Page 2333 - Cote clinical veterinary advisor dogs and cats 4th

1155.e4 Radiographic Interpretation, Abdomen

Differential Diagnoses for Changes in Renal Size and Shape gland may be seen on the VD view in the
pelvic canal.
Bilateral
○ With prostatomegaly, a triangular fat
Unilateral
VetBooks.ir Mildly Enlarged Kidney, Smooth Outline opacity is seen between the caudoventral
urinary bladder, the cranioventral prostate
• Acute kidney injury
• Renal neoplasia (except lymphoma)
• Acute pyelonephritis • Compensatory hypertrophy gland, and the ventral abdominal wall.
Severe prostatomegaly may displace the
• Congenital portosystemic shunts • Subcapsular abscess or hemorrhage
• Amyloidosis colon dorsally and the urinary bladder
• Acromegaly cranially.
Markedly Enlarged Kidney, Smooth Outline ○ Prostatomegaly is commonly caused by
benign prostatic hypertrophy in intact
• Hydronephrosis • Hydronephrosis dogs (p. 824).
• Renal lymphoma • Renal tumor ○ The finding of prostatic mineralization
• Feline infectious peritonitis • Subcapsular hematoma or abscess has a high positive predictive value for
• Perinephric pseudocysts • Perinephric pseudocyst prostatic neoplasia in neutered dogs (p.
Enlarged Kidney, Irregular Outline 828). A differential for mineralization is
• Metastatic neoplasia • Primary renal tumor chronic prostatitis, particularly in intact
• Polycystic kidney disease • Metastatic neoplasia dogs and those neutered late (p. 827).
• Feline infectious peritonitis • Renal abscess ○ Paraprostatic cysts are pedunculated,
• Renal hematoma fluid-opacity structures, occasionally with
• Renal granuloma a thin, mineral-opacity rim, extending
• Renal cyst(s) intraabdominally from the prostate gland.
Small Kidney, Smooth or Irregular Outline Stomach:
• Chronic kidney disease • Chronic kidney disease • Normal
• Developmental hypoplasia or dysplasia • Atrophy due to obstruction ○ A hollow viscus that is located caudal to
the liver. In fasted animals, the stomach
Modified from Seiler GS. The kidneys and ureters. In Thrall DE, editor: Textbook of veterinary diagnostic radiology, ed 6, St. Louis, should be empty or contain a small
2012, Elsevier.
amount of fluid and/or gas. The fundus
is located dorsally and on the left side of
are not seen on survey radiographs (pp. are seen around the final week before the abdomen, and the pylorus is located
1014, 1016, and 1019). parturition. ventrally and on the right. The distribution
A generalized and bilateral increase in • Abnormal of gastric contents will change with patient
■
renal opacity may indicate ethylene ○ When enlarged, the uterus displaces the positioning, altering the normal gastric
glycol intoxication (p. 314). colon dorsally and the urinary bladder appearance.
Urinary bladder: ventrally. Enlarged uterine loops are • Abnormal
• Normal generally seen in the caudal and ventral ○ In gastric dilation/volvulus (GDV [p.
○ The urinary bladder is an ovoid structure abdomen and can be confused with dilated 377]), the pylorus of the stomach is
that tapers toward the inguinal region intestinal loops. displaced dorsally and to the left and
(trigone). ○ Tubular enlargement of the uterus may the fundus ventrally and to the right.
○ The urinary bladder is distensible but be seen with mucometra, hydrometra, On a right lateral view, this leads to
should not extend cranially beyond the pyometra (p. 854), or early gestation and compartmentalization, or a “Smurf hat”
umbilicus. It is difficult to see radiographi- cannot be distinguished radiographically. appearance of the stomach.
cally when empty. ○ For dystocia (p. 278), check fetal presenta- ○ Distinguish gastric dilation without
• Abnormal tion at the pelvic canal and fetal size in volvulus from GDV as the latter requires
○ Most uroliths are mineral-opacity struc- comparison to the pelvic canal. Evaluate immediate surgery. The appearance of the
tures seen in the dependent portion of the the bitch/queen for signs of previous pelvic stomach can vary with the degree of gastric
urinary bladder or the urethra. Cystine trauma. torsion. Concurrent splenic congestion or
and urate uroliths are not seen on survey ○ Signs of fetal death include gas within torsion may occur.
radiographs. and around the fetus, overriding skull ○ Outflow tract obstruction causes moderate
○ Luminal or intramural gas is indicative of bones, a curled fetal position, or collapsed to severe gastric dilation. Recent vomiting
emphysematous cystitis, barring iatrogenic skeleton. Ultrasound is more sensitive in or intermittent obstruction can temper
causes. detecting early fetal death (lack of fetal gastric size. A left lateral view is used to
○ A ruptured urinary bladder may be small heartbeat). evaluate the pylorus for causes of obstruc-
or retain its shape; its serosal margin may Ovaries and testicles: tion and to distinguish this disease from
be obscured by the surrounding urine. • Not seen intaabdominally radiographically a gastric dilation without volvulus.
A positive contrast cystogram can aid unless enlarged or neoplastic Small intestine:
diagnosis. Prostate gland: • Normal
Uterus: • Normal ○ Tubular structure located throughout the
• Normal ○ In most patients, the normal prostate gland middle and caudal abdomen. May gather
○ The uterine body is located dorsal to the is not seen radiographically. together in obese cats
urinary bladder and ventral to the colon • Abnormal ○ Dog: diameter less than 1.6 times the
and is usually only seen in gravid animals. ○ The enlarged prostate gland is seen as a height of the L5 vertebral body at its
○ Mineralization of canine and feline skel- round, soft-tissue–opacity structure caudal midpoint
etons is first seen radiographically around to the neck of the urinary bladder. Pros- ○ Cat: diameter less than 12 mm
days 43 and 38 of gestation, respectively. tatomegaly is suspected when the prostate • Abnormal
Mineralization starts at the skull and spine gland exceeds 70% of the distance from ○ Obstruction (mechanical ileus)
and progresses distally through the limbs. the pubic brim to the sacral promontory ■ Dog: diameter greater than the preced-
Mineralized distal extremities and teeth on the lateral view. The enlarged prostate ing guideline

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