Hydronephrosis– a progressive pathology of the kidneys, in which a multiple enlargement of the renal pelvis occurs as a result of prolonged filling with urine, which leads to an increase in pressure inside the kidney and the gradual death (atrophy) of the medulla and renal cortex. Hydronephrosis of the kidneys is caused by a number of factors, which result in blockage of the lumen from the inside, or partial/complete compression of the ureter at any stage of its passage to the bladder. Hydronephrosis can be acute or chronic.
Rice. No. 1 The anatomical structure of the dog’s kidney, changed during the course of hydronephrosis
For a clearer picture hydronephrosis, you need to remember a little about the structure of the urinary system of dogs and cats. As you know, anatomically, the kidney has two layers: the cortical - outer layer and the medulla - inner layer, in which blood saturated with metabolic products is filtered and urine is formed. It continuously flows into the renal pelvis, from where, in turn, the ureter emerges, which connects the kidney to the bladder. Thus, if the patency of the ureter is impaired, the constantly formed urine accumulates in the pelvis, which leads to its significant expansion. At the same time, the lumen of the ureter increases.
Rice. No. 2 An example of unilateral hydronephrosis in a dog (right kidney) with obstruction of the proximal part of the ureter (arrow)
Causes
Let us dwell in more detail on the factors that lead the urinary system of dogs and cats to this pathological condition. There are congenital defects and acquired causes of pathologies of the pyelocaliceal system and ureters. Congenital anomalies include: accessory renal artery, ectopia of the ureter, ureterocele (hernia-like protrusion of the wall of the ureter due to narrowing of its mouth).
The second reasons include:
1. Urolithiasis and urological syndrome. In these pathologies, when obstruction by a mineral stone or mucus plug occurs in the ureters or underlying (distal) parts of the urinary system.
In this case, there is a gradation of the severity of the obstruction that occurs. For example, if there is a blockage of the distal parts of the urinary tract and the flow of urine, due to pressure in the overfilled bladder, retrograde (in the opposite direction) through the ureters reaches the pelvis and leads to its expansion (pyelectasia). In this case, emergency catheterization of the urethra or the formation of a perineal urethrostomy relieves the symptoms of obstruction and the outflow of urine from the renal pelvis is resumed. In another situation, when the localization of the calculus is detected directly in the lumen of the ureter, the symptoms of pyelectasia and subsequent hydronephrosis increase much more rapidly.
2. Iatrogenic ureteral ligation. Occurs as a complication after surgical operations on the abdominal organs. For example, during caesarean section, castration (ovariohysterectomy) in females, cryptorchid castration or cystotomy. The application of a ligature to the ureter is facilitated by a change in the anatomical location of the urinary and genital organs during their inflammation, prolapse, tumor infiltration, in which the ureters are affected in the process. Therefore, an important role in the prevention of postoperative hydronephrosis is the experience of the operating surgeon and his knowledge of the topographic connections of the abdominal organs in various pathological processes.
3. Adhesive process or adhesive disease. Adhesions are connective tissue (scar) adhesions that occur between closely located organs. The adhesive process is formed due to peritonitis, i.e. irritation and inflammation of the peritoneum - a specific membrane that covers the inner wall of the abdominal cavity and the surface of the internal organs. Thus, adhesions formed between the organs of the pelvic region can exert external compression on any part of the ureter and narrow or completely block its lumen.
4. K other, more rare causes include urethral spasm, spasms of the ureters during pregnancy; tumors leading to kinks of the ureters, etc.
Pathogenesis
The mechanism of development of hydronephrotic degeneration of the kidney is the same in all cases, regardless of the cause that caused it. The changes occurring in the kidney have a certain sequence; at the first stage, the obstructed outflow of urine causes an increase in pressure in the cavity of the pelvis. Along with this, stretching of the renal calyces occurs and compensation of functional capacity due to an active increase in the number of structural units of the kidney (stage II). At this stage, changes in the kidneys are reversible with timely intervention.
