Charlie is a 13-year-old cat who was referred to Northwest Veterinary Specialists for investigation of an enlarged left kidney. Charlie’s left kidney was noted to be enlarged for a few years, but more recently he was found to be more lethargic and his appetite was reduced. Charlie was examined by his vet and a large mass (about 10 cm) was palpated in his belly. Radiographs were performed and revealed a severely enlarged left kidney.
Charlie was evaluated at Northwest Veterinary Specialists by the Internal Medicine Specialist and his physical examination was found to be normal, apart from an enlarged left kidney.
Differential diagnoses for this were:
- Polycystic kidney
- Hydronephrosis (an enlarged kidney full of liquid, which could be a possible consequence of an obstruction given by a stone, clot, mass or narrowing etcetera)
- Kidney infection (pyelonephritis)
- Renal pseudocyst
Charlie was admitted to the hospital for investigation to try to determine the cause of the enlarged kidney, so bloods were performed and were normal. A urine analysis was also performed to assess for infections of the urinary tract and found normal, without evidence of infections. An abdominal ultrasound confirmed an enlarged left kidney with no ‘normal’ renal structure.
No stones, masses or clots were detected in the left ureter (the tube connecting the kidney to the urinary bladder) as possible causes of an obstruction.
Charlie was diagnosed with left renal hydronephrosis. Given his chronic history of an enlarged kidney, it was not clear which had been the cause of it, but we could speculate that something had caused an obstruction in the past, leading to this condition, which was not evident at the time of our investigation.
Due to the risk of infection or rupture of this kidney, left nephro-ureterectomy surgery (removing of the left kidney and its ureter) was elected.
Charlie underwent surgery and his left kidney was removed without intraoperative complications and he had an uneventful recovery.
Charlie was comfortable and is eating well since the surgery.
Histological diagnosis confirmed hydronephrosis of the left kidney. Charlie is reported to be doing really well so far.