The use of contrast‐enhanced ultrasonography for the detection of active renal hemorrhage in a dog with spontaneous kidney rupture resulting in hemoperitoneum

Abstract

To the authors' knowledge, this is the first report of CEUS for the detection of active hemorrhage from a kidney resulting in hemoretroperitoneum and hemoperitoneum in a dog. Although rare, the finding of nematode larvae within the renal parenchyma may have been the cause of kidney rupture. Importantly, surgical removal of the kidney was curative. Benign processes causing kidney rupture such as parasitic infestation should be considered in the working diagnosis as related to geographical location.

A unique complication: Iatrogenic renal pelvis perforation following accidental urinary catheterisation of an intramural ectopic ureter in a dog

“…The use of CEUS in detecting haemorrhage specifically, as was the intention in this case, is less common. CEUS has shown promise at being able to detect idiopathic renal haematuria 18 and previously been used to accurately diagnose spontaneous renal haemorrhage in a dog 19 . In the case described here, intravenously administered contrast microbubbles were immediately witnessed in the perirenal fluid of this patient, enabling authors to conclude renal haemorrhage and iatrogenic parenchymal damage.…”

Arterial malformations leading to bilateral spontaneous renal hemorrhage in a dog

“…9 This single reported case of SRH of unknown etiology described the presence of renal nematode larvae, which was hypothesized as a possible cause for the observed renal hemorrhage, although a coagulopathy secondary to Angiostrongylus vasorum was not excluded, as the presence of this parasite was not tested for. 7 The current report details a case of sequential bilateral SRH with associated bilateral renal arterial malformations, a combination of findings that has not been previously reported in the veterinary literature and which has only been sparsely reported in human medicine.…”

“…Similarly to other reports, CEUS was used to assess if ongoing renal hemorrhage was present. 7 However, four-dimensional CT was required to diagnose the underlying condition. This technique allows scanning both kidneys continuously during contrast medium application, thus enabling visualization of the arterial malformation.…”

“…1,3,5,6 Advanced imaging modalities are required to diagnose the underlying etiology. 1,3,5 Within the veterinary literature, to the authors' knowledge, there is only a single report of unilateral SRH of unknown etiology, 7 with all others being associated with neoplasia 8 or trauma. 9 This single reported case of SRH of unknown etiology described the presence of renal nematode larvae, which was hypothesized as a possible cause for the observed renal hemorrhage, although a coagulopathy secondary to Angiostrongylus vasorum was not excluded, as the presence of this parasite was not tested for.…”