Purrberry
Member Since 2020
https://www.felinediabetes.com/FDMB/threads/1-28-fred-amps-326-5-276-9-86-vet-update.258523/
I received the radiologist's report a bit ago. I just spoke with my regular vet, and she was happy because she said the radiologist who read it is their favorite go-to guy. However, and I didn't realize this, without an ultrasound, vets are apparently not supposed to comment on anything involving "thickness" or the like with x-rays. But I did glean some more information on what the "odd" view of the stomach was. My vet said it seemed a little pushed in, which could be "bad" or could be that his stomach was contracting because he had just vomited. So, the report is more along the lines of "take it for what it's worth". We are scheduled for an ultrasound on Tuesday.
One thing I'm furious about is they didn't send out blood for the fPLI! We (the new vet and I) had specifically spoken about it, and I said I wanted it done. Who WOULDN'T do it in a situation like this?? Super pissed about that.
I'll paste below. Just FYI, we've been aware of the kidney situation for years. It's why I watch his kidney values like a hawk. And he DID have some high protein dry about 2 hours before the bloodwork. (though it came up in the car) Oh, and he's likely not really a Chartreux. We just kind of wondered that when we first adopted him, and somehow, it made its way into his records. He's just a handsome gray guy.
HISTORY
Consult Type: MVRFILM INTERP 1-8 IMAGES, SIG: DOB: 9/3/2008, Age: 13.4 Y, Sex: M ALTERED, Wt: 17.0lbs, Breed: Chartreux, Species: FELINE, Images: 3, Case Details: 1 week history of hyporexia and occasional vomiting. Has vomited 3 x over the past week. Hx of DM and is on levemir 5U BID. Owner monitors BG at home. Bloodwork performed in hospital and showed a BUN of 58mg/dl and hypokalemia at 3.0 meq/l. UA showed no ketones and a USG of 1.046.
Findings
2 electronically transmitted images, including ventrodorsal and right lateral radiographs of the thoracic and abdominal regions (trunk) are provided for review, acquired January 28, 2022.
The left renal silhouette is significantly reduced in size and irregular in shape. The right kidney is normal in size. There are several 1-5 mm mineral opacity calculi in the renal pelvic regions bilaterally, larger and more numerous within the left renal pelvis.
The stomach and small bowel segments contain a very small amount of fluid and gas consistent with recent fasting or anorexia. The colon contains a moderate amount of partially formed feces and gas. The urinary bladder is moderately distended with fluid consistent with recent urination. The caudal ventral margins of the liver are slightly rounded and extend caudal to the costal arch, consistent with mild diffuse hepatomegaly. There is normal serosal detail.
There are several narrowed intervertebral disc spaces and intervertebral foramina in the visible portions of the spine, consistent with degenerative intervertebral disc disease, and there are changes consistent with spondylosis deformans of variable severity at several of these sites.
The lung pattern and cardiovascular structures are normal.
The pet is obese.
Conclusion
Renal changes consistent with chronic renal disease with bilateral renal pelvic calculi and significant loss of left renal parenchyma. (Considering the reported concentrated urine specific gravity the BUN elevation could be more likely secondary to gastrointestinal blood loss or a high protein meal ingested prior to bloodwork, assuming creatinine is normal and the reported urine specific gravity is accurate.)
Empty stomach and small bowel segments consistent with a history of partial anorexia and vomiting or fasting prior to radiography.
The cause of vomiting anorexia is not determined. Gastroenteritis of infectious or parasitic origin, secondary to inflammatory bowel disease or diffuse intestinal neoplasia such as small cell lymphoma are possible. Chronic pancreatitis cannot be ruled out.
Mild hepatomegaly consistent with a diffuse hepatopathy such as a vacuolar hepatopathy secondary to diabetes mellitus or hepatic lipidosis.
Chronic degenerative spinal changes.
Normal thoracic soft-tissue structures.
I received the radiologist's report a bit ago. I just spoke with my regular vet, and she was happy because she said the radiologist who read it is their favorite go-to guy. However, and I didn't realize this, without an ultrasound, vets are apparently not supposed to comment on anything involving "thickness" or the like with x-rays. But I did glean some more information on what the "odd" view of the stomach was. My vet said it seemed a little pushed in, which could be "bad" or could be that his stomach was contracting because he had just vomited. So, the report is more along the lines of "take it for what it's worth". We are scheduled for an ultrasound on Tuesday.
One thing I'm furious about is they didn't send out blood for the fPLI! We (the new vet and I) had specifically spoken about it, and I said I wanted it done. Who WOULDN'T do it in a situation like this?? Super pissed about that.
I'll paste below. Just FYI, we've been aware of the kidney situation for years. It's why I watch his kidney values like a hawk. And he DID have some high protein dry about 2 hours before the bloodwork. (though it came up in the car) Oh, and he's likely not really a Chartreux. We just kind of wondered that when we first adopted him, and somehow, it made its way into his records. He's just a handsome gray guy.
HISTORY
Consult Type: MVRFILM INTERP 1-8 IMAGES, SIG: DOB: 9/3/2008, Age: 13.4 Y, Sex: M ALTERED, Wt: 17.0lbs, Breed: Chartreux, Species: FELINE, Images: 3, Case Details: 1 week history of hyporexia and occasional vomiting. Has vomited 3 x over the past week. Hx of DM and is on levemir 5U BID. Owner monitors BG at home. Bloodwork performed in hospital and showed a BUN of 58mg/dl and hypokalemia at 3.0 meq/l. UA showed no ketones and a USG of 1.046.
Findings
2 electronically transmitted images, including ventrodorsal and right lateral radiographs of the thoracic and abdominal regions (trunk) are provided for review, acquired January 28, 2022.
The left renal silhouette is significantly reduced in size and irregular in shape. The right kidney is normal in size. There are several 1-5 mm mineral opacity calculi in the renal pelvic regions bilaterally, larger and more numerous within the left renal pelvis.
The stomach and small bowel segments contain a very small amount of fluid and gas consistent with recent fasting or anorexia. The colon contains a moderate amount of partially formed feces and gas. The urinary bladder is moderately distended with fluid consistent with recent urination. The caudal ventral margins of the liver are slightly rounded and extend caudal to the costal arch, consistent with mild diffuse hepatomegaly. There is normal serosal detail.
There are several narrowed intervertebral disc spaces and intervertebral foramina in the visible portions of the spine, consistent with degenerative intervertebral disc disease, and there are changes consistent with spondylosis deformans of variable severity at several of these sites.
The lung pattern and cardiovascular structures are normal.
The pet is obese.
Conclusion
Renal changes consistent with chronic renal disease with bilateral renal pelvic calculi and significant loss of left renal parenchyma. (Considering the reported concentrated urine specific gravity the BUN elevation could be more likely secondary to gastrointestinal blood loss or a high protein meal ingested prior to bloodwork, assuming creatinine is normal and the reported urine specific gravity is accurate.)
Empty stomach and small bowel segments consistent with a history of partial anorexia and vomiting or fasting prior to radiography.
The cause of vomiting anorexia is not determined. Gastroenteritis of infectious or parasitic origin, secondary to inflammatory bowel disease or diffuse intestinal neoplasia such as small cell lymphoma are possible. Chronic pancreatitis cannot be ruled out.
Mild hepatomegaly consistent with a diffuse hepatopathy such as a vacuolar hepatopathy secondary to diabetes mellitus or hepatic lipidosis.
Chronic degenerative spinal changes.
Normal thoracic soft-tissue structures.
