Lapis ISSN 2398-2969

Kidney: hydronephrosis

Contributor(s): Brendan Carmel, Lesa Longley, Sarah Pellett

Introduction

  • Hydronephrosis is dilation of the renal pelvis and calices.
  • Usually results in progressive atrophy and cystic enlargement of the kidney.
  • Cause:
    • Urinary tract obstruction (congenital or acquired).
    • External pressure on the ureters.
    • Abdominal adhesions.
    • Neoplasia.
  • Signs: abdominal discomfort, reduced appetite/fecal production, behavioral changes.
  • Diagnosis: clinical examination, abdominal ultrasonography/radiography, pyelogram. 
  • Treatment: supportive care, fluid therapy, surgery.
  • Prognosis: good to poor, depending on cause.

Presenting signs

  • Abdominal discomfort, eg grinding teeth, hunched posture, inappetence.
  • Reduced urine output.
  • Behavioral changes

Acute presentation

  • Collapse with acute abdominal pain.
  • Anorexia.
  • Oliguria/anuria.

Sex predisposition

  • None recorded.
  • Females potentially higher risk, as more likely to undergo abdominal surgery, eg ovariohysterectomy Ovariohysterectomy.

Cost considerations

  • Standard workup costs may be significant and involve:
    • Imaging:
      • Radiography.
      • Ultrasonography.
      • Contrast studies.
    • Urinalysis.
    • Blood analysis.
    • If surgery indicated, for example unilateral nephrectomy, considerable costs likely.

Special risks, eg anesthetic

  • Renal function impairment likely.
  • Pre-anesthetic work-up necessary Anesthesia: overview.
  • Avoid anesthetic drugs requiring renal clearance, if possible, eg ketamine Ketamine.
  • Residual renal function must be assessed before considering unilateral nephrectomy.

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Sequelae

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Duhamelle A, Tessier E & Larrat S (2017) Ureteral stenosis following ovariohysterectomy in a rabbit (Oryctolagus cuniculus). J Exotic Pet Med 26 (2), 132-136 VetMedResource.
  • Huynh M, Boyeaux A & Pignon C (2016) Assessment and care of the critically ill rabbit. Vet Clin North Am Exotic Anim Pract 19 (2), 379-409 PubMed.
  • Martorell J, Bailon D, Majó N et al (2012) Lateral approach to nephrotomy in the management of unilateral renal calculi in a rabbit (Oryctolagus cuniculus). J Am Vet Med Assoc 240 (70), 863-868 PubMed.
  • Bushma K M & Bushmas M I (2008) Role of lipid peroxidation systems and anti-oxidative protection of kidneys in predisposition of rabbits with hydronephrotoxicity posed by aminoglycosides on the example of gentamicin. Toksikologicheskii Vestnik 5, 27-31.
  • Rhody J L (2006) Unilateral nephrectomy for hydronephrosis in a pet rabbit. Vet Clin North Am Exot Anim Pract 9 (3), 633-641 PubMed.
  • Porzio P, Pharr J W & Allen A L (2001) Excretory urography by intraosseous injection of contrast media in a rabbit model. Vet Radiol Ultrasound 42 (3), 238-243 PubMed.
  • White R N (2001) Management of calcium ureterolithiasis in a French lop rabbit. JSAP 42 (12), 595-598 PubMed.

Other sources of information

  • Mancinelli E & Lord B (2014) Urogenital System and Reproductive Disease. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 191-204.
  • Keeble E & Benato L (2013) Urinary Tract Surgery. In: BSAVA Manual of Rabbit Surgery, Dentistry and imaging. Eds: Harcourt-Brown F & Chitty J. BSAVA, UK. pp 190-211.
  • Reusch B (2006) Urogenital System and Disorders. In: Manual of Rabbit Medicine and Surgery. 2nd edn.  Eds: Meredith A & Flecknell P. BSAVA, UK. pp 85-95.
  • Paré J A & Paul-Murphy J (2004) Disorders of the Reproductive and Urinary Systems. In: Ferrets, Rabbits and Rodents: Clinical Medicine and Surgery. 2nd edn. Eds: Quesenberry K E & Carpenter J W. Saunders, USA. pp 183-193.
  • Harcourt-Brown F (2002) Urinogenital diseases. In: Textbook of Rabbit Medicine. Butterworth-Heinemann, UK. pp 335-351.
  • Maxie M G (1993) The Urinary System. In: Pathology of Domestic Animals. 4th edn, Vol 2. Eds: Jubb K V F, Kennedy P C & Palmer N. Academic Press Inc, USA. pp 447-538.


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