Findings with feline AKI

Ultrasonographic findings in cats with acute kidney injury: a retrospective study

Laura P. Cole, Panagiotis Mantis, Karen Humm

Background
Acute kidney injury (AKI) in cats is characterized by an abrupt decline in renal function, affecting glomerular filtration, tubular function, and urine output. Ultrasonography (US) is a non-invasive tool for assessing renal abnormalities in AKI, but specific imaging criteria are not well defined. This study aimed to identify common US findings in feline AKI and assess their prognostic value.

Methods
A retrospective case series analyzed medical records of cats diagnosed with AKI between 2007 and 2016. US images were reviewed for six renal abnormalities: nephromegaly, cortical and medullary echogenicity, pyelectasia, and retroperitoneal and peritoneal fluid. A scoring system (0–6) was used to quantify abnormalities, and associations with oliguria/anuria and survival were evaluated.

Results
Among 45 cats with AKI, 93% had at least one renal abnormality. The most common findings were nephromegaly (68.9%), pyelectasia (57.8%), and increased renal echogenicity. Retroperitoneal fluid was significantly associated with oliguria/anuria (P = 0.006, OR 8.0). The total ultrasound score correlated with 6-month survival (P = 0.029), with higher scores linked to worse outcomes. However, no single US finding independently predicted survival to discharge.

Limitations
The retrospective nature limited data accuracy, and the small sample size reduced statistical power. Prior fluid therapy in referral cases may have influenced US findings, particularly pyelectasia and fluid accumulation. Diagnosis of AKI etiology was not confirmed in all cases.

Conclusions
US abnormalities are common in feline AKI, and a higher total US score may indicate a poorer prognosis. Retroperitoneal fluid is strongly associated with oliguria/anuria. Further studies are needed to refine the prognostic utility of US findings and their relationship to specific AKI causes.

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