First case of nodular dermatofibrosis with cystic renal disease in a beagle: An atypical case without FLCN gene mutation.

This report presents the first case of nodular dermatofibrosis with renal cysts (NDRC) in a beagle. In this atypical case, the gene mutation associated with the disease was not present, the renal cysts showed dynamic changes in size and number, and the patient has greatly surpassed the NDRC life expectation.

Diagnosis and Surgical Treatment of a Renal Cyst Causing Unilateral Lameness in a Golden Eagle (Aquila chrysaetos).

This report describes the diagnosis and treatment of a benign renal cyst in an adult, female golden eagle (Aquila chrysaetos) presented for unilateral leg lameness. A cyst at the cranial division of the left kidney was diagnosed by computed tomography and was suspected of compressing the lumbosacral nerve plexus, resulting in limb lameness. The renal cyst was incompletely excised because the cyst wall was closely adhered to the kidney parenchyma and local blood supply. Fluid analysis and surgical biopsy of the cyst and left kidney confirmed the diagnosis of a benign renal cyst. No evidence of an infectious, inflammatory, or neoplastic etiology was noted. Postoperatively, the eagle's lameness resolved and the bird was ultimately released following recovery. During treatment for the renal cyst, the eagle was concurrently found to have increased serum titers on elementary body agglutination for Chlamydia psittaci and a positive titer for Aspergillus species antibody testing. The bird was administered doxycycline, azithromycin, and voriconazole for treatment of these potential pathogens prior to release. Unfortunately, the eagle was found dead 86 days postrelease due to an unknown cause. To the authors' knowledge, this is the first report of a golden eagle with a benign solitary renal cyst causing unilateral lameness secondary to nerve compression that was resolved with surgical excision.

Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs.

BACKGROUND: Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. METHODS: Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). RESULTS: Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. CONCLUSIONS: The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.

Use of intraoperative impression smear cytology to guide successful treatment of a large renal cyst in a dog: a case report.

A 13-yr-old Shih tzu was referred for surgical management of right-sided cranial abdominal mass, which corresponded to large, cavitated renal mass on ultrasonography, and was suspected to represent neoplasia. Intraoperative impression smear cytology (ISC) of the renal mass wall was consistent with benign renal cyst (RC), without evidence of neoplasia or infection. Deroofing and omentalisation were performed and histopathology was consistent with benign RC. Chronic kidney disease was diagnosed 4 mon postoperatively, however, the dog was asymptomatic, without cyst reoccurrence. Intraoperative ISC is an expedient and inexpensive diagnostic technique that can guide most appropriate treatment in dogs with large RCs.

Long-term follow-up of a juvenile simple renal cyst in a dog treated by laparoscopic deroofing, fulguration, and omentalization.

CASE DESCRIPTION: A 10-month-old male crossbred dog presented with a 4-week history of polyuria and polydipsia and a 6-month history of vomiting. CLINICAL FINDINGS: Clinical examination revealed abdominal pain and right-sided nephromegaly. Biochemistry was within normal limits. Diagnostic imaging showed a well-defined, unilateral renal mass containing anechoic fluid consistent with a simple renal cyst (SRC). TREATMENT AND OUTCOME: The cyst was drained under ultrasonographic guidance but recurred 3 months later, concomitant with recurrence of the previously reported clinical signs. The cyst was then deroofed, fulgurated, and omentalized under laparoscopy by use of a 3-port technique. The resected cystic wall was histopathologically consistent with an SRC, presumptively congenital. The dog showed a good recovery with resolution of clinical signs. Renal function was normal at last follow-up, conducted 2 years postoperatively, without evidence of recurrent disease. CLINICAL RELEVANCE: To our knowledge, this was the first report of a symptomatic juvenile SRC of presumptively congenital origin in a dog treated successfully by laparoscopic deroofing, fulguration, and omentalization. The polyuria, polydipsia, chronic vomiting, and abdominal pain may all have been related to space-occupying effects of the cyst, as these symptoms resolved post-treatment. Results of long-term follow-up advocate for this durable cure of SRC by use of laparoscopic procedures, especially when compared to simple drainage of the cyst, as the latter initially failed in the present case.

