Erinephric P Pseudocysts in Cats

[Pages:1]Perinephric Pseudocysts in Cats

Cathy E. Langston, DVM, DACVIM (Small Animal)

BASIC INFORMATION

Description A perinephric pseudocyst is an accumulation of fluid around the kidney. The fluid accumulates inside the renal capsule, a fibrous tissue that normally surrounds the kidney. These cysts may occur on one or both kidneys. Causes The cause of perinephric pseudocysts is unknown.

Clinical Signs

Abdominal distention may occur from extremely large cysts and may be visible as a swelling in the abdomen behind the ribs. Sometimes pseudocysts are detected when an abdominal mass or enlarged kidney is found on a routine physical examination. In about half of the cases, chronic kidney failure is present at the time of diagnosis. Signs of chronic kidney failure include excessive thirst and urination, poor appetite, lethargy, weight loss, poor hair coat, and anemia. Rarely, pseudocysts may rupture and the fluid inside drains into the belly (causing abdominal distention) or into the chest (causing difficult or rapid breathing).

Diagnostic Tests

The most useful diagnostic test is an abdominal ultrasound (sonogram). On the ultrasound, the fluid around the kidney is easily seen and is clearly contained within the kidney capsule. The kidney may appear to be floating in the fluid. The kidney may look normal, or it may be small and scarred. Laboratory tests, a urinalysis, and urine culture are often performed to look for evidence of kidney failure and urinary infection. X-rays may be done to rule out other causes of abdominal masses.

An intravenous pyelogram (excretory urogram) may be recommended in some cases. It involves intravenous injection of a type of dye that is taken up by the kidneys, followed by a series

of timed x-rays. Occasionally fluid is retrieved from the cyst and submitted for analysis. Other tests may be recommended to rule out other causes of chronic kidney disease.

TREATMENT AND FOLLOW-UP

Treatment Options

If the pseudocyst is an incidental finding (that is, it is not causing the cat any problems), treatment may not be necessary. Draining the fluid by inserting a needle through the skin into the pseudocyst is relatively simple but is not encouraged because the procedure may cause the cat to become dehydrated or may cause an infection to develop in the cyst.

If the pseudocyst is so large that it causes abdominal discomfort, drainage of fluid may be helpful. The pseudocyst usually refills with fluid after simple needle drainage, however. Surgical removal of the capsule around the kidney allows the fluid to drain into the belly, where other tissues can resorb it.

In general, diminished kidney function does not recover after removal of the capsule, although there have been rare reports of improvement in kidney function after this surgery. Treatment for chronic kidney disease is started as needed. (See the handout on Chronic Kidney Disease in Cats.)

Follow-up Care

If the pseudocyst was incidentally discovered and kidney function is normal, examination of the cat every 6 months is prudent. If kidney function is impaired, examinations and laboratory tests are performed based on the severity of the kidney dysfunction. Prognosis Prognosis for cats with perinephric pseudocysts depends primarily on the presence and severity of any kidney failure.

IF SPECIAL INSTRUCTIONS HAVE BEEN ADDED, THEY WILL APPEAR ON THE LAST PAGE OF THE PRINTOUT. Copyright ? 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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