Ultrasonographic diagnosis of a lymphomatous lymph node presumptively infiltrating the ureter causing hydronephrosis in a 3-year-old dog.

A 3-year-old male neutered mixed breed dog was presented for chronic vomiting and diarrhea. Abdominal ultrasound revealed a large amorphous, heterogeneous mass within the left mid to caudal abdomen most consistent with medial iliac lymph node. It appeared to invade the left ureter and extend distally causing ureteral obstruction and hydronephrosis. Concurrent additional ultrasound findings were consistent with metastatic or multicentric neoplasia. Fine needle aspirates of the lymph node and spleen both confirmed large cell lymphoma. These findings present evidence of lymphoma invading directly from an organ into the ureter which has not previously been reported in dogs.

Ureteroneocystostomy for treatment of struvite urolithiasis in a ferret.

OBJECTIVE: To assess the clinical outcome of a ferret undergoing a ureteroneocystostomy for treatment of urolithiasis. ANIMAL: A 10-month-old spayed female ferret. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The ferret was evaluated for straining to urinate and defecate, hematochezia, and a rectal prolapse. Plain radiographs revealed large cystic and ureteral calculi. Clinicopathologic analyses indicated the ferret was anemic with an elevated creatinine concentration. Exploratory laparotomy defined bilateral ureteral calculi that were unable to be successfully moved into the bladder. A cystotomy was performed to remove a large cystic calculus. Serial abdominal ultrasonographic examinations showed progressive hydronephrosis of the left kidney and persistent pyelectasia of the right kidney secondary to bilateral ureteral calculi. This confirmed a left ureteral obstruction secondary to the distal calculus while the right ureter remained patent. TREATMENT AND OUTCOME: A ureteroneocystostomy was performed to allow for left renal decompression. The ferret recovered well despite worsening hydronephrosis of the left kidney in the perioperative period. The ferret was discharged from the hospital 10 days after initial evaluation. At 3-week follow-up, abdominal ultrasonography confirmed resolution of hydronephrosis and ureteral dilation of the left kidney and ureter. CLINICAL RELEVANCE: A ureteroneocystostomy successfully allowed renal decompression and ureteral patency in a ferret with urolithiasis. To the authors' knowledge, this is the first time this procedure has been reported in a ferret for treatment of a ureteral calculus obstruction and may result in good long-term outcome.

Rapport de cas Suspected congenital unilateral ureteral atresia and hydronephrosis in a 6-year-old dog.

A 6-year-old neutered male giant schnauzer dog was presented to an emergency clinic with stranguria and pollakiuria. On physical examination, the abdomen was generally and non-painfully distended. Diagnostic imaging revealed several large, anechoic, fluid-filled, space-occupying lesions from the cranial to caudal abdomen placing extramural pressure on the bladder and urethra and apparently causing the clinical signs. Unilateral ureteral atresia with secondary ipsilateral hydronephrosis and hydroureter were diagnosed on post-mortem examination. Due to a lack of history of abdominal surgery or trauma and the absence of scarring or stenosis of the ureter, the condition was suspected to be congenital. Key clinical message: Although rare, hydronephrosis and hydroureter secondary to a congenital ureteral defect should be considered when a dog is presented with abdominal distension and several peritoneal and retroperitoneal space-occupying lesions on diagnostic imaging.

Atrésie urétérale unilatérale congénitale suspectée et hydronéphrose chez un chien de 6 ans. Un chien schnauzer géant mâle castré âgé de 6 ans a été présenté à une clinique d'urgence avec une strangurie et une pollakiurie. À l'examen physique, l'abdomen était distendu de manière générale et non-douloureuse. L'imagerie diagnostique a révélé plusieurs grandes lésions anéchoïques, remplies de liquide et occupant de l'espace de l'abdomen crânien à caudal, exerçant une pression extra-murale sur la vessie et l'urètre et causant apparemment les signes cliniques. Une atrésie urétérale unilatérale avec hydronéphrose ipsilatérale secondaire et hydro-uretère ont été diagnostiqués lors de l'autopsie. En raison d'un manque d'antécédents de chirurgie abdominale ou de traumatisme et de l'absence de cicatrices ou de sténose de l'uretère, la condition a été suspectée d'être congénitale.Message clinique clé :Bien que rares, l'hydronéphrose et l'hydro-uretère secondaires à une anomalie urétérale congénitale doivent être envisagées lorsqu'un chien présente une distension abdominale et plusieurs lésions péritonéales et rétropéritonéales occupant de l'espace à l'imagerie diagnostique.(Traduit par Dr Serge Messier).