[Sclerotherapy of a simple, solitary kidney cyst using intraluminal ethanol instillation in a Swiss Fleckvieh cow]. / Sklerotherapie einer einfachen, solitären Nierenzyste mittels intraluminaler Ethanolinstillation bei einer Swiss Fleckvieh-Kuh.

INTRODUCTION: Renal cysts are fluid-filled cavities with an epithelial lining that, depending on their size, can cause clinical symptoms and thus require conservative or surgical therapy. Nephrectomy is primarily used in cattle for simple kidney cysts while sclerotherapy is well established in humans and individual case reports have been published in small animal medicine. This case report describes the first successful treatment of a solitary, perirenal cyst using a right-sided laparotomy and intraluminal instillation of 96% ethanol solution in a Swiss Fleckvieh cow. Diagnostics, surgical procedures and aftercare are descripted and risks are compared to other methods. Sclerotherapy is an organ-preserving alternative to nephrectomy that is suitable for buiatric practice, the methodology should be confirmed in subsequent intervention studies.

INTRODUCTION: Les kystes rénaux sont des cavités remplies de liquide avec une muqueuse épithéliale qui, en fonction de leur taille, peuvent provoquer des symptômes cliniques et nécessitent donc un traitement conservateur ou chirurgical. Alors que la sclérothérapie pour le traitement des kystes rénaux simples est bien établie chez l'homme et que des rapports de cas individuels ont également été décrits en médecine des petits animaux, la néphrectomie est principalement utilisée chez les bovins. Ce rapport de cas décrit pour la première fois le traitement réussi d'un kyste périrénal solitaire par instillation intraluminale d'une solution d'éthanol à 96% après une laparotomie droite chez une vache de race Swiss Fleckvieh. Les aspects du diagnostic, des procédures chirurgicales et des soins de suivi sont expliqués et les risques par rapport aux autres méthodes sont discutés. La sclérothérapie est une alternative de préservation des organes à la néphrectomie qui convient à la pratique buiatrique et dont la méthodologie doit être confirmée dans des études d'interventions ultérieures.

Single-Incision Laparoscopic Deroofing and Omentalization of a Cystic Renal Adenoma in a Dog.

A 12 yr old 13.5 kg male castrated Pembroke Welsh corgi was presented for evaluation of a suspected renal cyst following multiple episodes of lethargy and abdominal pain. Abdominal imaging revealed a large, thin-walled, hypoechoic cystic lesion associated with the cranial pole of the left kidney and a second smaller cystic lesion on the caudal pole. The larger cystic lesion was repeatedly drained percutaneously, but the lesion returned to initial size and clinical signs returned within weeks. Percutaneous ethanol sclerotherapy achieved only transient improvement in lesion size and abdominal discomfort. Laparoscopic deroofing and omentalization of the larger left renal cystic lesion was performed. The resected cystic wall was histopathologically consistent with a renal adenoma. Abdominal ultrasonography performed 1 mo postoperatively found no recurrence of the cystic renal adenoma. Repeated ultrasonography at 3 mo postoperatively detected a small cystic lesion at the cranial pole of the left kidney, which remained static in appearance at 11 and 18 mo postoperatively. During all follow-up visits, the dog was reported to be doing well with no recurrence of clinical signs. Renal cysts causing clinical signs and renal adenomas are rare in veterinary medicine; laparoscopic deroofing and omentalization provides a minimally invasive treatment approach.

Surgical fenestration combined with omentalization for the treatment of renal cysts in 2 dogs.

Two cases of surgical fenestration combined with omentalization for canine renal cysts using laparotomy and laparoscopy are described. After surgery, the cystic lesions gradually diminished in size, and a complete regression was confirmed in Case 2 by ultrasonography. The dogs maintained good condition without clinical signs of renal compromise for 14 months (Case 1) and 24 months (Case 2). Omentalization is a simple and effective procedure for canine renal cysts that conserves the remaining parenchyma and can be performed by a laparoscopic approach.

