Cat with vomiting and anorexia

Complete blood count:

Test (units)	Result	Ref. Range
Hematocrit (%)	35.0	33.6—47.4
WBCs (x103/µL)	8.2	5—15
Lymphocytes (x103/µL)	0.3	1.5—7.0
Platelets (x103/µL)	*	250—600
*Platelets too clumped to count, platelet mass appears adequate, enlarged platelets noted.

Blood chemistry profile:

Test (units)	Result	Ref. Range
Glucose (mg/dL)	72	75—134
Creatinine (mg/dL)	2.9	0.9—2.3
Blood urea nitrogen (mg/dL)	25	15—35
Phosphorus	3.7	2.6—8.8
Calcium (mg/dL)	13.9	9.0—11.7
Sodium (mmol/L)	157	148—157
Potassium (mmol/L)	4.1	3.5—5.1

Urinalysis (cystocentesis):

Test (units)	Result	Ref. Range
Specific gravity	1.017	1.010—1.030
Protein	2+	Negative
Blood	3+	Negative
WBC	20-29	Negative
RBC	50+	Negative
Triple phosphate crystals	Moderate	Negative

Abdominal radiographs show both kidneys are enlarged with rounded and irregular margins, right more severe than the left. The spleen is mildly enlarged with rounded margins. An oval soft tissue opacity is present ventral to S1 with ventral displacement of the cranial rectum. Portion of the thoracic cavity that is visible appears unremarkable.

Dorsoventral view:

Abdominal ultrasound shows both kidneys are enlarged with irregular margins and perirenal hypoechoic rims. Both renal cortices are also mottled in appearance with ill-defined multiple hypoechoic nodules. A small amount of aggregation of gravity-dependent hyperechoic sediment is present within the urinary bladder (not pictured).

Image of right kidney: