Hydronephrosis- progressive kidney pathology, in which there is a multiple increase in the renal pelvis as a result of prolonged filling of it with urine, which leads to an increase in pressure inside the kidney and gradual death (atrophy) of the medulla and the renal cortex. A number of factors lead to renal hydronephrosis, as a result of which there is a blockage of the lumen from the inside, or partial / complete compression of the ureter at any stage of its passage to the bladder. Hydronephrosis downstream is acute and chronic.
Rice. №1 Anatomical structure of a dog's kidney, altered during the course of hydronephrosis
For a clearer picture hydronephrosis, it is necessary to recall a little the structure of the urinary system of dogs and cats. As you know, anatomically, two layers are distinguished in the kidney: the cortical - the outer layer and the cerebral - the inner layer, in which the blood saturated with metabolic products is filtered and urine is formed. It continuously enters the renal pelvis, from where, in turn, the ureter leaves, which connects the kidney to the bladder. Thus, when the patency of the ureter is impaired, the constantly generated urine accumulates in the pelvis, which leads to its significant expansion. At the same time, the lumen of the ureter also increases.
Rice. No. 2 An example of unilaterally flowing hydronephrosis in a dog (right kidney) with blockage of the proximal 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 calyx-pelvic 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).
Second reasons include:
1. Urolithiasis and urological syndrome. With these pathologies, when in the ureters or the underlying (distal) parts of the urinary system, obstruction occurs with a mineral calculus or mucous plug.
In this case, there is a gradation of the severity of the obstruction that has arisen. For example, if there is a blockage of the distal urinary tract and urine flow due to pressure in the overflowing bladder retrogradely (in the opposite direction) through the ureters reaches the pelvis and leads to its expansion (pyelectasis). 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 resumes. In a different situation, when the localization of the calculus is detected directly in the lumen of the ureter, the symptoms of pyeloectasia and subsequent hydronephrosis increase much more rapidly.
2. Iatrogenic ligation of the ureter. It occurs as a complication after surgical operations on the abdominal organs. For example, by caesarean section, castration (ovariohysterectomy) in females, castration of cryptorchids, or cystotomy. The ligation of 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 involved 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 (cicatricial) adhesions that occur between closely spaced organs. The adhesion process is formed as a result of 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 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, the most rare reasons include spasm of the urethra, 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 pelvic cavity. Together with this, the renal calyx is stretched and the functional ability is compensated 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.
With long-term obstruction, the decompensatory stage (III) gradually develops, in which there is a thinning of the walls of the cups and a sharp expansion of the pelvis. At this stage, the kidney is greatly enlarged, the cortical layer is sharply thinned, the function of the kidney is barely traced or absent. At the same time, hypotrophy of the working kidney tissue, 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).
Distinguish between unilateral and bilateral hydronephrotic lesions. In case of bilateral (bilateral) hydronephrosis, the animal requires urgent 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 involvement. More often it occurs when there is a violation of the outflow of urine from the bladder. Monolateral (unilateral) hydronephrosis, in contrast to bilateral, in the initial stage is asymptomatic and invisible to the owners of the animal; often such an affected kidney is detected during routine ultrasound examination.
During embryonic development, females developed close anatomical connections between the urinary and genital organs, which determines the possible likelihood 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 measures directly during the operation, it is difficult to establish the defeat of the ureters in a timely manner. In this regard, the restoration of the animal's health can be delayed for a long time, and the 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
Diagnosis of hydronephrosis without special visual methods of research 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 a laboratory analysis of blood and urine has no specific deviations in their indicators in the preclinical stage. Therefore, the methods of choice in this case are ultrasound diagnostics, uro-contrast radiography, computed and magnetic resonance imaging. But a comprehensive examination of the animal will contribute to assessing the comprehensive picture of the disease. In which the data of visual and laboratory diagnostics are taken into account, giving 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 ability of the kidneys. The scope of the examination is determined in each 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, the doctor can make the right decision and draw up a rational treatment plan.
