemolytic Uremic Syndrome in Three Cats After Renal Transplantation and Cyclosporine Therapy

OBJECTIVE: To describe the clinical history of 3 cats with possible hemolytic uremic syndrome (HUS) after renal transplantation. STUDY DESIGN: This case series documents historical findings, physical examination findings, clinical pathologic features, necropsy and histopathologic findings of 3 cats with possible HUS. RESULTS: Two cats had chronic renal failure; 1 cat had acute renal failure secondary to ethylene glycol toxicity. A renal transplant was performed in each of the 3 cats without obvious problems. Complications that would support a diagnosis of HUS, including anemia, thrombocytopenia, and azotemia occurred within 24 hours in 1 cat, within 8 days in a second cat, and 2 months after transplantation in the third cat. In 2 cats, HUS was likely secondary to cyclosporine immunosuppression. In the third cat, HUS may have been secondary to allograft rejection. Renal biopsies from all 3 cats were suggestive of HUS. CONCLUSION AND CLINICAL RELEVANCE: In human beings, HUS in transplant recipients may occur secondary to immunosuppressive drugs, vascular rejection, or recurrence of original disease. Graft loss occurred in all 3 cats in this study and the mortality rate was 100%. Clinicians caring for these patients need to be aware of this disorder because early recognition and treatment is critical in the management of post-transplant HUS.     

Evaluation of the renal effects of experimental feeding of melamine and cyanuric acid to fish and pigs

OBJECTIVE: To determine whether renal crystals can be experimentally induced in animals fed melamine or the related triazine compound cyanuric acid, separately or in combination, and to compare experimentally induced crystals with those from a cat with triazine-related renal failure. ANIMALS: 75 fish (21 tilapia, 24 rainbow trout, 15 channel catfish, and 15 Atlantic salmon), 4 pigs, and 1 cat that was euthanatized because of renal failure. PROCEDURES: Fish and pigs were fed a target dosage of melamine (400 mg/kg), cyanuric acid (400 mg/kg), or melamine and cyanuric acid (400 mg of each compound/kg) daily for 3 days and were euthanatized 1, 3, 6, 10, or 14 days after administration ceased. Fresh, frozen, and formalin-fixed kidneys were examined for crystals. Edible tissues were collected for residue analysis. Crystals were examined for composition via Raman spectroscopy and hydrophilic-interaction liquid chromatography-tandem mass spectrometry. RESULTS: All animals fed the combination of melamine and cyanuric acid developed goldbrown renal crystals arranged in radial spheres (spherulites), similar to those detected in the cat. Spectral analyses of crystals from the cat, pigs, and fish were consistent with melamine-cyanurate complex crystals. Melamine and cyanuric acid residues were identified in edible tissues of fish. CONCLUSIONS AND CLINICAL RELEVANCE: Although melamine and cyanuric acid appeared to have low toxicity when administered separately, they induced extensive renal crystal formation when administered together. The subsequent renal failure may be similar to acute uric acid nephropathy in humans, in which crystal spherulites obstruct renal tubules.     

Eosinophilic fibrosing gastritis and toxoplasmosis in a cat

A 3-year-old, neutered male Tiffany cat was presented to the Animal Health Trust for investigation of pyrexia and a gastric lesion. Radiography and ultrasound showed severe thickening of the gastric wall and regional lymphadenopathy. There was altered gastric wall layering, predominately due to muscularis thickening. Histopathology confirmed eosinophilic fibrosing gastritis. The cat also had evidence of generalised Toxoplasma gondii infection, which may have been responsible for the gastric changes.     