Ultrasonographic and contrast-enhanced CT imaging diagnosis of idiopathic renal hematuria with bilateral hydronephrosis and hydroureter in a dog.

A 5-year-old spayed female Maltese presented with a 1-week history of severe hematuria. Abdominal ultrasonography and thoracic, and abdominal computed tomography identified bilateral hydronephrosis and hydroureter due to an obstruction at the left ureter and urinary bladder lesion with no evidence of metastasis. After surgical removal of the material and placement of a temporary ureteral stent, the patient was able to urinate normally. Histological examination revealed a massive blood clot. Based on our review of the literature, this is the first published report describing the imaging diagnosis of obstructive hydronephrosis and hydroureter induced by idiopathic renal hematuria in a dog.

[Outcome of selective mating in the Entlebucher Mountain Dog for reduction of ureteral ectopia]. / Ergebnis der selektiven Verpaarung beim Entlebucher Sennenhund zur Reduktion der ureteralen Ektopie.

INTRODUCTION: The Entlebucher Mountain Dog is predisposed to ureteral ectopia and associated diseases of the urinary tract as well as the kidneys, which can have severe to lethal consequences. Due to the clustered occurrence of clinical signs in 11 % of Entlebucher Mountain dogs in the absence of a genetic test for ureteral ectopia, screening was introduced in 2008 to allow phenotype-based breeding selection. The ureteral orifices of the dogs are visualized by ultrasound and existing urinary retention or urinary incontinence is documented. The diagnostic findings were evaluated centrally with assignment to one of five phenotypes depending on the localization of the ureteral orifices and the renal and ureteral shape. Breeding approval and mating restrictions are the responsibility of the respective breeding associations and predominantly Entlebucher Mountain Dogs with extravesical ectopic ureters and/or clinical signs were excluded from breeding. The effect of phenotype-based selective mating on the incidence of ureteral ectopia and its clinical signs, as well as possible factors influencing the expression of the phenotype, were determined in the birth cohorts after the introduction of screening. Analysis of the data set of 1456 phenotyped Entlebucher Mountain Dogs showed, that at 11 % versus 5 %, males were more frequently assigned to the extravesical phenotype than females. The effect of phenotype-based breeding selection was examined in a subpopulation consisting of phenotyped parents and their offspring (n = 876). The prevalence of the extravesical phenotype decreased from 24 % in the 2005 to 2007 birth cohorts to 1,4 % in the 2015 to 2017 birth cohorts. Since 2015 almost no Entlebucher Mountain Dogs with incontinence, hydroureter or hydronephrosis have been recorded. It was feared that the additional selection measures to control ureteral ectopia in the small Entlebucher Mountain Dog population would intensify the inbreeding increase. However, this has so far remained absent. Therefore, as long as no genetic test is available, it is recommended to continue phenotype-based breeding selection with exclusion of dogs with extravesical ureteral ectopia and/or hydroureter/hydronephrosis/urinary incontinence, while keeping an eye on the development of the inbreeding coefficient.