When obstruction persists for a long time, the decompensatory stage (III) gradually develops, during which thinning of the walls of the cups and a sharp expansion of the pelvis are observed. At this stage, the kidney is greatly enlarged, the cortex is sharply thinned, and kidney function is barely visible or absent. At the same time, hypotrophy of the working tissue of the kidney, impaired filtration of urine and blood circulation in the glomeruli are expressed, which leads to tissue hypoxia (ischemia) and, ultimately, to the death of the renal parenchyma (stage IV).
There are unilateral and bilateral hydronephrotic lesions. In case of bilateral (two-sided) hydronephrosis, the animal requires emergency surgical intervention, otherwise the animal may die within the first two days due to acute renal failure. Bilateral hydronephrosis is rarely caused by bilateral ureteral lesions. More often it occurs when the outflow of urine from the bladder is impaired. Monolateral (one-sided) hydronephrosis, unlike bilateral hydronephrosis, in the initial stage is asymptomatic and unnoticed by the animal owners; Often such an affected kidney is detected during routine ultrasound examination.
During embryonic development, females have formed close anatomical connections between the urinary and genital organs, which raises the possibility of iatrogenic injury to the bladder and ureters during obstetric and gynecological operations. Moreover, if a bladder injury, as a rule, is quite easy to recognize and take action immediately during the operation, damage to the ureters is difficult to establish in a timely manner. In this regard, the restoration of the animal’s health may take a long time, and treatment will require repeated surgical interventions. The outcome of these operations is predicted as cautious to unfavorable with a high probability of kidney loss.
Diagnostics
Diagnosing hydronephrosis without special visual research methods is very difficult, since there is not a single symptom that would indicate with 100% accuracy the presence of this disease, especially at an early stage. And even laboratory analysis of blood and urine does not have specific deviations in their indicators in the preclinical stage. Therefore, the methods of choice in this case are ultrasound diagnostics, uro-contrast radiography, computed tomography and magnetic resonance imaging. But a comprehensive examination of the animal will help to assess the comprehensive picture of the disease. Which takes into account visual and laboratory diagnostic data, providing not only information about the morphological state of the kidneys, but about the presence or absence of infection, as well as indirectly about the functional capacity of the kidneys. The scope of the examination is determined in each specific case, depending on the clinical picture. Is the kidney still working, is there any point in trying to save it, or is it necessary to remove it? All these questions can be answered by a number of the above studies. Only by analyzing all the information received can the doctor make the right decision and draw up a rational treatment plan.
Ultrasound is important in the diagnosis of hydronephrosis. In most sick animals, hydronephrosis was first detected during a routine ultrasound scan or accidentally during an examination regarding various diseases. Ultrasound evaluates the gradation of changes in the pyelocaliceal system, the size of the cortex and medulla of the kidney (Fig. No. 3, No. 4), as well as the condition of the second kidney.
Rice. No. 3 Ultrascanogram of stage III hydronephrosis in a dog, which clearly visualizes a sharp expansion of the pyelocaliceal system and ureter. Thinning of the cortex and atrophy of the medulla.
Rice. No. 4 Ultrascanogram of chronic hydronephrosis, with significant atrophy of the renal medulla. Such deformation of the renal architecture is possible only with prolonged obstruction.
Radiography is the basis for a comprehensive diagnosis of hydronephrosis. This method, like ultrasound, is publicly accessible financially, safe and highly informative. Plain X-rays may show an increase in the size of the kidneys. Excretory contrast urography makes it possible to assess the function of each kidney, the condition of the pyelocaliceal system, and the patency of the ureter (Fig. No. 5).
Rice. No. 5 A survey X-ray of the area of the kidneys and urinary tract using intravenous urography revealed (arrows): a significant increase in the size of the right kidney, ectasia of the pyelocaliceal system; the ureter is highly convoluted and huge in size, contrasted almost along its entire length, so the presence of distal obstruction is most likely.