Ultrasound is essential in the diagnosis of hydronephrosis. In most sick animals, hydronephrosis was first detected during a routine ultrasound scan or accidentally during an examination with regard to various diseases. Ultrasound examines 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 state of the second kidney.
Rice. №3 Ultrascanogram of the III stage of hydronephrosis in a dog, which clearly shows a sharp expansion of the calyx-pelvic system and ureter. Thinning of the cortical layer and atrophy of the medulla.
Rice. №4 Ultrascanogram of chronic hydronephrosis, with significant atrophy of the medulla of the kidney. Such deformation of the renal architecture is possible only with prolonged obstruction.
Radiography is the basis for the comprehensive diagnosis of hydronephrosis. This method, like ultrasound, is materially accessible, safe and highly informative. On plain x-rays, it is possible to visualize an increase in the size of the kidneys. Excretory contrast urography makes it possible to assess the function of each kidney, the state of the calyceal-pelvic system, and the patency of the ureter (Fig. No. 5).
Rice. №5 On the general X-ray of the kidney and urinary tract area, the method of 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 of enormous size, it is contrasted almost along its entire length, therefore, the presence of distal obstruction is most likely.
Treatment
Treatment of hydronephrosis begins with a thorough diagnosis - the search for the cause of the pathological condition that has arisen. Providing a complete and reliable anamnesis by the owners of a sick animal is essential in the diagnosis and treatment of hydronephrosis! It is necessary to provide information on the presence of a history of urolithiasis, cystitis, and operations on the abdominal organs. The decision to remove or preserve the affected organ depends on the stage of the identified hydronephrosis and the presence of a complication of the infection!
If the kidney has lost its function and has undergone a chronic infection, and also became a source of arterial hypertension, then an 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 preserving the kidney, then surgical treatment of hydronephrosis is indicated, in which the stricture of the ureter is eliminated.
Depending on the cause, type, duration of the course and the area of obstruction, surgical treatment can vary from the usual excision of the left ligature to the formation of a specific anastomosis.
If an accidentally left ureteral ligature is found during surgery, it should be removed immediately. If during examination of the ureter its contractility is preserved, the damage is assessed as minimal, then there is no indication for additional manipulations and should be limited 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. The stent is placed in the ureter and serves as the base on which it regenerates. The stent provides 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 excluding the likelihood of re-stricture of the ureter.
Forecast
A favorable outcome is possible in animals with unilateral hydronephrosis detected at 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. Caesarev. - 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 is the same -. Probably, there are no cats that would not have any problems with this organ. In some, these problems are congenital, in others - acquired. One way or another, with age, structural changes in the kidneys and disturbances in their work appear in every pet. It's just that some of them are insignificant, while others, alas ...
Why is this a weak point?
According to statistics, cats are much more likely to suffer from kidney disease than other animals, for example, three times more often than dogs. Why? It's hard to say for sure. Most likely, again because of its historical origin.
The ability to manage with a small amount of water received from time to time, domestic cats owe their ancestors - African desert cats. Hence the imbalance in water balance (especially when eating dry food and insufficient drinking).
Perhaps the anatomical structure of the urinary system in cats also plays a role - a long and narrow urethra with three constrictions causes frequent blockages of the urethra, and non-excretion of urine puts a load on the kidneys with all the ensuing consequences.
In general, all diseases of the genitourinary system of cats are various nephritis,, etc. interconnected and provoke each other, and everything affects the kidneys. Therefore, all cat owners should have an idea about this organ and know what a failure in its work leads to.
Why are kidneys needed?
The kidneys are a paired organ (there are two of them in the body) that performs many different functions: hormonal, to maintain the acid level and electrolyte composition of the blood, and to regulate 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 kidney is shaped like a bean. Outside, it is covered with a dense capsule, inside there is a layer of renal tissue directly. If you do not go into the anatomical details, then the kidney can be conditionally divided into two functional parts: the renal tissue itself is responsible for filtering blood with the formation of urine, and the calyx-pelvic system - 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 takes place. Of course, one nephron filters blood and produces very small amounts of urine, but if you consider that there are about 200,000 of them in each kidney, then the result is liters.