INTRODUCTION: Le Bouvier de l'Entlebuch est prédisposé à l'ectopie urétérale et aux maladies associées des voies urinaires ainsi que des reins, ce qui peut entraîner des conséquences fatales. En raison de l'apparition de signes cliniques chez 11 % des chiens et en l'absence d'un test génétique pour l'ectopie urétérale, un dépistage a été introduit en 2008 pour permettre une sélection d'élevage basée sur le phénotype. Les orifices urétraux des chiens ont été visualisés par échographie et la rétention ou l'incontinence urinaire existante documentée. Les résultats du diagnostic ont été évalués de manière centralisée avec attribution à l'un des cinq phénotypes en fonction de la localisation des orifices urétéraux ainsi que de la forme des reins et des uretères. L'approbation pour la reproduction et les restrictions d'accouplement relèvent de la responsabilité des associations d'élevage respectives et les bouviers de l'Entlebuch présentant des uretères ectopiques extravésicaux et/ou des signes cliniques ont majoritairement été exclus de la reproduction. L'effet de cet accouplement sélectif basé sur le phénotype sur l'incidence de l'ectopie urétérale et de ses signes cliniques ainsi que les facteurs possibles influençant l'expression du phénotype ont été déterminés dans les cohortes de naissance après l'introduction du dépistage. L'analyse de l'ensemble des données de 1456 Bouviers de l'Entlebuch phénotypés a montré que, à 11 % contre 5 %, les mâles étaient plus fréquemment affectés au phénotype extravésical que les femelles. L'effet de la sélection d'élevage basée sur le phénotype a été examiné dans une sous-population composée de parents phénotypés et de leur progéniture (n = 876). La prévalence du phénotype extravésical est passée de 24 % dans les cohortes de naissance de 2005 à 2007 à 1,4 % dans les cohortes de naissance de 2015 à 2017. Depuis 2015, presque aucun bouvier d'Entlebuch présentant une incontinence, un hydrouretère ou une hydronéphrose n'a été enregistré. Une possible augmentation de la consanguinité due aux mesures de sélection supplémentaires visant à contrôler l'ectopie urétérale ne s'est pas produite. Par conséquent, tant qu'aucun test génétique n'est disponible, il est recommandé de poursuivre la sélection d'élevage basée sur le phénotype avec exclusion des chiens présentant une ectopie urétérale extravésicale et/ou une hydrouretère/hydronéphrose/incontinence urinaire, tout en surveillant l'évolution du coefficient de consanguinité.

Renal Dysplasia with Hydronephrosis and Congenital Ureteral Stricture in Two Holstein-Friesian Calves.

We investigated the pathological characteristics of renal dysplasia with hydronephrosis and congenital ureteral stricture in two calves. Macroscopically, the affected kidneys were enlarged and the renal calyces were dilated and associated with ureteral strictures. Histopathologically, multifocal regions of mesenchyme were observed in the renal medulla. This mesenchyme was weakly eosinophilic with haematoxylin and eosin, blue with Alcian blue and pale blue with Masson's trichrome, and was immunopositive for vimentin and smooth muscle actin, consistent with persistent mesenchyme. There was asynchronous differentiation of the renal cortex characterized by immature glomeruli, immature tubules and arteriolar proliferation. Similar persistent mesenchyme was observed in the ureteral walls with ureteral stricture, and the ureteral musculature or smooth muscle bundles had a disorganized arrangement. Congenital ureteral stricture appeared to have caused ureteral obstruction and hydronephrosis. The lesions may represent a new phenotype of renal dysplasia with concomitant congenital ureteral stricture in Holstein-Friesian calves.

Hypertensive Cardiomyopathy as a Sequel to Hydronephrosis Induced by Transitional Cell Carcinoma.

A 10-year-old female Griffon dog was presented for evaluation due to a 5-month history of hematuria and systemic hypertension. Thoracic auscultation detected a grade II/VI left apical systolic murmur. Abdominal ultrasound revealed the presence of a heterogeneous mass at the trigonal area of the urinary bladder, extending to the left ureter cranially and caudally toward the bladder's neck. Marked left hydronephrosis and hydroureter were detected as well as mild right hydronephrosis. Cytological examination of urine sediment confirmed the presence of transitional cell carcinoma. Echocardiography disclosed marked left ventricular concentric hypertrophy, which likely developed as a consequence of systemic hypertension induced by the bilateral hydronephrosis due to bladder transitional cell carcinoma.

Surgical treatment of retroiliac ectopic ureters with secondary hydronephrosis and hydroureter in a dog.

CASE DESCRIPTION: An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters. CLINICAL FINDINGS: Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction. TREATMENT AND OUTCOME: The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence. CLINICAL RELEVANCE: To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.

