Perinephric pseudocyst?? Never seen anything like this before!

Re: Perinephric pseudocyst?? Never seen anything like this before!

Kara Gibson — Fri, 13 Mar 2015 01:44:37 GMT

The cyst is best demonstrated on a clip I took with ultrasound so not sure I'll be able to share but you can see it is contained within the renal capsule. There were no cysts in any other organs on ultrasound. I'm still awaiting cytology on this case. Currently he doesn't have any indication of renal failure (concentrated urine and no azotaemia) but I will check his blood pressure and retinas next time he is in. I will also be intrigued to see if it has refilled!

Re: Perinephric pseudocyst?? Never seen anything like this before!

macvet — Wed, 11 Mar 2015 20:34:17 GMT

I have seen a few cats with bilateral perirenal pseudocysts as you have described but not yet in dogs. The cats all have had CRF and most have had hypertension, so if you can check blood pressure / check retinas in this dog it may be helpful. I am treating a 17 yo CRF cat just now that has had these pseudocysts upto 7 or 8 cm diam around both kidneys (normal sized) for at least a year and doesnt seem to suffer any discomfort. With previous cases I tried draining them (clear fluid) fearing that the pressure would be painful but the cats showed no different behaviour pre/post drainage and just refilled in a week or so. I think Adam Gow at RDVS wrote a short article about them in uk vet a few years back - if its the article I'm thinking about there was a description about removing most of the renal capsule then the fluid would just be reabsorbed in the abdomen. Hope that helps!

Re: Perinephric pseudocyst?? Never seen anything like this before!

Tim Charlesworth — Wed, 11 Mar 2015 17:43:09 GMT

It could be a renal cyst in which case thay can (but aren't always) linked to underlying renal disease. It could be incidental but you can drain and then omentalise them (but they can bleed++). Another ddx would be a large paraprostatic cyst then is up against the kidney esp in an entire male. Seeing the ultrasound piccy would be good. Might be worth considering referral for surgery if you're out of your comfort zone,

Tim

Re: Perinephric pseudocyst?? Never seen anything like this before!

Charlotte Marshall — Wed, 11 Mar 2015 16:09:24 GMT

I had a cat case once who I was sure had one of these on ultrasound - not a great machine at the time. Interestingly I did not drain it and it seemed to go down of it's own accord and not refill. I always assumed it just drained into it's abdomen and was absorbed. The cat did well for several years before eventually being euthanized. As I recall it did develop CRF later on.

Re: Perinephric pseudocyst?? Never seen anything like this before!

Kate Richardson — Wed, 11 Mar 2015 11:57:28 GMT

Interesting. Do you have any ultrasound pics? I vaguely recall seeing one dog with similar, also had cysts on liver as well.