Treatment
Treatment of hydronephrosis begins with a thorough diagnosis - searching for the cause of the resulting pathological condition. Providing a complete and reliable history by the owners of a sick animal is of utmost importance in the diagnosis and treatment of hydronephrosis! It is necessary to provide information about the presence of urolithiasis, cystitis, and operations on the abdominal organs in the past. The decision to remove or preserve the affected organ depends on the stage of the identified hydronephrosis and the presence of complications with infection!
If the kidney has lost its function and has become chronically infected, and has also become a source of arterial hypertension, then emergency nephrectomy is required - complete removal of the kidney.
There is no specific drug treatment for ureteral injury. However, if there is any chance of saving the kidney, then surgical treatment of hydronephrosis is indicated, in which the ureteral stricture is eliminated.
Depending on the cause, type, duration and area of obstruction, surgical treatment can vary from conventional excision of the remaining ligature to the formation of a specific anastomosis.
If an accidentally left ureteral ligature is discovered during the operation, it must be removed immediately. If, during examination of the ureter, its contractility is preserved and the damage is assessed as minimal, then there are no indications for additional manipulations and one should limit oneself to routine monitoring of the patient in the postoperative period.
If diagnostic laparotomy/scopy reveals ischemia of the ureteral wall or a violation of its integrity, then ureteral stenting is indicated. A stent is installed in the ureter and serves as the basis on which its regeneration occurs. The stent ensures the evacuation of urine from the pelvis directly into the bladder. The stent is a support in which it is impossible to narrow its lumen, thereby eliminating the likelihood of developing a repeated stricture of the ureter.
Forecast
A favorable outcome is possible in animals with unilateral hydronephrosis detected in the first and second stages, subject to timely surgical intervention; cautious and unfavorable, with hydronephrosis of both kidneys, complicated by infection and chronic renal failure.
Bibliography
- Denisenko, V.N. Diseases of the urinary system in dogs and cats: a practical guide / V.N. Denisenko, Yu.S. Kruglova, E.A. Caesarean. – M.: “Zoomedlit”, 2009. – 236 p.
- Niesterok, C & Köhler, Claudia & Alef, Michaele & Kiefer, Ingmar. (2016). Causes of hydronephrosis in dogs and cats. Ultraschall in der Medizin - European Journal of Ultrasound
- Naber, KG & Madsen, PO (1974) Renal function in chronic hydronephrosis with and without infection and the role of lymphatics: an experimental study on dogs.
- Lanz OI, Waldron DR (2000) Renal and ureteral surgery in dogs. Clin Techniques Small Anim Pract 15:1–10.
If you ask any veterinarian to name the weakest point in cats, the answer will be the same -. There are probably no cats that do not have any problems with this organ. For some, these problems are congenital, for others they are acquired. One way or another, with age, structural changes in the kidneys and disruptions in their functioning appear in every pet. It’s just that for some they are insignificant, but for others, alas...
Why is this a weak point?
Statistically, cats are much more likely to develop kidney disease than other animals, for example three times more likely than dogs. Why? It's hard to say for sure. Most likely, again due to its historical origin.
Domestic cats owe their ability to get by with a small amount of water, obtained from time to time, to their ancestors - African desert cats. Hence the disturbance in water balance (especially when consuming dry food and not drinking enough).
Perhaps the anatomical structure of the urinary system in cats also plays a role - a long and narrow urethra with three narrowings causes frequent blockages of the urethra, and non-excretion of urine puts a strain on the kidneys with all the ensuing consequences.
In general, all diseases of the genitourinary system of cats - various nephritis, etc. are interconnected and provoke each other, and everything affects the kidneys. Therefore, all cat owners should have an understanding of this organ and know what a failure in its functioning leads to.
Why are kidneys needed?
The kidneys are a paired organ (there are two of them in the body), which performs many different functions: hormonal, maintaining the acid level and electrolyte composition of the blood, regulating blood pressure. But the main task of the kidneys is to filter metabolic products. The kidneys constantly cleanse the body of toxins and maintain the required amount of water in the body. Detoxification is carried out by the formation and excretion of urine with harmful substances dissolved in it.