Now the most important thing: kidneys are not capable of regeneration! The number of nephrons in the body is inherent from birth, new ones do not "grow". And if the nephron died, then it is irrevocable.
Kidney disease in cats and cats
Kidney disease can be acute or chronic, congenital or acquired.
Hereditary (genetic) kidney disease is common in certain breeds, such as renal amyloidosis (violation of protein-carbohydrate metabolism with deposition in the renal tissue of amyloid - a protein-polysaccharide compound) occurs in cats of the Abyssinian and Somali breeds, and polycystic(cysts appear and gradually increase in the kidneys) - in Persian, Himalayan and exotic cats.
Congenital anomalies can also include renal aplasia (one or both kidneys are missing at birth) and renal dysplasia (pathological development of the kidneys).
Sharp diseases appear suddenly, for example, as a result of abdominal trauma, large blood loss or dehydration, blockage of the urethra, the development of infection, poisoning (antifreeze is especially dangerous). They require intensive treatment of both the organ itself and the causes of its damage. If the disease is seized at the very beginning, then the prognosis is favorable.
Chronic diseases develop gradually and require constant supportive therapy. They usually progress over time and eventually lead to a sad end.
There is a very thin line between these types of diseases. An acute form can quickly turn into a chronic one!
Jade
(pyelonephritis, glomerunephritis, hydronephritis) - kidney diseases of an inflammatory and bacterial nature. Since the kidneys constantly filter the blood, any infection from it enters the kidneys.
Renal failure
- syndrome of impairment of all kidney functions (!), Leading to a disorder of water, electrolyte, nitrogenous 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 verdict for the animal (although this verdict may have a good reprieve).
What insidious kidney disease has:
- Late detection Many kidney diseases can last for a long time in a latent or erased form and make themselves felt late, no, very late, and sometimes too late ... Disorders in the work of the kidneys do not cause pain in the animal (probably in vain!) And do not give themselves away, since the healthy part can easily withstand the additional load. Until a certain point.
It often happens like this: 10% of the nephrons died - nothing happens, 20% died - nothing happens, 40% - nothing again, 50% - the cat is a little "sad", didn't eat well, well, it happens, 60% - the cat for several days lethargic, ate a little favorite food, vomited once, watery stools - perhaps you should see a doctor. And the doctor finds out that only 30% of the kidneys are working in the pet. And then the diagnosis of three letters can be announced - chronic renal failure - chronic renal failure.
Thus, kidney diseases often make themselves felt only when a significant part of them have already died irrevocably!
- Smudged symptoms Symptoms of kidney disease are common for other diseases, making diagnosis difficult.
Symptoms of kidney disease in cats and cats:
Increased thirst, profuse urination, dehydration, diarrhea, vomiting, lethargy, weight loss, anemia (pale mucous membranes), dental problems (gum and tongue ulcers, tartar, dental disease), drooling, mouth odor (sometimes ammoniacal), worsening hair, detachment of the retina, high blood pressure. With nephritis, there may be fever and soreness when feeling.
A little more detail:
Kidney Disease Causes:
Often it is not possible to accurately establish the causes of the disease. The most typical are: age, genetic predisposition or congenital anomaly, ecology, infectious and systemic diseases (for example, diabetes mellitus), poisoning, trauma, unbalanced diet.
All animals over 7 years old are at risk. They should be examined annually by a veterinarian, blood, urine, ultrasound, and blood pressure tests.
Diagnostics:
Clinical tests can help diagnose kidney disease. The analysis of urine will show its concentration, the ability of the kidneys to remove waste products from the body, a blood test - the level of creatinine and urea (high values indicate a loss of kidney performance), ultrasound - a change in kidney size.
High blood pressure, retinal detachment, dental problems, etc., together with diagnostic tests, can be considered symptoms of kidney disease.
