ULTRASOUND-ASSISTED DIAGNOSIS OF RENAL DYSPLASIA IN A 3-MONTH-OLD QUARTER HORSE COLT

A 3-month-old foal was presented for correction of bilateral angular limb deformities. Azotemia was detected as an incidental finding. Small, misshapened, hyperechoic kidneys with decreased corticomedullary demarcation were noted with ultrasonography. Additionally, the internal renal architecture was abnormal in that the intrarenal vessels and distant collecting system were not clearly seen in either kidney. Ultrasound-guided renal biopsy was suggestive of congenital renal dysplasia, which was later confirmed at necropsy. Clinical, sonographic, and pathologic features of equine renal dysplasia are discussed.     

ULTRASOUND LOCALIZATION AND GUIDANCE FOR RENAL BIOPSY IN THE HORSE

Real-time ultrasonography was used to assist percutaneous renal biopsies in seven normal horses. Ultrasound (US) guidance and blind biopsy following US localization were compared. Ten biopsies (seven right kidney and three left kidney) were performed. A transverse approach to the lateral border of the right kidney through the 17th intercostal space was favored, with the needle angle being approximately perpendicular to the body wall. Both biopsy techniques were effective, but blind biopsy following US localization was favored as it was easily performed by one operator without the need for specialized biopsy equipment. The spleen had a variable location and its penetration with the biopsy needle was necessary to obtain two left kidney biopsies. Macroscopic and microscopic hematuria was observed postbiopsy in one and four horses, respectively, out of six horses examined. Perirenal hemorrhage was a prominent finding on necropsy in five of six horses euthanized.     

EFFECT OF REPRODUCTIVE STATUS ON FELINE RENAL SIZE

Renal length and width dimensions were determined from survey radiography and excretory urography in 28 cats of various sex and reproductive status. Renal dimensions were expressed as a ratio to the length of the second lumbar vertebra. Renal dimensions were not significantly different when males were compared to females. However, significant differences in renal dimensions between intact and neutered cats were identified. Renal length ratios for neutered cats were: left kidney 2.22 +/- 0.14 (mean +/- standard deviation), right kidney 2.29 +/- 0.14. In intact cats, renal length ratios were: left kidney 2.60 +/- 0.19, right kidney 2.65 +/- 0.24. The mean renal length ratios for neutered cats was smaller than previously reported normal values. Thus, reproductive status should be considered when evaluating feline kidneys for alterations in size. Based on this study, normal feline renal length ratios range from 1.9 to 2.6 for neutered cats and 2.1 to 3.2 for intact cats.     

Nephrolithiasis resulting in intermittent ureteral obstruction in a cow

Bilateral nephrolithiasis with intermittent ureterolithiasis was diagnosed in a 7-year old Holstein cow. Two episodes of ureterolithiasis resulted in severe azotemia which resolved after spontaneous movement of the stone. A third episode of obstruction one year after the initial episode resulted in rupture of one kidney, necessitating euthanasia. The histopathological examination of the kidney was diagnostic for chronic pyelonephritis. Corynebacterium sp. was cultured from a nephrolith. In this case it is believed that the chronic pyelonephritis predisposed to the calculi formation.     

RENAL CALCULI IN APPARENTLY NORMAL SHEEP

SUMMARY The incidence of renal calculi in sheep was determined and the effects of season, sex and difference between left and right kidneys were considered. Examinations for calculi were made by x-ray photography and stereomicroscopy. The seasonal study extended from June 1972 to June 1973. The lowest incidence of calculi, occurred from November to February (25 to 35%) and the highest, in June 1972 (61%) and May 1973 (63%); in other months it generally ranged from 40 to 50%. These differences were highly significant (P < 0.001). The incidence of calculi greater than 2 mm diameter was 0% and 3% in January and February and, except for 18% in June 1972 values were about 8%. Subepithelial deposits ranged from 2% (April) to 25% (June 1972) about a mean of 11%. Calculi were found most frequently in the middle third of the kidney and near the fornices. Of kidneys with microcalculi (<0.05 mm diameter) visual assessment showed 64% contained silica, 29% oxalate, 15% carbonate and 5% material of undetermined nature. Differences in the incidence of calculi between ewes and wethers and between left and right kidneys were not significant and the distribution of calculi within these kidneys was similar to that in the seasonal study. These results are discussed in relation to urinary tract obstruction in grazing sheep and to possible factors affecting the retention in and movement of calculi from the kidney.     