Fenestration chirurgicale combinée à une omentalisation pour le traitement de kystes rénaux chez deux chiens. Deux cas de fenestration chirurgicale combinée à une omentalisation pour traiter des kystes rénaux canins utilisant la laparotomie et la laparoscopie sont décrits. Après la chirurgie, les lésions kystiques ont graduellement diminué en grosseur, et une régression complète fut confirmée par échographie dans le Cas 2. Les chiens ont maintenu une bonne condition sans signe clinique de complication rénale pendant 14 mois (Cas 1) et 24 mois (Cas 2). L'omentalisation est une procédure simple et efficace pour les kystes rénaux canins qui conserve le parenchyme restant et peut être réalisée par une approche laparoscopique.(Traduit par Dr Serge Messier).

Abdominal hamartoma with pancreatic and hepatic differentiation in a sow.

A 7-year-old Duroc sow exhibited emaciation, loss of appetite and rapid breathing, and was euthanized. Histopathological examination revealed mild to moderate fibrosis of the heart, cystic kidneys and ulcerative enteritis associated with Balantidium infection. Additionally, a small nodule was incidentally found in the peripancreatic fat tissue. The nodule consisted of disarranged cellular components: pancreatic islet cells (either insulin-, glucagon- or somatostatin-positive), pancreatic acinar cells, hepatocytes (human hepatocyte-positive) and ductal cells (cytokeratin 19-positive). Some of the human hepatocyte-positive cells were also positive for chromogranin A and cytokeratin 7, indicating that they were hepatic progenitor cells. The nodule was therefore diagnosed as hamartoma, probably originating from a fragment of the caudal verge of the liver bud, which contains hepatic and pancreatic progenitors.

Historical Incidence of Spontaneous Lesions in Kidneys from Naïve Swine Utilized In Interventional Renal Denervation Studies.

The use of preclinical animal models is integral to the safety assessment, pathogenesis research, and testing of diagnostic technologies and therapeutic interventions. With inherent similarity to human anatomy and physiology, various porcine models have been the preferred preclinical model in some research areas such as medical devices, wound healing, and skin therapies. The porcine model has been the cornerstone for interventional cardiology for the evaluation and development of this catheter-based renal denervation (RDN) therapy. The porcine model provides similar vascular access and renal neurovascular anatomy to humans. In these preclinical studies, the downstream kidneys from treated arteries are assessed for possible histopathological changes in the vessel dependent territories. In assessing renal safety following RDN, it becomes critical to distinguish treatment-related changes from pre-existing background pathologies. The incidence of background pathological changes in porcine kidneys has not been previously established in normal clinically healthy. Samples from the cranial, middle, and caudal portion of 331 naïve kidneys from 181 swine were processed histologically to slides and evaluated microscopically. The most commonly encountered spontaneous changes were chronic pyelonephritis found in nearly half of the evaluated naïve kidneys (∼40 %; score 1 = 91 %, score 2 = 8.4 %, score 3 = 0.76 %) followed by chronic interstitial inflammation in 9.7 % of the kidneys (score 1 = 90.6 %, score 2 = 9.4 %). Interestingly, there were a few rare spontaneous vascular changes that could potentially affect data interpretation in interventional and toxicology studies: arteritis and arteriolar dissection. The presence of pelvic cysts was a common occurrence (6.3 %) in the kidney. The domestic swine is a widely used preclinical species in interventional research, namely in the emerging field of transcatheter renal denervation. This retrospective study presents the historical incidence of spontaneous lesions recorded in the kidneys from naive pigs enrolled in renal denervation studies. There were commonly encountered changes of little pathological consequence such as pyelonephritis or pelvic cysts and rare vascular changes such as arteritis and arteriolar dissection that were of greater potential impact on study data interpretation. These results offer a benchmark by which to gage the potential effect of a procedure or treatment on renal histopathology in swine and assist in data interpretation.

