Bilateral multiple cystic kidney disease and renal cortical abscess in a Boerboel

A M Kitshoffa,V Mcclure,C K Lim,R M Kirberger

doi:10.4102/jsava.v82i2.45

Abstract

Cystic renal disease is rare in dogs and although infected renal cysts have been reported in humans, no report could be found in dogs. A 58 kg, 5-year-old, castrated, male Boerboel presented with weight loss, pyrexia, lethargy and vomiting, 20 months after an incident of haematuria was reported. The initial ultrasonographic diagnosis was bilateral multiple renal cysts of unknown aetiology. The cysts had significantly increased in size over the 20-month period and some contained echogenic specks which could be related to infection, normal cellular debris or haemorrhage. In both kidneys the renal contours were distorted (the left more than the right). The abnormal shape of the left kidney was largely due to multiple cysts and a large crescent-shaped septate mass on the cranial pole of the kidney. Aspirates of the septate mass were performed (left kidney) and the cytology and culture were indicative of an abscess. It is suggested that the previous incident of haematuria provided a portal of entry for bacteria into the cysts resulting in renal cortical abscess formation.

Highlights

Cystic structures in the kidney can be classified as true cysts or pseudocysts[14,36]
Simple renal cysts usually have a distinct sonographic appearance, which includes a round to oval contour, anechoic aSection Small Animal Surgery, bSection of Small Animal Medicine, cSection of Diagnostic Imaging, Department Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
The disease in the current report presented much like polycystic kidney disease (PKD), potential cystic renal disease in related dogs was not investigated

Summary

INTRODUCTION

Cystic structures in the kidney can be classified as true cysts (epithelial cell membrane separating them from the surrounding tissue) or pseudocysts (wall consisting of granulation and/or fibrous tissue as a result of inflammation)[14,36]. Renal cysts can be acquired or congenital, solitary or multiple and involve either one or both kidneys[14,19,30,35]. 3,9,13,15,16,20,23–25,27,29,39–45 To the authors’ knowledge, there are no previous case reports that documents renal cyst infection in dogs with multiple-, solitary cystic kidney disease or PKD. Two of the cranial pole cysts of the kidney were more hypoechoic and communicated with a large 5 × 3 ×3 cm hypoechoic well-marginated, crescentshaped mass which distorted the cranial pole of the kidney This structure had hyperechoic septa and multiple hyperechoic internal specks that swirled on ballotment. Multiple smaller (largest about 1 × 1 × 1.5 cm) anechoic structures were present mainly in the medulla (Fig. 3a,b) Some of these cysts communicated with each other and some had multiple hyperechoic internal specks. There were few residual renal cysts up to 22 mm in diameter, but no evidence of the renal abscess

DISCUSSION

Findings

CONCLUSION