A case of congenital ureteral atresia causing rare upper and lower urinary tract manifestations in a puppy: a case report.

BACKGROUND: Ureteral atresia is the congenital absence of a ureteral opening, resulting in a blind-ended ureter that fails to terminate at the urinary bladder. Consequently, severe hydroureter and hydronephrosis occur ipsilateral to the atresic ureter. However, hydronephrosis contralateral to severe hydroureter, although reported in humans, is not documented in the dog. Additionally, ureteral atresia has not been reported as a cause for lower urinary tract signs directly related to extramural urinary bladder compression. This report aims to describe these unique manifestations of this congenital urinary tract disease, as well as follow-up findings after successful treatment. CASE PRESENTATION: A 4-month-old male Husky puppy was evaluated for pollakiuria, stranguria, and urine dribbling of 1-month duration. During the physical examination, a mass was palpated in the mid-abdomen. Diagnostic imaging and cystoscopy findings were diagnostic for right-sided ureteral atresia with secondary hydroureter and hydronephrosis. The severe right hydroureter caused lower urinary tract signs and contralateral hydronephrosis secondary to regional compression of the left distal ureter and urinary bladder. A right-sided ureteronephrectomy was performed, resolving the stranguria and pollakiuria. Significant reduction in the contralateral (left) hydronephrosis also occurred. CLINICAL RELEVANCE: Ureteral atresia should be considered as a differential diagnosis for lower urinary tract signs and/or bilateral hydronephrosis in a young dog. Reporting this case expands our knowledge of congenital lower urinary tract disease and the etiology of their manifestations in dogs. Surgical resolution of the congenital ureteral abnormality can result in preservation of renal function in the contralaterally obstructed kidney.

A long-term study of the effects of SLC12A1 homozygous mutation (g.62382825G>A, p.Pro372Leu) in Japanese Black cattle.

Recessive missense mutation in the solute carrier family 12, member 1 (SLC12A1) gene (g.62382825G>A) is associated with hydrallantois, which is the accumulation of fluid in the allantoic cavity of a pregnant animal, and usually causes fetal death in Japanese Black cattle. However, the symptoms of a homozygote with this mutation that do not result in fetal death have not previously been tracked and evaluated. In the present study, we observed a homozygote with the SLC12A1 risk allele over a long-term period. The calf did not show any obvious clinical symptoms, although it did exhibit a slight growth retardation that accompanied mild calciuria. At 28 months of age, the homozygote showed renal dysfunction, which in turn resulted in hydronephrosis. The time course of the symptoms was consistent with the phenotype of Bartter syndrome in humans. Additionally, the risk heterozygous genotype did not any effects on carcass traits, which indicates that eliminating the risk allele would not have any unfavorable effects. Therefore, we emphasize that both the fetal- and late-stage symptoms associated with the SLC12A1 risk allele compromise animal welfare, and consequently may result in severe economic losses for individual farmers if the SLC12A1 risk allele is not eliminated from the population.

Prenatal Diagnosis of Megacystitis and Hydronephrosis in an Equine Fetus: How Transabdominal Ultrasonography Can Help to Diagnose Fetal Abnormalities.

Premature udder development constitutes an alarm signal in pregnant mares. The objective of this clinical case report is to highlight the importance of transabdominal ultrasound examination of the fetus in these cases and to report a unique case of prenatal diagnosis of obstructive uropathy based on the observation of severe fetal hydronephrosis and megacystitis in utero. A 4-year-old French chaser primiparous mare was referred for evaluation of premature udder development during the ninth month of pregnancy. The mare had clinical signs within normal limits, a developed and sensitive udder with secretions, and no vulvar discharge. Transrectal examination revealed the presence of an immobile fetus. Combined uteroplacental thickness was within normal limits. Transabdominal ultrasound revealed a single live fetus in posterior presentation with several abdominal abnormalities. Unilateral hydronephrosis and megacystitis lead to a hypothetical diagnosis of fetal multiple urinary tract malformation with outflow obstruction. Treatment was discontinued and the mare was monitored. Abortion occurred spontaneously a week later. Postmortem examination revealed a ruptured bladder of abnormally large dimensions and a severely distended left kidney without parenchyma (filled with free urine) and lack of permeability in the left ureter and urethra. Postmortem diagnosis was consistent with our prenatal ultrasonographic diagnosis. Even though described during human pregnancy with various etiologies and severity, prenatal diagnosis of fetal hydronephrosis and megacystitis has not been reported in equine veterinary medicine before. These malformations need to be characterized more precisely in the future. This case highlights the importance of transabdominal ultrasonography to detect equine fetal abnormalities.