Nephronophthisis and retinal degeneration in tmem218-/- mice: a novel mouse model for Senior-Løken syndrome?

Mice deficient in TMEM218 (Tmem218(-/-) ) were generated as part of an effort to identify and validate pharmaceutically tractable targets for drug development through large-scale phenotypic screening of knockout mice. Routine diagnostics, expression analysis, histopathology, and electroretinogram analyses completed on Tmem218(-/-) mice identified a previously unknown role for TMEM218 in the development and function of the kidney and eye. The major observed phenotypes in Tmem218(-/-) mice were progressive cystic kidney disease and retinal degeneration. The renal lesions were characterized by diffuse renal cyst development with tubulointerstitial nephropathy and disruption of tubular basement membranes in essentially normal-sized kidneys. The retinal lesions were characterized by slow-onset loss of photoreceptors, which resulted in reduced electroretinogram responses. These renal and retinal lesions are most similar to those associated with nephronophthisis (NPHP) and retinitis pigmentosa in humans. At least 10% of NPHP cases present with extrarenal conditions, which most often include retinal degeneration. Senior-Løken syndrome is characterized by the concurrent development of autosomal recessive NPHP and retinitis pigmentosa. Since mutations in the known NPHP genes collectively account for only about 30% of NPHP cases, it is possible that TMEM218 could be involved in the development of similar ciliopathies in humans. In reviewing all other reported mouse models of NPHP, we suggest that Tmem218(-/-) mice could provide a useful model for elucidating the pathogenesis of cilia-associated disease in both the kidney and the retina, as well as in developing and testing novel therapeutic strategies for Senior-Løken syndrome.

Bilateral diffuse cystic renal dysplasia in a 9-day-old Thoroughbred filly.

A 9-day-old Thoroughbred filly was presented for diarrhea and lethargy. Diagnostic test results were compatible with severe renal dysfunction. Diffuse cystic lesions of both kidneys were identified on ultrasonographic examination. Postmortem examination confirmed the presence of multiple renal cysts. Congenital nephropathy compatible with bilateral diffuse cystic renal dysplasia was diagnosed.

Dysplasie rénale kystique diffuse bilatérale chez une pouliche Thoroughbred âgée de 9 jours. Une pouliche Thoroughbred âgée de 9 jours a été présentée pour de la diarrhée et de la léthargie. Les résultats des tests diagnostiques étaient compatibles avec une dysfonction rénale grave. Des lésions kystiques diffuses des deux reins ont été identifiées à l'échographie. L'examen postmortem a confirmé la présence de kystes rénaux multiples. Une néphropathie congénitale compatible avec la dysplasie rénale kystique diffuse bilatérale a été diagnostiquée.(Traduit par Isabelle Vallières).

Maine Coon renal screening: ultrasonographical characterisation and preliminary genetic analysis for common genes in cats with renal cysts.

The objective of this study was to assess the prevalence of renal cysts and other renal abnormalities in purebred Maine Coon cats, and to characterise these through genetic typing. Voluntary pre-breeding screening programmes for polycystic kidney disease (PKD) are offered for this breed throughout Switzerland, Germany and other northern European countries. We performed a retrospective evaluation of Maine Coon screening for renal disease at one institution over an 8-year period. Renal ultrasonography was performed in 187 healthy Maine Coon cats. Renal changes were observed in 27 of these cats. Renal cysts were found in seven cats, and were mostly single and unilateral (6/7, 85.7%), small (mean 3.6 mm) and located at the corticomedullary junction (4/6, 66.7%). Sonographical changes indicating chronic kidney disease (CKD) were observed in 10/187 (5.3%) cats and changes of unknown significance were documented in 11/187 (5.9%) cats. All six cats genetically tested for PKD1 were negative for the mutation, and gene sequencing of these cats did not demonstrate any common genetic sequences. Cystic renal disease occurs with a low prevalence in Maine Coons and is unrelated to the PKD observed in Persians and related breeds. Ultrasonographical findings compatible with CKD are not uncommon in juvenile Maine Coons.

