Within the left renal pelvis there is a hyperechoic, strongly shadowing structure with adjacent mild renal pelvic and diverticular dilation. There is a focal hyperechoic effusion with abnormal echoes noted in the caudal pole of the left kidney that is subcapsular in position. There is a surrounding increased hyperechogenicity of the retroperitoneal fat (some degree of hyperattenuation) along with a mild perinephric effusion. Within the urinary bladder there is a suspended echogenic fluid with some evidence of reverberation from some of structures. There is thickening of the cranioventral apical portion of the urinary bladder wall with multiple mucosal pedunculated thickened areas that’s extended into the UB lumen. There are multiple gravity dependent hyperechoic structures with distal acoustic shadowing. There is a mild anechoic peritoneal effusion adjacent to the urinary bladder. Based on the images provided a dilated proximal left ureter is not seen.
The caudal pole was a renal abscess with E.coli being cultured (also from the urine). An EU documented evidence of renal pelvic/proximal ureteral leakage. The dog was not azotemic and the right kidney had normal EU appearance and features of contrast medium excretion. A left-sided nephrectomy and cystotomy (stone removal) was done.