Yaşlı Bir Köpekte Şiddetli İdrar Birikmesi ve İdrar Yolu Enfeksiyonu İle Birlikte Unilateral Renal Agenezis

Yedi yaşında dişi Büyük Münsterländer köpekte abdominal şişkinlik gelişti. Bilgisayarlı tomografide sağ böbrek ve üreter mevcut olmayıp şiddetli hidronefroz ve sol üreterde dilatasyon gözlemlendi. Beş yıl sonra, hasta acilde hastaneye alındı. Tanısal görüntülemede >350mm çapında sol böbrek ile temasta olup abdominal organların yerini değiştiren bir kist ile yaklaşık 150 mm çapında sağ böbrek hizasında bir kist ile sol böbreğin parankiminde belirgin bir incelme tespit edildi. Laparotomide sol böbrek nefrostomisi uygulandı ve 8.230 mL idrar parasentez sırasında drene edildi. Sol böbreği idrar kesesine bağlayan bir üreter bulunmamakla birlikte sol böbreği sağ tarafta idrar içeren bir kiste bağlayan genişlemiş üreterosel benzeri tübüler bir organ gözlemlendi. Sağ tarafta idrar içeren kist ile idrar kesesi benzeri organı bağlayan kısa tübüler bir organ mevcut olup neredeyse hiç idrar toplanması bulunmamaktaydı. İdrar kültürü testi Klebsiella pneumoniae için pozitif sonuç verdi. Postoperatif olarak hasta dört gün sonra taburcu edildi. Bu vaka takdimi yaşlı bir köpekte unilateral ranal agenezis (URA) için ilk sunum olma özelliği taşımaktadır. Bazı köpeklerde tanısı konulmamış URA bulunabilir. Dormant dönemi sonrası URA belirince vakalar iştah kaybı, abdominal şişkinlik, artmış yangısal belirteçler ve abdominal ultrasonografide kist benzeri olgu ile birlikte şiddetli seyredebilir. Bu durumlarda URA ayırıcı tanıda düşünülebilir.

Unilateral Renal Agenesis in an Aged Dog with Severe Urine Accumulation and Urinary Tract Infection

A 7-year-old intact female Large Münsterländer developed abdominal distention. Computed tomography showed absence of the right kidney and ureter, marked hydronephrosis, and left ureter dilatation. Five years later, the patient was hospitalized as an emergency. Diagnostic imaging showed a >350-mm-diameter cyst communicating with the left kidney displacing the abdominal organs, another approximately 150-mmdiameter cyst in the right kidney position, and marked parenchymal thinning of the left kidney. At laparotomy, a left kidney nephrostomy was established; 8.230 mL of urine were drained with paracentesis. There was no ureter connecting the left kidney and bladder, but an enlarged, ureterocele-like, tubular organ connected the left kidney to a urine-containing cyst on the right side. A short, tubular organ connected the urine-containing cyst on the right side with a bladder-like organ, but it showed almost no urine accumulation. Urine cultures tested positive for Klebsiella pneumoniae. Postoperatively, the patient was discharged after four days. This is the first case about unilateral renal agenesis (URA) in an aged dog. Some dogs may have undiagnosed URA. When URA manifests after a dormant period, cases may be severe, with total loss of appetite, abdominal distension, elevated inflammatory markers, and cyst-like phenomena on abdominal ultrasonography. In such cases, URA must be considered in the differential diagnosis.

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