Nodular dermatofibrosis in a German shepherd dog: case report.

An 7-year-old male German shepherd dog not neutered was attended presenting several cutaneous nodules ranging from 0.5-3 cm in diameter at least a one year history, located mainly in thoracic and pelvic limbs, with progressive weight loss over two months. Fine needle aspiration biopsy and pelvic and thoracic limbs nodules excision biopsy were performed. After histopathological diagnosis, nodular dermatofibrosis diagnosis was determined and abdominal ultrasound was performed for possible renal cysts evaluation. The animal received treatment to control secondary bacterial infection. It is necessary to carry out histopathological examination and ultraosund to identify possible renal cysts and for definitive diagnosis. There is no specific treatment for nodular dermatofibrosis.

Bilateral multiple cystic kidney disease and renal cortical abscess in a Boerboel.

Cystic renal disease is rare in dogs and although infected renal cysts have been reported in humans, no report could be found in dogs. A 58 kg, 5-year-old, castrated, male Boerboel presented with weight loss, pyrexia, lethargy and vomiting, 20 months after an incident of haematuria was reported. The initial ultrasonographic diagnosis was bilateral multiple renal cysts of unknown aetiology. The cysts had significantly increased in size over the 20-month period and some contained echogenic specks which could be related to infection, normal cellular debris or haemorrhage. In both kidneys the renal contours were distorted (the left more than the right). The abnormal shape of the left kidney was largely due to multiple cysts and a large crescent-shaped septate mass on the cranial pole of the kidney. Aspirates of the septate mass were performed (left kidney) and the cytology and culture were indicative of an abscess. It is suggested that the previous incident of haematuria provided a portal of entry for bacteria into the cysts resulting in renal cortical abscess formation.

Cistolitectomia e ressecção de cisto renal por laparoscopia em uma cadela com aderências intraperitoneais: relato de caso / Cystolithectomy and renal cyst resection by laparoscopic surgery in a female dog with intraperitoneal adhesions: case report

No presente relato descreve-se a remoção de urólitos vesicais, bem como o tratamento de um cisto renal por cirurgia laparoscópica em um cão com aderências intraperitoneais. Para o acesso foram utilizados três portais, dois de 10mm e um de 5mm, dispostos na linha média ventral e nas paredes abdominal direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical em duas camadas. O cisto renal direito foi drenado e sua cápsula extirpada. Ocorreu a perda temporária de um urólito na cavidade abdominal e sua posterior recuperação pela cirurgia laparoscópica. O paciente não apresentou recidiva da doença pelo período mínimo de 14 meses. A cirurgia laparoscópica mostrou-se eficaz na terapêutica de ambas as patologias, sem a necessidade de alteração do posicionamento dos portais.

This study reports the laparoscopic treatment of urolithys and renal cist in a dog with adherences after laparotomy. Three portals (two with 10mm and one with 5mm) were used in the middle ventral line or lateral flanks. The calculi were removed, and two intracorporeal sutures were made in the vesicle tissue. The right cystic tissue was drained and its capsule was extirpated. One calculus was lost in the peritoneal cavity, but later recovered by laparoscopy. The patient did not show urinary vesicle disease during at least 14 months. The laparoscopic cistotomy appears to be adequate to remove urolithys and to treat renal cystic disease in dogs.

Ultrasonographic findings in Cairn Terriers with preclinical renal dysplasia.

Renal dysplasia is a hereditary disease characterized by abnormal differentiation of renal tissue. The ultrasonographic appearance of dysplastic canine kidneys has been reported in the late stage of the disease where inflammatory and degenerative changes are already present and the dogs are in chronic renal failure. In this study, we describe the ultrasonographic appearance of the kidneys of five related Cairn Terriers affected with renal dysplasia before the onset of clinical or laboratory evidence of renal failure. Common findings included poor corticomedullary definition and multifocal hyperechoic speckles in the renal medulla, or a diffusely hyperechoic medulla. Severity of ultrasonographic changes was related to the severity of histopathologic findings. The ability to detect dysplastic changes before clinical signs develop makes ultrasound a potentially useful screening method for canine renal dysplasia.