The bud has the shape of a bean. On the outside it is covered with a dense capsule; inside there is a layer of kidney tissue itself. Without going into anatomical details, the kidney can be conditionally divided into two functional parts: the renal tissue itself is responsible for filtering the blood with the formation of urine, and the pyelocaliceal system is responsible for the accumulation and excretion of this formed urine.
The kidneys are made up of small structural units called nephrons. It is in them that the process of urine formation occurs. Of course, one nephron filters the blood and produces urine in very small quantities, but if you consider that there are about 200,000 of them in each kidney, the result is liters.
Now the most important thing: kidneys are not capable of regeneration! The number of nephrons in the body is determined from birth; new ones do not “grow.” And if the nephron is lost, then it is irrevocable.
Kidney diseases in cats and kittens
Kidney diseases can be acute or chronic, congenital or acquired.
Hereditary (genetic) Kidney disease is common in certain breeds, e.g. renal amyloidosis (a disorder of protein-carbohydrate metabolism with the deposition of amyloid, a protein-polysaccharide compound, in the renal tissue) occurs in cats of the Abyssinian and Somali breeds, and polycystic disease(cysts appear in the kidneys and gradually increase in size) – in Persian, Himalayan and exotic cats.
Congenital anomalies may also include renal aplasia (one or both kidneys are missing at birth) and renal dysplasia (pathological development of the kidneys).
Acute diseases appear suddenly, for example, as a result of abdominal trauma, large blood loss or dehydration, blockage of the urethra, infection, poisoning (antifreeze is especially dangerous). They require intensive treatment of both the organ itself and the cause of its damage. If the disease is caught at the very beginning, the prognosis is favorable.
Chronic diseases develop gradually and require constant maintenance therapy. Usually progress over time and eventually lead to a sad end.
There is a very fine line between these types of diseases. The acute form can quickly turn into chronic!
Jades
(pyelonephritis, glomeronephritis, hydronephritis) – kidney diseases of an inflammatory and bacterial nature. Since the kidneys constantly filter the blood, any infection from it enters the kidneys.
Kidney failure
– syndrome of impairment of all kidney functions (!), leading to a disorder of water, electrolyte, nitrogen and other types of metabolism of the body. It is characterized by progressive damage to a significant part of the nephrons and their gradual replacement with connective tissue. Chronic renal failure (CRF) is already a death sentence for an animal (although this sentence may have a good reprieve).
How insidious kidney diseases are:
- Late detection Many kidney diseases can proceed for a long time in a latent or erased form and make themselves felt late, no, very late, and sometimes too late... Disturbances in the functioning of the kidneys do not cause pain in the animal (probably in vain!) and do not give themselves away in any way, since the healthy part can easily withstand the additional load. Until a certain point.
It often happens like this: 10% of nephrons die - nothing happens, 20% die - nothing happens, 40% - again nothing, 50% - the cat is a little “sad”, didn’t eat well, well, it happens, 60% - the cat is a few days old lethargic, barely ate my favorite food, vomited once, loose stools - perhaps I should see a doctor. And the doctor finds out that only 30% of the pet’s kidneys are working. And then a three-letter diagnosis may be announced - chronic renal failure - chronic renal failure.
Thus, kidney diseases often make themselves felt only when a significant part of them has already died irrevocably!
- Vague symptoms Symptoms of kidney disease are common to other diseases, making diagnosis difficult.
Symptoms of kidney disease in cats:
Increased thirst, excessive urination, dehydration, diarrhea, vomiting, lethargy, weight loss, anemia (pale mucous membranes), dental problems (ulcers on the gums and tongue, tartar, dental disease), drooling, mouth odor (sometimes ammonia), deterioration wool, retinal detachment, high blood pressure. With nephritis, there may be increased temperature and pain when palpated.
A little more detail:
Causes of kidney diseases:
Often it is not possible to accurately determine the causes of the disease. The most typical are: age, genetic predisposition or congenital anomaly, ecology, infectious and systemic diseases (for example, diabetes), poisoning, trauma, unbalanced nutrition.
