Avaliação Semiológica e Diagnóstico em Pequenos Animais - Aula 14.1 e 14.2

Summary

This video covers the ultrasound examination of the urinary system in small animals, focusing on kidney anatomy and diagnostic indications. It explains how ultrasound helps identify renal issues, such as enzyme elevation, hematuria, and abnormalities caused by infection, trauma, or tumors. The video also provides an overview of kidney structure, including the cortical and medullary regions, and the importance of different ultrasound imaging angles. Additionally, it highlights the normal size ranges of kidneys in canines and felines, offering essential insights for veterinary practice and diagnosis.

Takeaways

• 😀 Ultrasonographic evaluation is crucial in assessing the urinary system of small animals, especially for kidney and bladder health.
• 😀 Indications for an ultrasound include elevated renal enzymes, hematuria, urinary difficulties, and changes in urination behavior.
• 😀 Radiological exams may not always provide conclusive results, making ultrasound a valuable tool for diagnosis.
• 😀 Recurrent urinary infections, bladder stones, and post-trauma assessments are also key reasons to use ultrasound for urinary system evaluation.
• 😀 The kidneys are located in the retroperitoneal space with the right kidney being more cranial and near the liver, and the left kidney near the spleen and stomach.
• 😀 Kidney anatomy includes the cortical (outer) and medullary (inner) regions, with a transitional zone between them.
• 😀 Different ultrasound cuts (longitudinal, transversal, and parallel) offer various views and help visualize kidney structures.
• 😀 In ultrasound images, the renal cortex appears more echogenic than the medulla, which appears anechoic.
• 😀 It is essential to understand normal kidney ultrasound appearance to effectively identify abnormalities and pathology.
• 😀 Kidney size and cortical thickness are important metrics, with canine kidneys ranging from 2.2 to 9.4 cm in length, and feline kidneys being smaller (3 to 8 cm).
• 😀 A 10% size difference between the left and right kidneys is typical, with the right kidney generally being slightly larger.

Q & A

What is the primary purpose of performing an ultrasound of the urinary system in small animals?

The primary purpose is to evaluate the kidneys, ureters, and urinary bladder, especially when there are signs like elevated renal enzymes, hematuria (blood in the urine), difficulty urinating, or changes in urination behavior. It's also used to assess potential urinary tract infections, trauma, or malformations.

What are the common indications for requesting an ultrasound of the urinary system?

Indications include elevated renal enzymes in preoperative patients, hematuria, difficulty or pain while urinating, changes in urination frequency or behavior, urinary tract infections, and post-trauma evaluation for possible kidney or bladder ruptures.

How does the ultrasound differentiate between the cortical and medullary regions of the kidney?

On ultrasound, the cortical region appears more echogenic (brighter) and is located on the outer part of the kidney, while the medullary region is hypoechoic (darker) and is found more centrally within the kidney. The transition between these regions is called the cortico-medullary junction.

What are the normal appearances of the kidney on an ultrasound image?

The normal kidney shows a hypoechoic (darker) cortex compared to the liver, with a more anechoic (darker) medullary region due to urine. The cortex is finely granular, and the renal capsule is hyperechoic (brighter). The shape is typically round or oval, and the central medullary region contains renal pyramids.

What is the significance of the cortico-medullary junction on an ultrasound of the kidney?

The cortico-medullary junction is the area where the cortical (outer) and medullary (inner) regions of the kidney meet. It is important for measuring kidney size and determining if there is any abnormal enlargement of either region, which could indicate a pathology.

Why is it important to assess kidney size during an ultrasound examination?

Measuring kidney size helps assess if the kidneys are normal or if there is an enlargement or shrinkage, which could indicate diseases like renal failure, tumors, or other abnormalities. Normal kidney size varies by species, and any deviations from the standard can signal a pathological condition.

What is the normal range for kidney size in dogs and cats?

In dogs, kidney length typically ranges from 2.2 to 9.4 cm, and the cortical thickness ranges from 0.3 to 0.8 cm. In cats, the kidney size is smaller, with a length of about 3 to 4 cm, and the cortical thickness ranges from 0.3 to 0.6 cm.

What is the typical size difference between the left and right kidneys in animals?

The right kidney is usually slightly larger than the left, with a size difference of up to 10%. This is considered normal, and variations within this range are not indicative of pathology.

How does the ultrasound help in identifying pathologies in the renal system?

Ultrasound allows for visualization of abnormal structures, such as tumors, cysts, stones, or infections. By comparing the images with normal kidney anatomy, veterinarians can identify changes that suggest renal diseases, ureteral issues, or bladder problems.

Why is it important to understand the normal appearance of the kidneys on ultrasound before diagnosing a pathology?

Knowing the normal kidney appearance is essential because it helps differentiate between normal anatomical variations and pathological changes. Without this baseline, it would be difficult to accurately identify diseases or abnormalities based on ultrasound images.