Felin Enfeksiyöz Peritonitisli Kedilerde Renal Ultrasonografi Bulguları

Öz

Felin enfeksiyöz peritonitis (FIP), mutasyona uğramış felin enterik koronavirüs (FECV) tarafından oluşturulan, çok çeşitli klinik bulgulara sebep olan ölümcül, viral bir hastalıktır. Effüziv forma kıyasla non-effüziv form göz, beyin, omentum, karaciğer ve böbrek gibi çeşitli organlarda piyogranülamatöz yangıya sebep olduğundan antemortem tanı zorlaşabilir. FIP ile ilişkili lezyon gelişimine en duyarlı organın böbrek olduğu tartışılmış olduğundan, bu çalışmada doğal gelişmiş non-effüziv FIP’li kedilerde renal ultrasonografi bulgularını değerlendirmek amaçlandı. Non-effüziv FIP varlığından şüphelendirecek uyumlu klinik bulgulara sahip 17 adet kedinin klinik muayeneleri ve uygun protokol ile renal ultrasonografik muayeneleri gerçekleştirildi. Tüm kedilerin her iki böbreği ekojenite, boyut (longitidunal uzunluk), şekil, varsa serbest sıvı varlığı ve bu sıvının ekojenitesi yönünden değerlendirildi. Yapılan renal ultrasonografi sonucu en belirgin anormal ultrasonografik bulguların kortikal hiperekojenite (17 kedinin 11’i), medullar rim sign (17 kedinin 11’i), renomegali (17 kedinin 10’u), piyelektazi (17 kedinin 5’i), kortikomedullar ayrımın azalması (17 kedinin 4’ü) ve internal yapıda bozulma (17 kedinin 4’ü) olduğu belirlendi. Sonuç olarak, çalışmamızda non-effüziv FIP’li kedilerde renal ultrasonografik değerlendirmede morfolojik ve parankimal değişimler oluştuğu ve renal ultrasonografinin FIP’e bağlı oluşan vaskülitisin klinik yansımasını değerlendirmede faydalı klinik bilgiler sağladığı gözlendi. Her ne kadar tespit edilen bu anormal renal ultrasonografi bulguları FIP için spesifik olmasa da, tespit edilen ultrasonografik bulgular ile diğer uyumlu klinik bulguların kombinasyonu ve hepsinin birlikte değerlendirilmesi, antemortem FIP enfeksiyonu şüphesi indeksini arttırmada kullanılabileceği kanısına varıldı.

Anahtar Kelimeler

• kedi
• tanı
• FIPV
• Renal korteks
• Vaskülit

Renal Ultrasonography Findings in Cats with Feline Infectious Peritonitis

Öz

Feline infectious peritonitis (FIP) is a fatal disease caused by a mutated feline enteric coronavirus (FECV) that causes a wide diversity of clinical findings. Antemortem diagnosis may be challenging as the non-effusive form causes pyogranulomatous inflammation in various organs including the eye, brain, omentum, liver and kidney compared to the effusive form. Since it has been discussed that the kidney is the organ most susceptible to FIP-related lesion development, this study aimed to evaluate the renal ultrasonography findings in cats with naturally developed non-effusive FIP. Clinical and renal ultrasonographic examinations of 17 cats with compatible clinical findings that would suggest the presence of non-effusive FIP were performed with the appropriate protocol. Both cats’ kidneys were evaluated for echogenicity, size (longitudinal length), shape, presence of free fluid, if any, and echogenicity of this fluid. As a result of renal ultrasonography, it was observed that the most prominent abnormal ultrasonographic findings were cortical hyperechogenicity (11 out of 17 cats), medullary rim sign (11 out of 17 cats), renomegaly (10 out of 17 cats), pyelectasis (5 out of 17 cats), loss of corticomedullary differentiation (4 out of 17 cats) and distortion of internal architecture (4 out of 17 cats). In conclusion, it was observed that morphological and parenchymal alterations occur in the renal ultrasonographic evaluation in cats with non-effusive FIP, and renal ultrasonography could provide useful clinical information in evaluating the clinical reflection of vasculitis due to FIP. Although these abnormal renal ultrasonography findings were not specific for FIP, it was concluded that the combination of the observed ultrasonographic findings and other compatible clinical findings and their evaluation together can be used to increase the index of suspicion for antemortem FIP infection.

Anahtar Kelimeler

• cat
• diagnosis
• FIPV
• Renal cortex
• Vasculitis

Kaynakça

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