OSSEOUS METAPLASIA IN THE RENAL PELVIS OF A DOG WITH HYDRONEPHROSIS

A 3-year-old male Sheltie dog was presented with abdominal distension, diarrhea, and vomiting. Hematologic and blood chemistry studies revealed a mild anemia and a few leukocytes in the urine. Radiographic examination was made, and a large mass with calcified trabeculae was present in the ventral right cranial quadrant of the abdomen. Exploratory celiotomy was performed, and a mass identified as the right kidney was removed. The excised kidney was cystic and multiloculated, and contained areas of bone and cartilage. This mass weighed 1120 g and was in excess of ten percent of the dog's body weight. Transitional epithelium can stimulate osseous metaplasia. The presence of both tissues in a biopsy specimen might indicate urinary tract disease.     

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.     

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.     

Renal hypoplasia and dysplasia in an American miniature foal

Diagnostic imaging, including computed tomography, of a two-month-old foal with renal failure indicated that its right kidney was probably absent and that its left kidney was abnormal in shape. The foal was stabilised and released, but three days later its clinical signs recurred. Postmortem examination revealed renal hypoplasia and dysplasia, the first reported case of this condition in an American miniature horse.     

ULTRASONOGRAPHIC EVALUATION OF RENAL AUTOGRAFTS IN NORMAL CATS

The purpose of this study was to determine changes in resistive index (RI) and renal size that occur in normal feline kidney autografts in the immediate post-transplant period. Qualitative changes in renal parenchymal echogenicity and pelvic dilation were also noted, although this was not a major focus of the study. Fourteen domestic short-haired cats underwent bilateral nephrectomies followed by an autograft of the right kidney to either the aorta or external iliac artery. Due to post-operative complications, only nine of these cats completed the study. Ultrasonographic determination of the RI and renal size was made before transplantation and on days 1, 4, 7, 10, and 13 following transplantation. No significant changes in renal RI were identified during the study. Renal size increased significantly, peaking at 63% above baseline on day 7, and stayed elevated at 50% above baseline on day 13. There was no evidence of rejection or other abnormalities found on histologic evaluation of the transplanted kidneys. It was concluded that the RI of normal feline renal autografts does not significantly change in the immediate post-operative period. However, significant renal enlargement, likely due to a combination of post-operative edema and hypertrophy, does occur. This study provides baseline information for comparison with feline allografts in the immediate post-transplant period.     

EFFECT OF OBSERVER VARIABILITY ON GLOMERULAR FILTRATION RATE MEASUREMENT BY RENAL SCINTIGRAPHY IN DOGS

Observer variation in kidney depth measurement for correction of soft-tissue attenuation and kidney region of interest (ROI) drawing was evaluated using 60 clinical dogs with a wide range of glomerular filtration rate (GFR) for their effect on the calculated percentage uptake of 99mTc-diethylenetriamine pentaacetic acid (DTPA) and individual kidney GFR by scintigraphy. Kidney depth was measured separately on the lateral image using two color tables: a threshold and a continuous red-green-blue. Within-observer variability of the semi-automatic ROI drawing of the estimated total GFR was up to 10% for the right kidney (RK) and 9% for the left kidney (LK). The variability was lower between observers, 6% for RK and 8% for LK. Manual ROI drawing caused more within observer variation than semi-automatic: up to 14% for RK and 11% for LK. Continuous red-green-blue table caused more variation within and between observers than threshold table. Average within-observer variability from both observers of kidney depth measurement on different color tables could vary up to 5.5% and 6.5% variation of the GFR of RK and LK, respectively. Most variation affecting the DTPA percentage uptake came from the ROI drawing technique. Variations of the method because of the effects of both kidney depth and kidney ROI drawing were up to 8% and 10% for RK and LK, respectively. To minimize these variations a threshold scale should be used for the kidney depth measurement and an automatic or semi-automatic ROI should be used whenever possible. In sequential examinations the same person should make all the measurements.     