Unfortunately, blood and urine tests may not show impaired kidney function until they have lost more than half of their normal function. For an earlier diagnosis, you can use the ratio of creatinine in the urine and in the blood - CFP (concentrating function of the kidneys). In healthy animals, CFP is greater than or equal to 100%.
In pyelonephritis, urine culture is used to determine whether bacteria are susceptible to a specific 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).
With genetic and congenital kidney anomalies, 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.
For the treatment of glomerulonephritis, glucocorticoids and cytostatics can be used.
2. Since kidney disease a significant number of nephrons are damaged, extremely important eliminate the consequences of their inoperability.
To eliminate dehydration and electrolyte disturbances, relieve intoxication (poisoning by poisonous metabolic products), intravenous and subcutaneous infusions (droppers) are used.
You also need constant supportive therapy to relieve concomitant symptoms: anemia, high blood pressure, gastritis, urinary tract infections, acidosis, anorexia, increased potassium in the blood (hence muscle weakness and heart rhythm disturbances), abnormal liver function, cardiac activity, etc.
3. It is necessary reduce the load on the rest of the nephrons... Diet therapy and control of fluid intake play a major role here.
Proteins (protein) give an increased load on the kidneys. The diet for renal failure should be low in protein, phosphorus and sodium, while being a balanced, nutritious diet. Of course, the easiest way is to use ready-made veterinary diets.
Forecast: All kidney diseases with delayed treatment and relapses eventually turn into chronic renal failure - a syndrome that leads to death. BUT! Correct supportive therapy significantly slows down the progression of the disease, ensures good quality and longevity of the animal.
Kidneys are very serious! Therefore, with any suspicion of a disease of this organ, we do not hope that everything will "resolve" by itself, 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 preferably two) we visit a veterinarian for a comprehensive preventive examination.
P.S. My cat Kuzya (16 years old) is a HePeeNschik with two years of experience. Kidney problems were discovered by accident when they came to brush their teeth and were tested for admission and anesthesia. Before that, the disease was not even suspected. A little more and everything would be completely sad. Be sure to regularly diagnose older animals !!!
Today we passed another full examination. All organs are in good condition, except for the kidneys. One kidney has a change in size and shape, the other is better. Both have significant thickening of the upper cortex, low blood flow. According to blood tests - increased values of urea and creatinine. Very high blood pressure.
Prescribed: to lower the pressure - amlodipine + vasotop, to replenish the protein deficiency - ketosteril (Kuzya has been on the Renal diet for two years). All drugs - according to the scheme and a long course, possibly for life.
(24
estimates, average: 4,71
out of 5)
At first, renal hydronephrosis in cats may be asymptomatic, and clinical signs appear at more advanced stages of the disease. The pathology is characterized by impaired function of the urinary organ against the background of enlargement of the pelvis and atrophy of the renal parenchyma. An increase in the kidney and other pathological changes that require immediate treatment are recorded. Only a veterinarian is able to cope with hydronephrosis in a cat, who selects therapeutic measures after carrying out diagnostic procedures.
Main reasons
According to veterinarians, inflammatory processes are considered the main source of enlargement of the renal pelvis, which negatively affect the structure of the urinary organ.
Hydronephrosis can be unilateral and bilateral, in which one kidney is damaged in a cat or both at once. 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 injuries occurring in road accidents, bites of other animals, falls or bruises;
- the formation of stones, which is associated with the overlap of the ureter by large uroliths;
- malignant or benign tumors in the urinary system that interfere with the outflow of urine;
- abnormal development of the cat's internal organs;
- insufficient fluid intake or poor quality;
- being overweight;
- complications arising after pet sterilization or other surgical intervention.
How does it manifest?
As the disease progresses, the urinary organs work worse and worse. Feline kidney disease 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, the owners are not always able to determine hydronephrosis in a timely manner and consult a doctor. Symptoms tend to occur later in the course, when the disease is harder to cure. For disorders in cats and cats, the following pathological signs are characteristic:
With such a pathology, the animal may have an increased body temperature. - enlarged abdominal cavity;
- increased body temperature of the pet;
- refusal to eat;
- bloody spots in the urine;
- delayed urination.