Use of radiography, ultrasonography, and computed tomography in the diagnosis of a pyogranulomatous ureteral mass in a cat.

An 8-year-old, spayed female, domestic short haired cat, with diabetes mellitus, was presented to the University of Florida Veterinary Medical Center for an acute onset of vomiting and inappetence. Abdominal radiographs showed mild retroperitoneal effusion and asymmetric left-sided renomegaly. Subsequently, on abdominal ultrasound, a hypoechoic left ureteral mass with left hydronephrosis and hydroureter was identified. An abdominal computed tomography revealed a heterogeneously contrast-enhancing mass circumferentially surrounding the mid to distal left ureter, mild retroperitoneal effusion, left-sided hydronephrosis and hydroureter, and a distally located ureteral calculus at the level of the ureterovesicular junction. The patient was diagnosed with left-sided pyogranulomatous ureteritis via surgical biopsy and histopathology.

Congenital Unilateral Ureteral Stenosis With Hydronephrosis in a Kitten.

A 4-month-old, intact male, domestic longhair cat was admitted with a 2-month history of abdominal distention. Physical examination revealed a mild inspiratory distress and a large palpable intraabdominal mass, in an otherwise bright and alert cat. Abdominal ultrasonography revealed a large hypoechoic cystic structure compatible with hydronephrosis or a renal cyst. On exploratory celiotomy, hydronephrosis of the right kidney was documented and ureteronephrectomy was performed. Histopathology of the excised tissues revealed severe stenosis in the proximal ureteral lumen without evidence of obstructive material, a normal ureteral epithelium and severe atrophy of the renal cortex and medulla, supporting the diagnosis of congenital unilateral ureteral stenosis. The cat recovered uneventfully and 8 months later was in excellent clinical condition. Congenital ureteral stenosis with secondary hydronephrosis may occur rarely in cats and should be included in the differential diagnosis of progressive abdominal distention in young cats.

Type II retrocaval ureter causing hydronephrosis in a cat: case report / Ureter retrocava tipo II causando hidronefrose em um gato: relato de caso

Retrocaval ureter (RU) is an abnormal embryonic development of the caudal vena cava (CVC) that leads the ureter to be entrapped dorsal to the CVC. In most cases there is no clinical impact; however, it can cause hydronephrosis. We report a rare case of type II symptomatic retrocaval ureter in a feline treated with nephroureterectomy. A 4-year-old, intact male, mixed breed cat was submitted to abdominal ultrasound and severe right hydronephrosis was diagnosed, with no signs of obstruction. We performed an exploratory celiotomy, in which a displacement of the right ureter dorsal to the CVC was observed. The animal was treated with ureteronephrectomy and recovered well. No intraluminal cause was found, and a urethral catheter could be easily inserted across the ureter length. The real clinical relevance of the RU is unknown, since it is a common find in post-mortem examination without kidney impact and, when significant, is often associated to other causes of ureteral obstructions, such as calculi and strictures. Additionally, in humans, type II RU seldom develops obstruction and hydronephrosis. In our case, due to absence of other causes of obstruction, probably mechanical compression of the CVC against the psoas muscle caused the hydronephrosis.(AU)