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.     

CHRONIC RENAL FAILURE IN A YOUNG PONY

SUMMARY A 19-month-old pony gelding was presented with chronic renal failure, after deteriorating progressively during the preceding 3 months. There was pronounced azotaemia, hyponatraemia and hypochloraemia, but plasma calcium and phosphorus levels were normal. At autopsy both kidneys were small and nodular and were characterised by collapsed segments of cortex and medulla interspersed with areas of pale tissue. The latter showed glomerular immaturity associated with a range of degenerative processes involving the glomeruli and tubules. The condition bore many similarities to that of renal cortical dysplasia in other species.     

SONOGRAPHIC APPEARANCE OF RENAL NEOPLASIA IN THE DOG

Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography com-plemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant.     

Dilated ureters, renal dysplasia, and chronic renal failure in an African elephant (Loxodonta africana)

An ultrasonographic reproductive health examination of a 26-yr-old female African elephant (Loxodonta africana) revealed bilateral ureteral wall thickening and dilatation. On ultrasonographic examination, the bladder and both ureters were normal near the trigone; however, the cranial-most aspect of each ureter was dilated and thickened for a length of 30-50 cm. The same month, elevated blood creatinine (3.0 mg/dl), and urine protein-creatinine ratio (4.0) were observed. Chronic renal failure was diagnosed based on these abnormalities, and the persistent ureteral dilatation was seen on subsequent ultrasound examinations. Complete blood cell counts, serum chemistries, and urinalyses remained relatively unchanged until 24 mo after diagnosis, at which time azotemia, hypophosphatemia, and hypercalcemia (including elevated ionized calcium) developed. Hydronephrosis of both kidneys and prominent sacculation of the left ureter were noted on ultrasonographic examination. Lethargy, ventral edema, and oral mucosal ulceration acutely developed 30 mo after diagnosis. Although blood urea nitrogen remained elevated, creatinine, total calcium, and ionized calcium returned to within reference ranges at that time. Due to rapid clinical decline and grave prognosis, humane euthanasia was elected. Bilateral ureteral dilatation, dysplasia of the right kidney, and chronic nephritis of the left kidney were identified postmortem.     

RENAL FAILURE, HYPERPARATHYROIDISM AND HYPERCALCAEMIA IN A DOG

A 4-year Basset bitch with a 9-week history of depression, lethargy, inappetence and weight loss was found to have azotaemia, hypercalcaemia and hyperphosphataemia. Laparotomy and kidney biopsy revealed end-stage renal disease and the dog was killed. Hyperplasia of all 4 parathyroid glands was found at autopsy. The presumptive diagnosis was idiopathic renal failure with resulting tertiary hyperparathyroidism.     

Urethrolithiasis and nephrolithiasis in a horse.

A 9-year-old, quarter horse gelding with obstructive urethrolithiasis was treated with a perineal urethrostomy. The horse's condition deteriorated and abdominocentesis confirmed septic uroperitonitis. The horse was euthanized and postmortem examination revealed peritonitis, a tear in the lateral wall of the bladder, and a nephrolith within the left renal pelvis.     

Renal dysplasia in a Shih Tzu dog in Japan.

A 5-month-old, male, Shih Tzu dog manifesting polyuria and polydipsia since 2-month-old was presented to our hospital with additional clinical complaints of vomiting and depression during recent a few days. Despite the symptomatic therapy for chronic renal failure, he died on the day after medication. Macroscopically, both kidneys were small in size with rough surface. Microscopical examination revealed bilateral renal fibrosis with dysplastic changes consisting of immature glomeruli and tubules, and foci of adenomatoid proliferation of tubular epithelium. In addition, incomplete lobulation of medulla with pelvic structures was also noticed in the right kidney. From these findings, the present case was diagnosed as renal dysplasia in Shih Tzu dog which was documented in the literatures.     

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.