Kidney ultrasound mumbo jumbo

Anyone able to decipher this in english please:

The kidneys are bilaterally hyperechoic with irregular margination and adequate corticomedullary distinction.

 

Hyperexhoic means less density than normal, irregular margins...kidneys usually have smooth edges (ie:margins) and the other I’m not sure but corticomedullary is the middle workings. Let me text my ultrasound tech and have her say it in plain English...brb

Ps edit - I might have hyperechoic backward. Lots of echo would mean more density. Still waiting for my friend to reply. I do like the word adequate though.

 

Sent text. She doesn’t always respond right away but she will. Smartest ultrasound tech I’ve ever known, she traveled for 30 years and is pretty well known all over US.

 

Thanks! IM vet wasn't too worried about it, but I know he has some level of kidney disease.

 

That would be the irregular margins. In CT when we do humans with kidney disease they have a scalloped like edge rather than smooth as they should be.

 

when he had his ultrasound done, his kidney numbers actually had lowered since the times(s) before. This was back in Feb. Now 2 months later his numbers have gone up, and I suspect from a new med. Just has me worried if he had kidney disease and now new med will make it worse

 

How were his kidney function labs?

 

I don’t know much about decifering labs, especially felines. I just know on a human if the BUN or Creatinine are past or below certain s numbers we don’t give CT contrast.

 

My friends reply:
Basically: cat has diabetic kidneys which can improve over time with meds. Also, the fact that you can see a good distinction between the 2 parts of the kidney, means the effects of the diabetes at this time , is mild.

 

We started Adequan and Atopica about a month ago. I've read that the Atopica is not good for the kidneys We are hoping this is short term med

 

Thank you!

 

Boy I dont know kitty labs at all. Remember I ran over and asked the lab guy and he confused me even more. lol

 

I tried googling it and got more confused!!

 

BUN can be affected among other things by what he ate, dehydration, liver problems, stress and if he lost weight a little bit suddenly and tends to be a little on the high side when a cat is having a high protein diet but it can certainly vary

Creatinine can also be affected by a big weight loss ( because cats tend to loose muscle mass when they loose since is related with the amount of muscle mass a cat has a cat with a lot of muscle would have higher creatinine levels than a small one ) or by dehydration

Both can be affected by infection, so there are a lot of issues in place has he had an SDMA test? this test would tell you more accurately if there's something wrong with his kidneys

 

SDMA wasnt included on the in-house IDEXX for some reason. He had a CBC back in Novemeber and I asked what his SDMA was then and they said inconclusive or something along those lines. She said she never saw that before. They say he is not dehydrated, and he hasn't lost weight. He is not eating great and has been sneezing a little and breathing a little harder. But all of his other numbers seem ok, so not sure if it could be an infection. Neither IM vet or reg vet think anything is wrong.

 

SDMA would give you a more accurate diagnose, as I said creatinine and BUN can vary a little from one time to another for a number of reasons but so far with either of his creatinine results he would be at risk of having some percentage of kidney function lost or what is considered stage 1 in either case it would be good to know the rest of his blood work results to see how he's in other values .

Usually vets don't start worrying about kidney issues until creatinine levels go higher but

Just as a precaution probably he would benefit if you started to consider protecting his kidneys see if you can find a low carb ( do not get his diabetes out of control, so no renal diet at this point ) and low phosphorus diet that he accepts and that suits you , adding some omega-3 to his diet can also help, both options would benefit him even if his kidneys were totally ok

There's a page with amazing information on CKD http://www.felinecrf.org/how_bad_is_it.htm

 

Thanks! I've been checking out that website since August, when he first started having issues. His phos number went down which is good, but it is soo hard to find him a food he'll eat. Needs to be low carb, novel, and low phos. Almost non existent. I'll look into the omega-3.

 

Corticomedullary: Relating to, or joining, the renal medulla and cortex.
medulla is the soft inner part with the cortex
Cortex: The outer layer of an internal organ or body structure, such as the kidney or the brain.

In actuality hyperechoic means that the ultrasound image is brighter than normal, that it it reflect the sound ways better. It does not mean it is denser since reflection is not directly related to density

 

Ok, can someone tell me about Urine Specific Gravity numbers? According to Tanya's CKD website, A USG level below 1.040 is considered low in cats. Most CKD cats have a much lower USG of between 1.008 and 1.012. So if Rufus number was 1.012 he is right on the edge. But does that number reflect any kind of stage? Or is that only determined by creatinine and BUN? I know that the USG can vary, but at what number would/should I be concerned with? The vet doesn't think I need to worry.

 

For staging see the following. I would start at page 6
http://www.iris-kidney.com/pdf/003-5559.001-iris-website-staging-of-ckd-pdf_220116-final.pdf
Based on the USG of 1.012 kidney degradation is severe

 

Where do you read that 1.012 is severe?

 

Isosthenuria develops when 67% of nephrons become nonfunctional (USG 1.007-1.015). Cats can retain concentrating ability after onset of azotemia (see above) especially when serum creatinine concentration is in the 2.0-3.0 mg/dL range. above from:
https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/isosthenuria
Do you have any other abe values like:
Protein in urine
Blood creatitine
If using Idexx labs SDMA
Also based on several of my cats that had such USG values