O ureter retrocava (UR) é originado por uma falha na formação embriológica da veia cava caudal (VCC), que leva ao aprisionamento do ureter dorsal à VCC. Na maioria dos casos, não há impacto clínico; entretanto, essa anomalia pode causar hidronefrose. Relata-se um raro caso de UR tipo II sintomático em um felino, tratado com nefroureterectomia. O referido animal, sem raça definida, macho intacto de quatro anos de idade, foi submetido à ultrassonografia abdominal, que revelou acentuada hidronefrose direita, sem sinais de obstrução. Realizou-se celiotomia exploratória, na qual foi possível observar o ureter direito dorsal à VCC. O animal foi tratado com nefroureterectomia e se recuperou satisfatoriamente. Nenhuma causa intraluminal foi encontrada e um cateter uretral pôde ser facilmente inserido por todo o comprimento do ureter. A real relevância clínica do UR é desconhecida, visto que é um achado comum em exames post mortem, sem impacto aos rins e, quando significante, frequentemente está associado a outras causas de obstrução ureteral, como cálculos e estenoses. Adicionalmente, em humanos, o UR tipo II raramente desenvolve obstrução e hidronefrose. Neste caso, devido à ausência de outros motivos de obstrução, acredita-se que a compressão mecânica da VCC contra o músculo psoas foi a causa da hidronefrose.(AU)

Hydronephrosis in a dairy calf: A diagnosis delayed by a clinician's Bayesian brain reasoning.

A 3-week-old female dairy calf was presented because of severe weakness and diarrhea. Physical examination and ultrasound findings lead to a tentative diagnosis of intestinal obstruction, although serum biochemistry suggested a primary renal disorder. Reassessment of ultrasound images allowed diagnosis of hydronephrosis that had been misdiagnosed probably because of the clinician's biased Bayesian reasoning. Pyelonephritis without renal failure was diagnosed 2.5 months later. The calf was euthanized and the diagnoses were confirmed.

Une hydronéphrose rénale chez un veau laitier : quand le raisonnement Bayesien du clinicien rend le diagnostic plus difficile. Une génisse âgée de 3 semaines est présenté pour faiblesse générale et diarrhée. L'examen clinique et les images échographiques de l'abdomen sont compatibles avec une obstruction intestinale. Mais les résultats d'analyse biochimique montrent une anomalie rénale. Un examen échographique supplémentaire est compatible avec un diagnostic d'hydronéphrose. Le diagnostic d'hydronéphrose n'avait pas été fait à la première visite probablement suite au raisonnement Bayesien du clinicien. Le veau est revu 2,5 mois plus tard. L'échographie de l'abdomen, les analyses urinaire et sanguine montrent une pyélonéphrite sans insuffisance rénale. Le veau est euthanasié et l'autopsie montre l'hydronéphrose et pyélonéphrite bilatérale.(Traduit par les auteurs).

Resolution of nonurine transudative pleural effusion in a cat after removal of a hydronephrotic kidney.

CASE DESCRIPTION A 3-year-old spayed female Bengal cat was evaluated because of a history of bilateral pleural effusion and hydronephrosis of the right kidney. CLINICAL FINDINGS Cytologic analysis of a pleural fluid sample revealed characteristics of a pure transudate with a high percentage of lymphocytes. Results of fluid biochemical testing were not consistent with urine or chyle. Serum biochemical analysis and echocardiography yielded no evidence of hypoalbuminemia or high hydrostatic pressure secondary to cardiac disease. Abdominal ultrasonography revealed hydronephrosis of the right kidney and hydroureter of the right ureter. TREATMENT AND OUTCOME Exploratory laparotomy with nephrectomy of the right kidney was performed. At the time of surgery, there was no evidence of communication between the retroperitoneal space and thoracic cavity. No other treatments were performed. No evidence of pleural fluid accumulation was detected 1 week after surgery, and no recurrence of clinical signs associated with pleural effusion was observed for > 1 year after surgery. CLINICAL RELEVANCE Transudative, or nonchylous lymphatic, pleural effusion secondary to intra-abdominal disease, but independent of a low plasma protein concentration, is uncommon in veterinary medicine. This case emphasized that urinary tract obstruction should be considered as a differential diagnosis for cats with pleural effusion when more common disorders are not identified. Even without evidence of direct communication between the abnormal kidney or retroperitoneal space and the pleural space, removal of the hydronephrotic kidney appeared curative.

