PMC6267714_01
Transverse ultrasonographic image of the left kidney prior to surgery.. Notes: Sonogram of the left kidney of a cat referred for progressive azotemia and progressive pyelectasia of the left kidney. White hash marks demarcate the borders of a dilated renal pelvis (width 0.57 cm). Depth is marked in centimeters on the right of the image.. Abbreviation: LS7 Exp, Logiq S7 Expert.
vmrr-9-073f1.jpg
PMC6267714_01_vmrr-9-073f1.jpg
f1-vmrr-9-073
Repeat sonography revealed progressive dilation of the left renal pelvis to 0.57 cm (Figure 1), while the right renal pelvis remained stable.
Right lateral radiographic projection of the abdomen prior to surgery.. Notes: One large and one small kidney are apparent in this preoperative lateral radiograph. There are small mineral-dense opacities in the region of the ureters as well as a wispy opacity in the retroperitoneal region.
vmrr-9-073f2.jpg
PMC6267714_01_vmrr-9-073f2.jpg
f2-vmrr-9-073
There were wispy fluid opacities in the retroperitoneal space (Figure 2).
Right lateral radiographic projection of the abdomen immediately following surgery.. Notes: This postoperative lateral radiograph shows the SUB system (Norfolk Vet Products, Skokie, IL, USA), including nephrostomy tube, subcutaneous port, and cystoscopy tube. A Jackson-Pratt drain (MILA International, Florence, KY, USA) is also visible. Radiographic contrast (omnipaque; GE Healthcare, Princeton, NJ, USA) remains within the urinary bladder.. Abbreviation: SUB, subcutaneous ureteral bypass.
vmrr-9-073f3.jpg
PMC6267714_01_vmrr-9-073f3.jpg
f3-vmrr-9-073
Prior to recovery, a right lateral radiographic projection was obtained to document proper placement of the SUB system (Figure 3).
Transverse ultrasonographic image of the left kidney 4 days following surgery.. Notes: Pyelectasia has resolved 4 days following placement of a SUB device. Depth is marked in centimeters on the right of the image.. Abbreviations: GE P6, General Electric Logiq P6; SUB, subcutaneous ureteral bypass.
vmrr-9-073f4.jpg
PMC6267714_01_vmrr-9-073f4.jpg
f4-vmrr-9-073
Four days postoperatively, repeat sonography of the left kidney showed that pyelectasia had resolved (Figure 4).
Creatinine values obtained in-house during hospitalization, plotted against time following placement of a SUB device.. Notes: Azotemia improved rapidly following SUB placement on day 0. A urethral obstruction was relieved on day 4. On day 6, treatment with fluconazole was started, and the SUB port was exchanged due to obstruction. Medical therapy was continued, and azotemia again showed rapid improvement on day 9.. Abbreviation: SUB, subcutaneous ureteral bypass.
vmrr-9-073f5.jpg
PMC6267714_01_vmrr-9-073f5.jpg
f5-vmrr-9-073
Following this time azotemia improved rapidly; on day 13, BUN was 56 mg/dL and creatinine 2.8 mg/dL (Figure 5).