All animals over 7 years of age are at risk. They should be examined annually by a veterinarian, have blood tests, urine tests, ultrasounds and blood pressure checked.
Diagnostics:
Kidney disease can be diagnosed using clinical tests. A urine test will show its concentration, the ability of the kidneys to remove waste products from the body, a blood test will show the level of creatinine and urea (high values indicate loss of kidney function), an ultrasound will show changes in kidney size.
High blood pressure, retinal detachment, dental problems, etc., along with diagnostic tests, can be considered symptoms of kidney disease.
Unfortunately, blood and urine tests may not reveal kidney dysfunction until the kidneys have lost more than half of their normal function. For earlier diagnosis, you can use the ratio of creatinine in urine and blood - KFP (concentrating function of the kidneys). In healthy animals, the CFP is greater than or equal to 100%.
For pyelonephritis, urine culture is used to determine the sensitivity of bacteria to a particular antibiotic.
Treatment
1. First of all, treatment is aimed at identification and elimination of the underlying disease, causing renal impairment (if, of course, this is possible).
For genetic and congenital kidney abnormalities, only symptomatic therapy is carried out, aimed at maintaining a normal standard of living.
Kidney infections (such as pyelonephritis) are usually treated with a long course of antibiotics.
Glucocorticoids and cytostatics can be used to treat glomerulonephritis.
2. Because in case of kidney diseases a significant number of nephrons are damaged, extremely important eliminate the consequences of their inoperability.
To eliminate dehydration and electrolyte disturbances, and relieve intoxication (poisoning with toxic metabolic products), intravenous and subcutaneous infusions (droppers) are used.
Constant maintenance therapy is also needed to relieve associated symptoms: anemia, high blood pressure, gastritis, urinary tract infections, acidosis, anorexia, increased potassium in the blood (hence muscle weakness and heart rhythm disturbances), liver dysfunction, cardiac dysfunction, etc.
3. Necessary reduce the load on the remaining nephrons. Here, diet therapy and control of fluid intake play a major role.
Proteins (protein) put an increased load on the kidneys. A diet for renal failure should be low in protein, phosphorus and sodium, while being a balanced, complete diet. Of course, the easiest way is to use ready-made veterinary diets.
Forecast: All kidney diseases, if not treated in a timely manner and with relapses, eventually develop into chronic renal failure - a syndrome leading to death. BUT! Proper supportive therapy significantly slows down the progression of the disease and ensures a good quality and longevity of the animal’s life.
Kidneys are very serious! Therefore, if there is any suspicion of a disease of this organ, we do not hope that everything will “resolve” on its own, we do not self-medicate, but immediately run to the veterinary clinic. If the pet is over seven years old, then once a year (or better yet, twice) we visit a veterinarian for a comprehensive preventive examination.
P.S. My cat Kuzya (16 years old) is a professional with two years of experience. Kidney problems were discovered by chance when we came to brush our teeth and were tested for admission and anesthesia. Before this, the disease was not even suspected. A little more and everything would be completely sad. Be sure to regularly diagnose older animals!!!
Today we had another full examination. All organs are in good condition, except the kidneys. One kidney has a change in size and shape, the second is better. Both have significant thickening of the upper cortex and low blood flow. Blood tests show elevated levels of urea and creatinine. Very high blood pressure.
They prescribed: to lower blood pressure - amlodipine + vasotope, to compensate for protein deficiency - ketosteril (Kuzya has been on the Renal diet for two years). All medications are prescribed according to a schedule and for a long course, possibly for life.
(24
ratings, average: 4,71
out of 5)
At first, renal hydronephrosis in cats may be asymptomatic, and clinical signs appear in more advanced stages of the disease. The pathology is characterized by impaired function of the urinary organ against the background of dilation of the pelvis and atrophy of the renal parenchyma. There is an enlargement of the kidney and other pathological changes that require immediate treatment. Only a veterinarian who selects therapeutic measures after diagnostic procedures can cope with hydronephrosis in a cat.
Main reasons
According to veterinarians, the main source of enlargement of the renal pelvis is considered to be inflammatory processes that negatively affect the structure of the urinary organ.
