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. 2017 Aug;19(8):784-790.
doi: 10.1177/1098612X16656910. Epub 2016 Jul 7.

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

Jessica M Quimby  1 , Kristy Dowers  1 , Andrea K Herndon  1 , Elissa K Randall  2
Affiliations

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

Jessica M Quimby et al. J Feline Med Surg. 2017 Aug.

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.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Renal pelvic width measurements for (a) sagittal left (L) and right (R) and (b) transverse left and right planes are presented as box and whisker plots. Statistically significant differences between normal, chronic kidney disease (CKD), pyelonephritis (Pyelo) and ureteral obstruction (UO) groups are denoted by an asterisk (P <0.05)
Figure 2
Figure 2
Average of left and right (L&R) renal pelvic width measurements in (a) sagittal and (b) transverse planes are presented as box and whisker plots. Statistically significant differences between normal, chronic kidney disease (CKD), pyelonephritis (Pyelo) and ureteral obstruction (UO) groups are denoted by an asterisk (P <0.05)
Figure 3
Figure 3
Greatest of two (left and right) renal pelvic width measurements in (a) sagittal (Sag) and (b) transverse (Trans) planes are presented as box and whisker plots. Statistically significant differences between normal, chronic kidney disease (CKD), pyelonephritis (Pyelo) and ureteral obstruction (UO) groups are denoted by an asterisk (P <0.05)
Figure 4
Figure 4
Cat with stable International Renal Interest Society stage 2 chronic kidney disease with a creatinine of 2.1 mg/dl, showing 12.5 mm renal pelvic dilation left transverse plane and 9.8 mm renal pelvic dilation left sagittal plane. This patient experienced no progression of disease and had unchanged ultrasound findings for 4 years after initial ultrasound evaluation
See this image and copyright information in PMC

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