A 3-year-old castrated male domestic shorthair cat was referred for examination in August 2000 with a 3-week history of poor appetite, vomiting, and weight loss. One week before referral, evaluation by the referring veterinarian identified anemia (PCV 21% [reference range 29–48%]) and moderate renal insufficiency (BUN 55mg/dL [reference range 14–36mg/dL], serum creatinine 4.2mg/dL [reference range 0.6–2.4mg/dL], urine specific gravity 1.015) with an inflammatory urine sediment (proteinuria, white blood cells, bacteria) on a voided sample. The results of enzyme-linked immunosorbent assays for feline leukemia virus (FeLV) antigen and feline immunodeficiency virus (FIV) antibodies were negative. Radiographs disclosed bilateral renomegaly and microcardia. Abdominal ultrasound examination identified a thin cortex in the left kidney and both kidneys were hyperechoic. The cat was treated with lactated Ringer’s solution IV and enrofloxacin 6mg/kg/d IV for 3 days. Upon examination at the referral hospital, the cat was quiet and responsive. Physical examination abnormalities were limited to bilaterally enlarged kidneys that appeared to be painful on palpation and a body condition score of 3/9. Body weight was 3.6 kg. On CBC there was a severe nonregenerative macrocytic normochromic anemia (PCV 17% [reference range 30–47%], MCV 55 fL [reference range 41–51 fL], MCHC 31 g/dL [reference range 31–35 g/dL], aggregate reticulocytes 20,880/mL) in the presence of normal serum erythropoietin concentration (17mU/mL [reference range 10–30mU/mL]). The WBC count (10,200/mL [reference range 5,500–19,500/ mL]), differential cell count (segmented neutrophils 7,040/mL [reference range 2,500–12,500/mL], lymphocytes 2,860/mL [reference range 1,500–7,000/mL], monocytes 260/mL [reference range 0–800/mL], eosinophils 50/mL [reference range 0–1,500/mL]), and platelet count (485,000/mL [reference range 300,000–800,000/ mL]) were normal. Serum chemistry results indicated moderate azotemia (BUN 36mg/dL [reference range 16–34mg/dL], serum creatinine 3.5mg/dL [reference range 0.7–2.3mg/dL]), increased AST activity (173U/L [reference range 5–30U/L]), and hypoalbuminemia (1.8 g/dL [reference range 2.0–3.1 g/dL]). Results of urinalysis collected by cystocentesis indicated isosthenuria (USG 1.011), proteinuria, and bacteruria. Aerobic urine culture was negative, and plasma prothrombin and partial thromboplastin times were within normal limits. Ultrasonographic examination of the abdomen identified moderate bilateral renomegaly with pyelectasia, mesenteric lymphadenopathy, and an enlarged hypoechoic pancreas. By means of ultrasound guidance, fineneedle tissue aspirates were collected from kidney, mesenteric lymph node, and pancreas, and slides were prepared for cytologic evaluation using Wright-Giemsa stain. Preparations obtained from the kidney were very cellular, consisting primarily of large, epitheliod macrophages arranged in sheets and individually. The cytoplasm of many of the macrophages contained long, thin, negatively staining, rod-shaped inclusions consistent withMycobacteria spp. (Fig 1). Renal epithelial cells were also observed in the preparation.Macrophages containing similar negatively staining rods were observed in tissue aspirate preparations from the pancreas and a mesenteric lymph node, along with pancreatic epithelium and lym-