Hydronephrosis can be unilateral or bilateral, in which one or both kidneys of a cat are damaged. The second form of the disease is more difficult to treat because it leads to more serious structural changes. The development of hydronephrosis is influenced by the following factors:
- mechanical damage that occurs during road accidents, bites of other animals, falls or bruises;
- formation of stones, which is associated with blocking of the ureter by large uroliths;
- malignant or benign tumors in the urinary system that disrupt the outflow of urine;
- abnormal development of the cat’s internal organs;
- insufficient fluid intake or poor quality;
- problems with excess weight;
- complications that arise after sterilization of a pet or other surgical intervention.
How does it manifest?
As the disease progresses, the urinary organs work less and less well. Kidney disease in cats has different symptoms depending on the stage of hydronephrosis. The main stages of the disease and pathological changes are presented in the table:
At the initial stages, owners are not always able to identify hydronephrosis in a timely manner and consult a doctor. Symptoms tend to occur in later stages, when the disease is more difficult to treat. The following pathological signs are characteristic of the disorder in cats:
With this pathology, the animal may have an elevated body temperature. - enlarged abdominal cavity;
- increase in pet's body temperature;
- refusal of food;
- bloody spots in the urine;
- delayed urination.
Diagnostic procedures
To identify hydronephrosis, you need to contact a veterinary clinic, since it is almost impossible to determine kidney disease on your own, especially in the early stages. The veterinarian conducts a visual examination of the pet and collects a detailed medical history. It is possible to establish the causes of the pathological process and the degree of hydronephrosis using the following diagnostic procedures:
- ultrasound diagnostics of the kidneys;
- radiography;
- contrast excretory urographic examination;
- laboratory urine test.
Necessary treatment
According to veterinarian I. G. Sharabrin, treatment of hydronephrosis in cats of the bilateral type is not effective, while the unilateral type of the disease can be cured with early diagnosis.
Most often, this pathology requires surgical treatment. As a rule, the main therapeutic measure is surgery, in which the affected paired organ is completely or partially excised. A urorostomy is often performed, and in a more advanced form a kidney can be removed. Such radical surgery is indicated in the following cases:
- atrophy of the renal parenchyma;
- hemodynamic problems;
- urine retention;
- ineffectiveness of drug therapy.
Cats diagnosed with hydronephrosis need to monitor their diet and also take medications. Treatment helps relieve the unpleasant symptoms of kidney disease and improve urinary function. Such therapeutic measures are required not only in the early stages of the pathological process, but also after surgery.
Hydronephrosis- kidney disease, characterized by expansion of the pyelocaliceal system, atrophy of the renal parenchyma and progressive deterioration of all basic functions of the kidney as a result of impaired outflow of urine from the kidney, as well as impaired blood circulation.
In modern practice, there are two types of hydronephrosis: primary and secondary.
Primary or congenital hydronephrosis develops due to congenital obstructions in the area of the ureteropelvic segment (ureteric ectopia, stenosis, ureteral atresia).
Secondary or acquired hydronephrosis is usually a consequence of any disease (urolithiasis, tumor of the kidney, pelvis, ureter, bladder, traumatic injury to the bladder, neoplasms of the abdominal and pelvic cavities, prostatic hypertrophy, etc.)
Hydronephrosis can be either unilateral, in which one of the kidneys is affected, or bilateral, in which both kidneys are affected. The presence of an obstruction at the level of the ureterovesical segment leads to the development of unilateral hydronephrosis, and with obstruction in the area of the bladder neck or urethra, bilateral hydronephrosis occurs.
There is a classification of obstacles that arise in various parts of the urinary tract and lead to the development of hydronephrosis:
Obstructions located in the urethra, urethra, and bladder (uroliths, tumors, clots and hematomas after injuries, etc.)
