Term
| What allows us to see the margins of the normal kidney? |
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Definition
| -contrast given by the retroperitoneal fat |
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Term
| What are the 4 primary reasons for inability to see kidneys? |
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Definition
-absence of sufficient retroperitoneal fat: most common
-retroperitoneal disease: most common
-ectopic or absent kidney
-superimposition of bowel/uingesta/feces |
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Term
| Which kidney is more cranial? Describe its location. |
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Definition
-right kidney
-cranial pole at T13-Lt in contact with the caudate lobe of the liver, right limb of the pancreas, and the descending duodenum |
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Term
| Are cat or dog kidneys easier to see? Why? |
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Definition
-cat
-more retroperitoneal fat |
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Term
| How does the location of the kidneys change in an obese animal? |
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Definition
|
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Term
| What are the three main sections of the kidney? |
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Definition
| -cortex, medulla, sinus/pelvis |
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Term
| How does the shape of cat kidneys differ from dog kidneys? |
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Definition
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Term
| Do we normally see the ureters? |
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Definition
|
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Term
| What are the guidelines we use for normal kidney size? |
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Definition
-Dog: 2.5-3.5 X length of L2
-Cat: 2.4-3.0 X length of L2
-Older cats: 1.9-2.6 X length of L2 |
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Term
| What are some causes of bilateal renal enlargement with smooth margins? |
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Definition
-acute nephritis
-polycystic kidneys
-neoplasia
-feline infectious peritonitis
-portosystemic shunts
-pyelonephritis
-perirenal pseudocyst
-hydronephrosis secondary to bilateral obstruction |
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Term
| What are some possible causes of unilateral renal enlargement with smooth margins? |
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Definition
-compensatory hypertrphy
-primary or secondary neoplasia
-renal cyst or abscess
-perirenal pseudocyst
-hydronephrosis secondary to obstruction
-hematoma
-granuloma |
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Term
| What are some possible causes of renal enlargment with focally irregular margins? |
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Definition
-primary or metastatic renal neoplasia
-renal abscess
-renal hematoma
-renal granuloma
-renal cyst |
|
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Term
| What are some possible causes of renal enlargement with multi-focal/diffuse irregular margins? |
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Definition
-neoplasia
-polycystic renal disease
-feline infectious peritonitis
-leptospirosis |
|
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Term
| What are some possible causes of kidneys of normal size with irregular margins? |
|
Definition
-renal infarct
-renal abscess
-chronic pyelonephritis
-polycystic kidneey disease |
|
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Term
| What are some possible causes of decreased renal size with irregular margins? |
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Definition
-end stae renal disease
-amyloidosis
-glomerulonephritis
-chronic pyelonephritis
-renal hypoplasia |
|
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Term
| What are some examples of disease in wich the kidneys may appear normal? |
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Definition
-amyloidosis
-glomerulonephritis
-pyelonephritis |
|
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Term
| What are some reasons for mineralization in the kidney? |
|
Definition
-RENAL CALCULI
-calcified tumors
-mineralized cysts
-nephrocalcinosis due to systemic disorders (chronic uremia, vit D toxicity)
-osseous metaplasia of the renal pelvis in the presence of renal disease |
|
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Term
| What are some possible causes for gas in the kidneys? |
|
Definition
-vesicureteral reflux from previous negative contrast admin (cystography)
-trauma
-abscess |
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Term
| What is an excretory urography? |
|
Definition
-IV admin of water soluble iodinated contrast media (nonionic are safer)
-normally >99% of contrast agent is excreted by the kidneys for a qualitative test of renal function |
|
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Term
