Case Index - April 2003 - Case of the Month.

Click on an image for a larger view and scroll down to the bottom for the final answer.


7 year old, female spayed American Cocker Spaniel with a 3 day history of anorexia. What do you think?

Image is sagittal plane from the left dorsal abdomen.

  1. Describe the abnormalities
  2. What are your differentials?
  3. Testing Considerations

Ultrasound findings:

  1. Dialated left renal pelvis and proximal left ureter.
  2. Atophy of renal parenchyma
  3. Echogenic urine in dilated segments.
















Differentials

  1. Left ureteral obstruction
    1. Stricture secondary to ureteritis
    2. Neoplastic obstructing mass in bladder trigone
    3. Infiltrative mass between kidney and bladder

Testing Considerations

  1. Complete the US exam
    1. No trigone mass was seen
    2. No mass between kidney and bladder
    3. Normal appearing right kidney (right ureter not seen)
  2. UA was normal
  3. Increased neutrophils on CBC

















Findings:
Suspected ureteritis and secondary obstructive stricture. Pyelocentesis revealed suppurative urine with a positive culture of E.coli. The kidney was resected surgically.