title: The use of contrast-enhanced ultrasonography for the detection of active renal hemorrhage in a dog with spontaneous kidney rupture resulting in hemoperitoneum.
abstract: OBJECTIVE
  To describe the use of contrast-enhanced ultrasonography (CEUS) for the detection of active renal hemorrhage in a dog with spontaneous kidney rupture resulting in hemoperitoneum.
  
  
  METHODS
  A 9-month-old, sexually intact male Boxer dog presented for acute collapse, abdominal pain, and tachycardia. Physical examination findings were consistent with hypovolemia and acute abdomen. B-mode ultrasonography revealed peritoneal effusion and a right kidney mass. Subsequently, a CEUS study was performed on the right kidney, which demonstrated active hemorrhage from that kidney resulting in both hemoretroperitoneum and hemoperitoneum. At exploratory surgery, ultrasonographic findings were confirmed and a right nephrectomy was performed. Histopathology demonstrated severe parenchymal alterations along with the presence of nematode larvae. Fecal and urine testing for the presence of parasitic ova were negative. Identification of the larvae was inconclusive. At 30 days postoperatively, repeat B-mode ultrasound and clinicopathologic testing was unremarkable. The dog was alive at 1 year postsurgery with no ill effects.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinica Veterinaria Malpensa, Varese, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Gerboni
authors.affiliation: Clinica Veterinaria Malpensa, Varese, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Capra
authors.affiliation: the Department of Comparative Biomedicine and Food Science, University of Padua, Padova, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferro
authors.affiliation: the Department of Veterinary Sciences, University of Turin, Torino, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Bellino
authors.affiliation: Clinica Veterinaria Malpensa, Varese, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Perego
authors.affiliation: the Department of Veterinary Sciences, University of Turin, Torino, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Zanet
authors.affiliation: the Department of Veterinary Sciences, University of Turin, Torino, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Angelo
authors.affiliation: the Department of Veterinary Sciences, University of Turin, Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gianella
mesh_terms: D000006:Abdomen, Acute; D015746:Abdominal Pain; D000818:Animals; D003287:Contrast Media; D004283:Dog Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D004285:Dogs; D006465:Hemoperitoneum / Q000209:etiology / Q000662:veterinary*; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000662:veterinary*; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000662:veterinary*; D008297:Male; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000662:veterinary; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: canine; contrast harmonic ultrasound; endoparasites; hemoperitoneum