Diagnostic procedures
To detect 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 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 examination of urine.
Necessary treatment
According to the veterinarian I. G. Sharabrin, the treatment of hydronephrosis in cats of the bilateral type is not effective, while the one-sided 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 surgical intervention, in which the affected paired organ is completely or partially excised. Often, urotrostomy is performed, and in a more advanced form, the kidney is successful. Such a radical operation is indicated in the following cases:
- atrophy of the renal parenchyma;
- hemodynamic problems;
- retention of urine;
- ineffectiveness of drug therapy.
Cats with a determined hydronephrosis need to monitor their diet and take medication. Treatment helps relieve 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 the expansion of the pelvic-pelvic 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 as a result of congenital obstructions in the region of the pelvic-ureteric segment (ectopia of the ureter, stenosis, ureteral atresia).
Secondary or acquired hydronephrosis is usually a consequence of any disease (urolithiasis, tumors of the kidney, pelvis, ureter, bladder, traumatic damage 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 bladder neck or urethra, bilateral hydronephrosis occurs.
There is a classification of obstacles that arise in different parts of the urinary tract and lead to the development of hydronephrosis:
Obstacles in the urethra, urethra, and bladder (uroliths, tumors, clots and hematomas after trauma, etc.)
Obstacles in the ureter or outside its lumen (tumors, uroliths, ureteral diverticula, abdominal or retroperitoneal neoplasms, 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 prolonged inflammatory process, ectopia)
Obstacles in the lumen of the pelvis - nephroliths, neoplasms, blood clots after injuries and hematomas.
Hydronephrosis is divided into three stages:
Stage 1- expansion of only the pelvis (pyelectasia) with a slight dysfunction of the kidney.
Stage 2- expansion of the pelvis and a decrease in the thickness of the renal parenchyma and a significant violation 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 diseases of the kidneys (secondary pyelonephritis).
When the internal structure of the kidneys changes, its hemodynamics are also disturbed. Increased intraparenchymal pressure and edema of the organ leads to compression of the intrarenal vessels and an increase in the rate of blood flow and blood pressure in them. Violation of blood circulation in the capillaries of the cortical and medullary 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 kidney cortex.
So how do you know if your pet is developing such a serious condition? Hydronephrosis is often asymptomatic in its early stages, especially in animals. Unfortunately, clinical symptoms are nonspecific and are most often accompanied by apathy, lethargy, possibly increased 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 own metabolic products is growing. Acute postrenal
Often the owner thinks that we are talking about poisoning or 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, it can take hours to count.
The risk group includes animals
Recently injured (falling from a high floor, car injury, beating, biting 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: it is mandatory, 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 form of hydronephrosis (stages 2-3).
After a complete examination of the animal and obtaining the results of laboratory tests, the doctor makes predictions and chooses the methods of treatment. Treatment can be both conservative (at the initial stage of the development of pathology, depending on its cause), and operative if the kidney is severely altered structurally and impaired, or its function is absent.
If bilateral hydronephrosis develops due to obstruction of the ureters or urethral obstruction, the animal can quickly die from acute postrenal renal failure even before the development of significant atrophy of the renal parenchyma. At the same time, ultrasound may reveal not so 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 must be immediately taken to the clinic ! When an acute urinary retention is established due to blockage of the urethra by uroliths, as a rule, an operative intervention is performed - a dilating urethrostomy. In the presence of large uroliths in the bladder, they are removed promptly through an incision in the bladder. When unilateral hydronephrosis of stage 3 is detected, as a rule, the affected kidney is removed provided that the structure and function of the second kidney are normal. When a neoplasm of the bladder or ureter is detected, treatment depends on the results of a histological or cytological examination. In any case, the method of treatment 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 attentively we treat them, the better the quality of their life. Love for our animals also lies in taking care of their health.
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