Obstructions in the ureter or outside its lumen (tumors, uroliths, ureteral diverticula, neoplasms of the abdominal cavity or retroperitoneum, hematomas due to trauma, adhesions after surgery)
Disturbances in the position of the ureter (twisting or kinking, congenital atresia of the ureter, congenital stenosis or due to a long-term inflammatory process, ectopia)
Obstacles in the lumen of the pelvis - nephrolites, neoplasms, blood clots after injuries and hematomas.
Hydronephrosis is divided into three stages:
Stage 1- expansion of only the pelvis (pyelectasia) with minor impairment of kidney function.
Stage 2- expansion of the pelvis and reduction in the thickness of the renal parenchyma and significant impairment of its function.
Stage 3- sharp atrophy of the kidney parenchyma and its transformation into a thin-walled sac. With the development of hydronephrosis, secondary microflora may join, which provokes the development of secondary inflammatory kidney diseases (secondary pyelonephritis).
When the internal structure of the kidney changes, its hemodynamics are also disrupted. Increased intraparenchymal pressure and swelling of the organ leads to compression of the intrarenal vessels and an increase in the speed of blood flow and blood pressure in them. Impaired blood circulation in the capillaries of the cortical and medulla layers of the kidney leads to oxygen starvation of the kidney and disruption of tissue metabolism, which in turn contributes to atrophic changes in the renal cortex.
So how can you recognize that your pet is developing such a serious illness? Hydronephrosis often develops asymptomatically in the early stages, especially in animals. Unfortunately, clinical symptoms are nonspecific and are most often accompanied by apathy, lethargy, possibly elevated body temperature, refusal to feed, possibly increased thirst, a specific odor from the mouth and vomiting (with the development of severe uremia). The longer hydronephrosis develops, the worse the animal feels. Intoxication with one's own metabolic products increases. Acute postrenal
Often the owner thinks that we are talking about poisoning or a pathology of the gastrointestinal tract (refusal of food), and if the diagnosis is not accurate enough, a completely different pathology is treated. In this case, the role of an erroneous diagnosis can be fatal for the animal, since with the development of hydronephrosis, the clock can count.
Animals at risk include
Recent injuries (fall from a high floor, car injury, beating, bites by other animals),
First of all, the animal is examined, palpated and a detailed history is collected, then blood is taken, if possible, a urine test is collected, then additional diagnostics are carried out: necessarily, possibly contrast excretory urography. In the early stages of hydronephrosis development, excretory urography is more sensitive and gives an idea of the secretory function of the kidneys. Ultrasound examination is more reliable in moderate and severe forms of hydronephrosis (stages 2-3).
After a complete examination of the animal and receipt of laboratory results, the doctor makes predictions and selects treatment methods. Treatment can be either conservative (at the initial stage of development of the pathology, depending on its cause), or surgical if the kidney is severely changed structurally and impaired, or its function is absent.
If bilateral hydronephrosis develops due to ureteral or urethral obstruction, the animal may quickly die from acute postrenal renal failure before significant atrophy of the renal parenchyma develops. At the same time, ultrasound may reveal less significant structural changes in the kidneys. In the case of unilateral ureteral obstruction, compensatory processes in the unaffected kidney lead to its hypertrophy and hydronephrosis of the affected kidney. That is why it is very important for cat owners (especially those with a history of urolithiasis) to pay attention to the urination of their pets; any urinary retention for more than 12 hours is suspicious; urinary retention for more than a day is an acute condition in which the animal should be immediately taken to the clinic ! When acute urinary retention is detected due to blockage of the urethra by uroliths, surgical intervention is usually performed - dilating urethrostomy. If there are large uroliths in the bladder, they are removed surgically through a bladder incision. When unilateral hydronephrosis stage 3 is detected, as a rule, the affected kidney is removed provided that the structure and function of the second kidney is normal. If a tumor of the bladder or ureter is detected, treatment depends on the results of histological or cytological examination. In any case, the treatment method and the decision on surgical intervention are made individually in accordance with the condition of the animal at the time of admission to the clinic.
In conclusion, I would like to add that the health of our beloved pets is in our hands and the more attentive we are to them, the better their standard of living. Love for our animals also includes caring for their health.
Loading...