Pepper: A Case of Hydronephrosis

Pepper, a 10 month female spayed mixed breed dog, presented to the Animal Care Center of Polaris for a few days duration of a slightly reduced appetite.  Given her non-specific signs, blood work was performed.  Initial lab work (complete blood count, chemistry profile, and urinalysis) showed a mild elevation in SDMA (early biomarker of kidney disease) and a very mild amount of crystals (calcium oxalate) in her urine.  Pepper was negative for tick borne diseases.  Over the next few days, Pepper did not improve.  She developed diarrhea, stopped eating and became nauseous.

She re-presented to the hospital for worsening of her clinical signs.  Abdominal palpation revealed a large mass within her cranial abdomen.  On initial X-rays, one of Pepper’s kidneys was enlarged and is outlined on the image.  An abdominal ultrasound allowed us to determine that Pepper’s left kidney was extremely enlarged and, which is a condition known as hydronephrosis.  Surgery was performed to remove the affected kidney in a procedure known as a nephrectomy.  The kidney was cultured and submitted for biopsy.  Upon further evaluation of Pepper’s kidney, two large stones (nephroliths) were found inside of her kidney (pictured).  The stones served as an obstruction to kidney outflow and pressure from the back flow destroyed the normal architecture of her kidney.

Pepper was kept hospitalized on intravenous fluids, pain medications, and antibiotics.  Her blood work was repeated in 24 hours and all of her kidney values returned to normal ranges.  Pepper’s fluids were gradually tapered and discontinued.  She was discharged from the hospital and at home is doing well.  Pepper was started on a special prescription diet designed prevent future formation of stones in her remaining kidney and to support overall kidney health.  Pepper is expected to make a full recovery.