IMAGING DIAGNOSIS-RADIOGRAPHY AND ULTRASONOGRAPHY OF BILATERAL CONGENITAL URETEROVESICAL JUNCTION STENOSIS CAUSING HYDRONEPHROSIS AND HYDROURETER IN A FERRET (MUSTELA PUTORIUS FURO).

An 8-month-old neutered male ferret was presented for vaccination and preventive treatment for adrenal gland disease. Abdominal ultrasound revealed severe bilateral hydronephrosis and hydroureter. Excretory urography and negative contrast cystography showed bilateral ureterovesical junction stenosis. Positive retrograde cystography demonstrated right ureteral reflux. A subcutaneous ureteral bypass was placed in the left kidney; however, it had to be removed 3 months later due to an obstruction and persistent urinary tract infection. Bilateral ureteroneocystotomy was performed. Although congenital strictures are uncommon in veterinary patients, they should be included in the differential diagnosis in ferrets presenting with hydronephrosis and hydroureter of undetermined cause.

BILATERAL HYDRONEPHROSIS IN A SUGAR GLIDER (PETAURUS BREVICEPS).

An adult, intact male sugar glider ( Petaurus breviceps ) presented for acute caudal abdominal swelling. Treatment by the referring veterinarian included aspiration of urine from the swelling. On physical examination, mild depression, pale mucus membranes, and caudal abdominal swelling were noted. Focused ultrasonographic assessment revealed a fluid-filled caudal abdominal structure and subjective bladder wall thickening. The following day, the sugar glider was severely depressed. Hematology results included hypoglycemia, hyperkalemia, hyponatremia, and azotemia. Ultrasonography revealed bilateral hydronephrosis and hydroureter. Despite supportive care, the animal died. Postmortem examination confirmed bilateral ureteral dilation, renal petechial hemorrhage, and dilation of the right renal pelvis. Submucosal edema, hemorrhage, and lymphoplasmacytic infiltration of the urinary bladder, ureters, and renal pelvises were noted. Hyperplasia of the urinary bladder and ureteral epithelium, coupled with inflammation, may have caused functional obstruction leading to bilateral hydronephrosis and hydroureter. This is the first reported case of hydronephrosis in a marsupial.

Practical Use of Ultrasound Scan in Small Ruminant Medicine and Surgery.

Modern portable ultrasound scan machines provide the veterinary clinician with an inexpensive and noninvasive method to further examine sheep on farms, which should take no more than 5 minutes with the results available immediately. Repeat examinations allow monitoring of the disease process and assessment of therapy. 5 MHz linear array scanners can be used for most organs except the heart and right kidney. Transthoracic ultrasonography is particularly useful for critical evaluation of lung and pleural pathologies. Transabdominal ultrasonographic examination can readily identify distended urinary bladder and advanced hydronephrosis.

Surgical management of vesicoureteral reflux with recurrent urinary tract infection after renal transplantation in a dog.

CASE DESCRIPTION A 3-year-old male Cocker Spaniel renal transplant recipient was readmitted 39 weeks after transplantation because of acute clinical signs of pollakiuria, intermittent vomiting, decreased appetite, lethargy, and mild fever. CLINICAL FINDINGS Hydronephrosis and hydroureter were observed with ultrasonography and contrast cystography, and a diagnosis of vesicoureteral reflux (VUR) was made. Urinary tract infection (UTI) caused by Escherichia coli was also diagnosed on the basis of results of urine culture. TREATMENT AND OUTCOME Despite treatment of the UTI with an appropriate antimicrobial for 6 weeks, the VUR persisted and the UTI recurred 9 weeks after cessation of antimicrobial treatment. Therefore, surgical correction by means of revision extravesicular ureteroneocytostomy was performed. Both VUR and hydronephrosis resolved after surgery. No recurrences of clinical signs of urinary tract complications were observed during the subsequent 22-month follow-up period. CLINICAL RELEVANCE Results suggested that ureteral reimplantation with an extravesicular technique incorporating a long submucosal tunnel may be an effective treatment for VUR when medical management fails in canine renal transplant recipients with recurrent UTIs.