Resistance to a triple combination of broad-spectrum anthelmintics in naturally-acquired Ostertagia circumcincta infections in sheep

Extract

To the veterinary practitioner, the challenge of managing a cat with renal failure is very real. The specific goals of therapy are to:     

Calcinosis involving multiple paws in a cat with chronic renal failure and in a cat with hyperthyroidism

Calcinosis of multiple paws is described in two cats. A metastatic pathogenesis was supported by the laboratory findings of hyperphosphataemia and a calcium x phosphorus solubility product > 7 g/L. Hyperparathyroidism could not be confirmed because a valid feline parathyroid hormone assay was not available at the time. One cat was diagnosed with chronic renal failure and presented initially with an irregular nodular calcification on the chin. Dietary and medical management was unsuccessful and ultimately the animal was euthanased. Hyperthyroidism was diagnosed in another cat by laboratory findings and scintigraphic imaging. In addition, the cat had a hyperphosphataemia in the absence of azotaemia. Intravenous administration of radioactive iodine as (131)I was accompanied by reduction and normalization in serum total thyroxine and phosphorus concentrations and resulted in resolution of calcification in the paws.     

Poisoning induced by administration of a phosphate-containing urinary acidifier in a cat

Signs of depression, hyperphosphatemia, azotemia, high anion gap metabolic acidosis, and renal failure developed in an adult cat following administration of an excessive dose of a phosphate-containing urinary acidifier. After extracellular fluid volume expansion, diuresis, and administration of a phosphate binder, serum phosphorus concentration returned to normal in 12 hours; the cat recovered fully. The urinary acidifier had been given as part of treatment for a urinary tract infection. Findings suggest that phosphate-containing urinary acidifiers should be administered cautiously because, like other sources of phosphate, they are capable of causing life-threatening metabolic disturbances.     

BILOBED GALLBLADDER IN A CAT: ULTRASONOGRAPHIC APPEARANCE

A five-month-old male domestic shorthair cat presented with a history of vomiting for 4 days. An ultrasound examination of the abdomen was performed as part of the diagnostic workup. The gallbladder appeared to be bilobate. The cat died the following day from renal failure. At necropsy, a bilobed gallbladder was confirmed and considered to be a congenital anomaly unrelated to the cat's death.     

Incidence of and risk factors for diabetes mellitus in cats that have undergone renal transplantation: 187 cases (1986-2005)

OBJECTIVE: To compare incidence of diabetes mellitus in cats that had undergone renal transplantation with incidence in cats with chronic renal failure, compare mortality rates in cats that underwent renal transplantation and did or did not develop diabetes mellitus, and identify potential risk factors for development of posttransplantation diabetes mellitus (PTDM) in cats. DESIGN: Retrospective case series. ANIMALS: 187 cats that underwent renal transplantation. PROCEDURES: Medical records were reviewed. RESULTS: 26 of the 187 (13.9%) cats developed PTDM, with the incidence of PTDM being 66 cases/1,000 cat years at risk. By contrast, the incidence of diabetes mellitus among a comparison population of 178 cats with chronic renal failure that did not undergo renal transplantation was 17.9 cases/1,000 cat years at risk, and cats that underwent renal trans-plantation were 5.45 times as likely to develop diabetes mellitus as were control cats with chronic renal failure. The mortality rate among cats with PTDM was 2.38 times the rate among cats that underwent renal transplantation but did not develop PTDM. Age, sex, body weight, and percentage change in body weight were not found to be significantly associated with development of PTDM. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats that undergo renal transplantation have an increased risk of developing diabetes mellitus, compared with cats with chronic renal failure, and that mortality rate is higher for cats that develop PTDM than for cats that do not.     

Atypical membranoproliferative glomerulonephritis in a cat

Membranoproliferative glomerulonephritis was observed in a 2-year-old male Japanese domestic cat with clinical renal failure. In the glomeruli, moderate mesangial hypercellularity with an increased mesangial matrix and thickening of the capillary walls were prominent. In addition, frequent duplication of the capillary walls, splitting, and spike formation were observed in the glomerular basement membrane. Granular cat IgG and complement component deposition were detected globally along the glomerular capillary walls and in the mesangium. Transmission electron microscopy revealed dense deposits in the subendothelial and subepithelial regions and the mesangium. Mesangial interposition was also observed. These glomerular lesions are also found in humans with membranoproliferative glomerulonephritis type III, which has not been reported in animals.