Renal pelvic and ureteral ultrasonographic characteristics of cats with chronic kidney disease in comparison with normal cats, and cats with pyelonephritis or ureteral obstruction

Abstract

Objectives The objective was to describe ultrasonographic characteristics of cats with stable chronic kidney disease (CKD) and determine if these were significantly different from cats with pyelonephritis (Pyelo) and ureteral obstruction (UO), to aid in clinical assessment during uremic crisis. Methods Sixty-six cats with stable CKD were prospectively enrolled, as well as normal control cats (n = 10), cats with a clinical diagnosis of Pyelo (n = 13) and cats with UO confirmed by surgical resolution (n = 11). Renal ultrasound was performed and routine still images and cine loops were obtained. Analysis included degree of pelvic dilation, and presence and degree of ureteral dilation. Measurements were compared between groups using non-parametric one-way ANOVA with Dunn's post-hoc analysis. Results In total, 66.6% of CKD cats had measurable renal pelvic dilation compared with 30.0% of normal cats, 84.6% of Pyelo cats and 100% of UO cats. There was no statistically significant difference in renal pelvic widths between CKD cats and normal cats, or CKD cats and Pyelo cats. On almost all measurement categories, UO cats had significantly greater renal pelvic widths compared with CKD cats and normal cats ( P <0.05) but not Pyelo cats. Six percent of stable CKD cats had measurable proximal ureteral dilation on one or both sides vs 46.2% of Pyelo cats and 81.8% of UO cats. There was no statistically significant difference in proximal ureteral width between normal and CKD cats, or between Pyelo and UO cats. There was a statistically significant difference in proximal ureteral width between CKD and Pyelo cats, CKD and UO cats, normal and UO cats, and normal and Pyelo cats. Conclusions and relevance No significant difference in renal pelvic widths between CKD cats and Pyelo cats was seen. These data suggest CKD cats should have a baseline ultrasonography performed so that abnormalities documented during a uremic crisis can be better interpreted.

Diagnostic imaging observations in cats treated with the subcutaneous ureteral bypass system

“…Renal pelvic dilatation is frequently observed in cats with ureteric obstruction, but also occurs with other causes of acute or The number of days following surgery when abnormality was noted on an imaging study is provided in brackets * Indicates that cat underwent surgical correction of the abnormality chronic renal disease, such as pyelonephritis, and in cats with normal renal function receiving intravenous fluids; therefore, pelvic diameter is an inaccurate indicator of ureteral obstruction (D'Anjou et al 2011, Quimby et al 2017, Lamb et al 2018). Furthermore, renal pelvic size cannot be reliably assessed in fluoroscopic images because of the tendency for the renal pelvis to dilate with the pressure of contrast medium injection.…”

Ultrasonographic findings in cats with acute kidney injury: a retrospective study

“…These findings suggest, alongside previous literature, that severe pyelectasia may be sufficient enough to support a diagnosis of ureteral obstruction. 11–16…”

“…These findings suggest, alongside previous literature, that severe pyelectasia may be sufficient enough to support a diagnosis of ureteral obstruction. [11][12][13][14][15][16] Increased renal echogenicity has been reported in a wide range of renal diseases, including glomerular and interstitial nephritis, acute tubular necrosis, nephrocalcinosis and end-stage renal disease. 4 In the current study 22/45 (48.9%) patients had increased renal echogenicity; of these 77% (17/22) had both increased cortical and medullary echogenicity.…”

Stability and profiling of urinary microRNAs in healthy cats and cats with pyelonephritis or other urological conditions

“…In practice, diagnosis is often based on compatible clinical, laboratory, and ultrasonographic features along with a positive vesical urine culture. However, the clinical presentation of PN can be nonspecific, and substantial overlap exists in clinical and diagnostic findings between cats with PN and cats with other urological conditions in particular chronic kidney disease (CKD) and ureteral obstruction (UO) …”