| What is an example of a test used for quantitative, not qualitative, function of the kidneys? |
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Definition
| -GFT nuclear scintigraphy |
|
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Term
| What are some of the indications for an excretory urography? |
|
Definition
-kidneys are abnormal on physical, lab work, or radiographs
-abnormal urine of suspected renal origin
-mass lesion originating in the region of the kidney
-prior to nephrectomy
-evaluation of the ureters: especially ectopic ureter
-eval of bladder concurrently or if unable to catheterize |
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Term
| What are some contraindications for an excretory ureography? |
|
Definition
-dehydration: increases the severity of dehydration
-congestive heart disease (expands IV fluid volume)
-known hypersensitivity to contrast media |
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Term
| True or False: Azotemia is not a contraindication for EU IF the patient is well-hydrated. |
|
Definition
|
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Term
| How do we prepare a patient for an excretory urogram? |
|
Definition
-12-24h fasting
-cleansing enema 2-4h prior
-bloodwork to determine renal function
-SSESS HYDRATION STATUS
-survey rads |
|
|
Term
| What are the different contrast agents we use for excretory urography? |
|
Definition
-water soluble sterile aqueous solution
-iodinated: tri-iodinated benzic acid derivatives
-HYPERTONIC: Renovist, Hypaque-M, Conray, Renograffin
-Nonionic, isotonic agents can be used if the patient is at risj for contrast induced renal failure or if cost effective |
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Term
| Do we decrease or increase the dose of contrast agent in animals with impaired renal function for EU? |
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Definition
-increase
-inc [plasma] to counteract dec in GFR |
|
|
Term
| What are some of the complications of EU? |
|
Definition
-extravasation of contrast medium: irritating
-nausea/vomiting: due to hypertonicity of the contrast
-anaphylaxis
-contrast induced renal failure: due to acute tubular necrosis |
|
|
Term
| What are the 3 phases of EH? |
|
Definition
1) Vascular: immediate
2) Nephrogram: 10-30 seconds post-injection; opacification of renal parenchyma
3) pyelogram: greater than 1 min; opacification of renal pelvis, diverticula, andureters |
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Term
| How does chronic renal disease appear on EU? |
|
Definition
-shrunken, irregular shaped kidneys
-peanut shaped
-distored diverticula
-kidneys may fial to opacify
-usually end-stage
-may have mineralization
-results from long standing inflammatory diseases |
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Term
| How does acute pyelonephritis appear on EU? |
|
Definition
-smooth renal enlargement
-may be unilateral
-blunted diverticuli
-possible renal pelvis dilation
-possible uretral dilation |
|
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Term
| How does chronic pyelonephritis appear on EU? |
|
Definition
-may be normal in size and hsapr or shrunken and irregular
-blunted diverticula
-widened renal pelvis
-enlarged ureter |
|
|
Term
| What are the two patterns that neoplasia takes on with excretory urography? |
|
Definition
-poor opacificaition of the whole mass if the tumor has outgrown its blood supply
-part of the kidney appears normal while the tumo shows distortion of hte adjacent pelvis and diverticula or filling defect |
|
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Term
| What causes hydronephrosis? |
|
Definition
| -obstruction of the ureter |
|
|
Term
| What do renal calculi look like? |
|
Definition
-most commonly radiopaque, many shapes, show up as filling defects on an EU
-usually centrally located in the pelvis but can extend into the diverticuli |
|
|
Term
| Do we normally see the ureters? |
|
Definition
-no
-if you can see the entire ureter, neeed to consider poor peristalsis partial, or complete obstruciton or pyelonephritis |
|
|
Term
| What is the typical cause of a diffusely enlarged ureter? |
|
Definition
| -obstruction or atony from chronic infection |
|
|
Term
| What are some causes of a focally enlarged ureter? |
|
Definition
| -ureterocele or diverticulum |
|
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Term
| What are some causes of a regularly shaped uretur with irregular mucosal surfaces? |
|
Definition
| -fibrosis or inflammaiton |
|
|
Term
| What is the most common termination point of ectopic ureters? |
|
Definition
| -in the vagina > urethra > bladder neck > uterus |
|
|
Term
| What clinical signs do we see with ectopic ureters? |
|
Definition
| -signs of chronic pyelonephritis |
|
|
Term
| What is the best test to run to visualize an ectopic ureter? |
|
Definition
|
|
Term
| What usually causes a ruptured ureter? What does it look like? |
|
Definition
-blunt trauma
-extravasation of contrast: whispies without filling of bladder |
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