hello and welcome to this case from first opinion veterinary ultrasound I'm Dr Camilla Edwards this was a seven-year-old female muted Cavalier King Charles Spaniel with a history of pre-general anesthetic Bloods revealing elevated creatinine urea sdma and also an anemia was present so let's have a look at some ultrasound images of our findings so here we have one of her kidneys so we can see it's it's not appearing like a normal kidney it's quite small for a dog of this size um there's no real obvious cortex or medulla um there's this darker hypoechoic area and a more hyperechoic area and surrounded by this tissue but not very clear um cortex or medulla or peripelvic region like we would normally expect here we're Fanning through the region of the kidney and we can really appreciate how tiny this kidney is and how we've got the uh sort of peripelvic area uh this hypoechoic area but no real cortex or my Dollar in this transverse section either now looking at the other kidney in longitudinal we can see again looking abnormal no real normal kidney structure um to be seen there and again looking in longitudinal and and transverse through this now right kidney you can see that in the center of our image there so it's always good to um attempt to assess the vascularity of organs when we're unsure what's going on and there was vascularity within this organ here we're using um tissue Doppler which is a form of Doppler which doesn't give directional flow and it can be more sensitive to those small vessels we might see in the kidney and unfortunately it often picks up on on movement as well but we can certainly see there's some vascularity within this kidney here foreign so in this case we had bilateral kidney pathology and um from appearance bilateral congenital renal dysplasia appeared most likely this can be genetic or can occur with neonatal herpes virus infection and this condition has been seen in Cavalier King Charles Spaniels before differential diagnosis might include a bilateral renal neoplasia but unfortunately bilateral kidney disease like this must carry a guarded prognosis so there won't be a surgical cure a medical treatment will only slow any deterioration we should aim to support kidneys and possibly repeat ultrasound examinations and bloods to see if there's any deterioration observable there but given that the dog is seven years old if it is congenital or from a neonatal herpes virus infection it may be that she will still continue to deteriorate slowly
