BILATERAL URETEROLITHIASIS AND HYDRONEPHROSIS IN A 10-YEAR-OLD FEMALE SPAYED DLH CAT

OUCH! Acute pain on palpation…. who would have thought there would be not one, but TWO ureteroliths causing pain in this DLH feline patient!

Normal ureters are generally NOT visible on a scan, but acute pain in the region of the kidneys should clue you in to pay particular attention to the kidney region, including use of not just the micro convex probe but also the linear probe to highlight and create those “artistic” views, as seen here.

When you find pathology, such as a dilated ureter, FOLLOW it and see where it goes and what may be hiding there…. Our 17-point SDEP Abdomen protocol teaches you how to do this routinely with EVERY patient, and every potential pathology.

Many thanks to Dr. Candace Remcho of West Hills Animal Hospital in Corvallis, Oregon for the proficient case management of this patient. A loud shout out to Heidi Putnam, clinical SDEP sonographer of The Focal Zone Veterinary Mobile Ultrasound for the exemplary imaging as well as the comprehensive interpretation of this case by the newest addition to the Sonopath Team of Specialists, Dr. R.McKenzie “Mac” Daniel, DVM, DABVP (Canine and Feline).

Come meet Dr. Daniel at SonoPath’s SDEP Abdomen Ultrasound Lab February 23-25th in Atlanta, GA where you can learn the 17-point SDEP (SonoPathDiagnostic Efficiency Protocol™) to obtain all the views needed for a full diagnostic ultrasound exam.

Patient Information:

Age:           10-year old
Gender:   Female, Spayed
Species:   Feline

Presenting Clinical Signs:

• Pain in the area of the kidneys, dehydration, and anorexia with increased renal values
• The patient initially improved after treatment with I.V. fluids, but the symptoms returned 5 days later
• Cerenia, SQ fluids, and buprenorphine were added to the treatment plan
• Preliminary blood chemistry revealed: BUN 128, creat. 7.6 which improved to a BUN of 29 and a creat. of 2.2
• All other parameters were WNL

Above:  Right Kidney Ureterolith   Below: Left Kidney Ureterolith

Image Interpretation:

• The left kidney was small in size with mildly irregular margination.
• Moderate hydronephrosis was present with obliteration of the renal medulla parenchyma.
• Indistinct corticomedullary differentiation was present between the cortex and remaining medulla.
• The hydronephrosis in the left kidney measured 1.6 x 0.8 cm and extended into the proximal left ureter.
• Left ureter dilation measured 0.3 cm.
• A focal, echogenic ureterolith with acoustic shadowing was present within the lumen of the left ureter and measured 0.3 cm in diameter and was located approximately 0.5 cm from the renal pelvis.
• The left kidney measured 2.3 cm in length.
• The right kidney presented normal in size and margination with indistinct corticomedullary distinction and emerging mild hydronephrosis was present.
• Mild obliteration of the right renal medulla parenchyma was noted.
• The hydronephrosis in the right kidney measured 0.9 x 0.8 cm and extended into the right ureter.
• Right ureter dilation measured 0.3 cm.
• A focal, echogenic ureterolith with distal acoustic shadowing was located approximately 2.0 cm from the right kidney renal pelvis.

2018 SDEP Ultrasound Education Labs

2018 Registration is now open!

Our team will help hone your skills and refine those elusive high-end views. Developed by Dr. Lindquist, the SDEP™ (SonoPath Diagnostic EfficiencyProtocol) is an innovative and incredibly efficient instructional ultrasound technique used to obtain all of the views needed for a full diagnostic ultrasound exam in a short period of time.

• All scanning levels welcome (Beginner – Advanced)
• Scanning groups are limited to 3 people per instructor to ensure a personalized learning experience
• Technicians welcome and encouraged
• Post lab support to help build your confidence when you go home

Contact us at info@sonopath.com to ask about our SDEP Certification Program.