Extrarenal Pelvis in a Cat - Diagnosis by Scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report. Keywords: renal scintigraphy, chronic kidney disease, ultrasonography, nuclear medicine. Título: Pelve extrarrenal em uma gata - diagnóstico por cintilografia. Descritores: cintilografia renal, doença renal crônica, ultrassonografia, medicina nuclear

Extrarenal pelvis in a cat : diagnosis by scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report

Biogeographic implications of new avian records from a patch of white-sand forest in southwestern Brazilian Amazonia.

Campinas constituem um tipo florestal de porte arbóreo reduzido e aspecto geral aberto, que cresce em solos arenosos e lixiviados de toda a Amazônia; apesar de sua ampla distribuição, campinas ocorrem predominantemente nas regiões do alto e médio rio Negro, no noroeste do Amazonas e sul de Roraima, incluindo também o sul da Venezuela e o sudeste da Colômbia. Existem pequenas manchas isoladas de campinas no sudoeste da Amazônia brasileira que ainda não foram estudadas sistematicamente por ornitólogos; portanto, são reportados aqui alguns resultados importantes obtidos durante uma expedição ornitológica a uma mancha de campina no extremo sudoeste do estado do Amazonas (7º22'33,2"S e 73º00'42,5"W). Foram documentados para região os primeiros registros das seguintes espécies: Hemitriccus striaticollis (Lafresnaye, 1853) (Aves, Tyrannidae) e Xenopipo atronitens Cabanis, 1847 (Aves, Pipridae); adicionalmente, foram obtidos registros com as seguintes espécies raras ou de distribuição pouco conhecida no sudoeste da Amazônia: Formicivora grisea (Boddaert, 1783) (Aves, Thamnophilidae), Conopias parvus (Pelzeln, 1868) (Aves, Tyrannidae) e Heterocercus linteatus (Strickland, 1850) (Aves, Pipridae). Como verificado em manchas de campina distribuídas por todo o norte do Peru, a avifauna de campina que ocorre no sudoeste da Amazônia brasileira é também altamente influenciada por espécies associadas à região do alto rio Negro. Entretanto, uma segunda influência biogeográfica também pôde ser notada: aquela de espécies cujo centro de distribuição está localizado nas campinas do centro e leste da Amazônia, ao sul do rio Amazonas. A avifauna das campinas do sudoeste da Amazônia ainda é pouco conhecida; futuros levantamentos de enclaves de campina nesta região podem levar a novas extensões de distribuição e também à descoberta de novos táxons

Notes on the Vertebrates of northern Pará, Brazil: a forgotten part of the Guianan Region, II. Avifauna

We carried out seven two-week long avifaunal inventories in five newly-established conservation units spanning the entire ‘CalhaNorte’ area, a portion of the Guiana Shield in the northern part of the state of Pará, Brazil, between January 2008 and January 2009.Prior to our study, most of this part of Amazonia was regarded as virtually unsampled from an ornithological perspective. Here, wepresent an annotated check-list with 446 species of birds recorded during the surveys, including 62 species for which our recordsrepresented significant range extensions, and hence are discussed in detail. The number of species recorded at each site variedbetween 203 and 302, and was positively correlated with the local availability of steep altitudinal and vegetational (forest/savannaand seasonally-flooded/upland forest) gradients. The number of unique species recorded at each site varied between 2 and 27, andreflected an interesting biogeographic pattern in which the Trombetas river appears to separate distinct upland and white-sand forestbird faunas on the Guiana Shield, a pattern also verified for the herpetofauna. Our results also showed that savannas represent avery important component of the local biota, with enclaves harboring a typical bird fauna also distributed in similar habitats in nearbysouthern Guyana, Suriname, and the state of Amapá in Brazil. Altogether, the five conservation units surveyed harbour 74 birdspecies of special interest for conservation (threatened, endemic, rare, range-restricted, and hunted species) and therefore play akey role in the preservation of all main subsets of the heterogeneous bird fauna of the Guiana Shield

Notes on the Vertebrates of northern Pará, Brazil: a forgotten part of the Guianan Region, II. Avifauna.

We carried out seven two-week long avifaunal inventories in five newly-established conservation units spanning the entire ‘Calha Norte’ area, a portion of the Guiana Shield in the northern part of the state of Pará, Brazil, between January 2008 and January 2009. Prior to our study, most of this part of Amazonia was regarded as virtually unsampled from an ornithological perspective. Here, we present an annotated check-list with 446 species of birds recorded during the surveys, including 62 species for which our records represented significant range extensions, and hence are discussed in detail. The number of species recorded at each site varied between 203 and 302, and was positively correlated with the local availability of steep altitudinal and vegetational (forest/savanna and seasonally-flooded/upland forest) gradients. The number of unique species recorded at each site varied between 2 and 27, and reflected an interesting biogeographic pattern in which the Trombetas river appears to separate distinct upland and white-sand forest bird faunas on the Guiana Shield, a pattern also verified for the herpetofauna. Our results also showed that savannas represent a very important component of the local biota, with enclaves harboring a typical bird fauna also distributed in similar habitats in nearby southern Guyana, Suriname, and the state of Amapá in Brazil. Altogether, the five conservation units surveyed harbour 74 bird species of special interest for conservation (threatened, endemic, rare, range-restricted, and hunted species) and therefore play a key role in the preservation of all main subsets of the heterogeneous bird fauna of the Guiana Shield

Notas sobre os vertebrados do norte do Pará, Brasil: uma parte esquecida da Região das Guianas, II. Avifauna.

Entre janeiro de 2008 e janeiro de 2009, executamos sete inventários de avifauna com a duração de duas semanas cada em cinco unidades de conservação estaduais estabelecidas recentemente na região da 'Calha Norte', uma porção do escudo guianense no norte do estado do Pará, Brasil. Antes deste esforço de campo, a maior parte desta região da Amazônia era considerada virtualmente não amostrada ornitologicamente. Apresentamos, neste artigo, uma lista comentada de 446 espécies registradas durante os levantamentos supracitados, incluindo uma discussão pormenorizada para 62 espécies, cujos registros representaram importantes extensões de distribuição para a região da 'Calha Norte' no Pará. O número de espécies registradas em cada uma das sete localidades amostradas variou entre 203 e 302, sendo correlacionado positivamente com a disponibilidade local de gradientes altitudinais e de ecótonos vegetacionais (floresta de terra firme/cerrado e floresta sazonalmente alagada/floresta de terra firme). O número de espécies exclusivas em cada sítio variou entre 2 e 27, refletindo um interessante padrão biogeográfico, no qual o rio Trombetas aparenta separar avifaunas distintas do escudo guianense ligadas aos ambientes de floresta de terra firme e campina/ campinarana, de modo análogo ao verificado para a herpetofauna. Os resultados também mostraram que o cerrado representa um importante componente da biota local, contribuindo com um contingente único de espécies associadas a este ambiente e também distribuídas em localidades vizinhas do sul da Guyana, Suriname e no estado do Amapá. Em conjunto, as cinco unidades de conservação estudadas abrigam 74 espécies de aves de especial interesse para a conservação (ameaçadas, endêmicas, raras, de distribuição restrita e de interesse cinegético), o que atesta a importância estratégica destas áreas para a preservação dos principais conjuntos únicos de espécies da heterogênea avifauna do escudo guianense