1. FELINE HYDRONEPHROSIS Christina Copple Class of 2007 Block 15

2. 10 yr old MC Bengal 10 yr old MC Bengal Weakness and anorexia of 1 day duration Weakness and anorexia of 1 day duration Significant weight loss over past few months Significant weight loss over past few months One month ago was seen for constipation, anorexia, and vomiting One month ago was seen for constipation, anorexia, and vomiting Continued poor appetite for last month Continued poor appetite for last month

3. Physical Examination: Physical Examination: 10% dehydrated 10% dehydrated Depressed Depressed BCS-2/9 BCS-2/9 T-97F, P-160, R-18, CRT- 2sec, MM-pale pink T-97F, P-160, R-18, CRT- 2sec, MM-pale pink On palpation abdomen is soft, left kidney is irregular/enlarged, right kidney is small On palpation abdomen is soft, left kidney is irregular/enlarged, right kidney is small Marked ventroflexion of neck Marked ventroflexion of neck Pronounced muscle wasting Pronounced muscle wasting Diagnostics Diagnostics CBC CBC Anemia Anemia Urinalysis Urinalysis USG-1.009 USG-1.009 Proteinuria Proteinuria hematuria hematuria Chemistry Panel Chemistry Panel Azotemia Azotemia Hypokalemia Hypokalemia

4. Abdominal Radiographs from referring DVM VD-bilateral renal mineralization (nephroliths) and left renomegaly

5. Abdominal Radiographs from referring DVM Right Lateral-bilateral renal mineralization

6. Ultrasound Images Left Kidney-4.39cm (normal measurement is 3.8-4.4cm) severe hydronephrosis

7. Ultrasound Images Left kidney-severe hydronephrosis

8. Ultrasound Images Left ureter-hydroureter due to obstruction from ureterolith

9. Ultrasound Images Right Kidney- 3.52cm with renal cyst, the kidney is hyperechoic and there is decrease in corticomedullary distinction, a nephrolith is also noted that measures 3.5mm

10. Outcome of Case This cat had his left kidney removed after 3 days of medical management (IV fluids, potassium supplementation and amitriptyline) were unsuccessful in treating the ureterolith and relieving his obstruction. This cat had his left kidney removed after 3 days of medical management (IV fluids, potassium supplementation and amitriptyline) were unsuccessful in treating the ureterolith and relieving his obstruction. He also had a gastrotomy tube placed at the time of surgery to provide post-op nuturition. He also had a gastrotomy tube placed at the time of surgery to provide post-op nuturition. The cat was discharged four days following his nephrectomy. The cat was discharged four days following his nephrectomy.