Bilateral laparoscopic subtotal perinephric pseudocyst resection in a cat.

A 17-year-old castrated male domestic shorthair cat was diagnosed with bilateral perinephric pseudocysts (PNPs). Bilateral subtotal resection of the PNPs was performed via a laparoscopic approach. There was no regrowth or reformation of the PNPs after the procedure and the cat's serum concentration of creatinine remained stable for 6 months after surgery. Laparoscopic bilateral subtotal resection of PNPs appears to have been an effective treatment option in this cat with the advantages of being minimally invasive and requiring only a brief hospital stay.

Doença renal medular cística em uma cadela Yorkshire Terrier: relato de caso / Cystic medullary renal disease in a Yorkshire Terrier bitch: a case report

Uma cadela da raça Yorkshire Terrier apresentou hematêmese, distensão abdominal, poliúria e polidipsia. Após o exame clínico do paciente, estabeleceu-se a suspeita clínica de nefropatia. Os resultados dos exames laboratoriais revelaram anemia normocítica normocrômica e concentrações séricas de uréia (306mg/dl) e de creatinina (3,6mg/dl) acima dos valores de referência. Ao ultra-som bidimensional observaram-se áreas císticas hipoecóicas e anecóicas, padrão renal hipercogênico e perda da relação corticomedular. À necropsia, a região medular apresentou grande quantidade de cistos pequenos em meio a tecido conjuntivo fibroso. A lesão tubulointersticial cortical foi a responsável pela insuficiência renal resultante. Firmou-se diagnóstico de nefrite tubulointersticial.

A Yorkshire Terrier bitch presented hematemesis, abdominal distention, poliuria, and polidipsia. After clinical examination, it was established a clinical suspect of nephropathy. The complementary exams showed normochromic and normocytic anemia and serum concentrations of ureia (306mg/dl) and creatinine (3.6mg/dl) above the references values. At two-dimensional ultrasound hipoechoic and anechoic cystic areas were observed, as well as hiperechogenic renal pattern and corticomedullary ratio loss. At necropsy, the medullary region presented many small cysts in a fibrous connective tissue. Cortical tubulointesticial lesion was responsible to the resulting renal failure. It was established a tubulointersticial nephritis diagnosis.

Cystic renal disease in the domestic ferret.

Cystic renal diseases in domestic ferrets are a common anecdotal finding but have received scant systematic assessment. We performed a 17-y, case-control retrospective analysis of the medical records of 97 ferrets housed at our institution between 1987 and 2004, to determine the prevalence and morphotypes of cystic renal diseases in this species. Histologic sections stained with hematoxylin and eosin, Masson trichrome, or periodic acid-Schiff were evaluated by a comparative pathologist, and statistical analysis of hematologic and serum chemistry values was correlated with morphologic diagnosis. Of the 97 available records, 43 were eliminated due to lack of accompanying tissues. Of the 54 remaining cases, 37 (69% prevalence) had documented renal cysts, and 14 of the 54 ferrets (26%) had primary polycystic disease consisting of either polycystic kidney disease affecting renal tubules or, more commonly, glomerulocystic kidney disease. Secondary polycystic lesions were identified in 11 ferrets (20%), and 12 ferrets (22%) exhibited focal or isolated tubular cysts only as an incidental necropsy finding. Ferrets with secondary renal cysts associated with other developmental anomalies, mesangial glomerulopathy, or end-stage kidney disease had hyperphosphatemia and elevated BUN in comparison with those with primary cystic disease and elevated BUN compared with those without renal lesions. Although reflecting institutional bias, these results implicate primary and secondary cystic renal diseases as highly prevalent and underreported in the domestic ferret. In addition to the clinical implications for ferrets as research subjects and pets, these findings suggest a potential value for ferrets as a model of human cystic renal diseases.