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Renal lymphoma?

Species: Cat
Breed: mixed...
Age: 8-11 years
my cat just had dental surgery. After about a week I noticed she was still listless and not having bowel movements so I took her to the vet.

After an exam the vet noticed an enlargement. She did an xray and thinks her kidney is whats enlarged. Without doing a biopsy, she believes its lymphoma due to its sudden onset (not present at time of surgery). could it be anything else? She has no temperature so an infection is unlikely. We did a blood test before the surgery and everything looked normal. Its just the one kidney enlarged.

At this point euthanasia is whats being discussed.

I have some pain meds, and they did a sub q IV so i could take her home tonight.

She is not the same cat she was before the tooth extraction. It was extracted because it had a chip exposing the pulp (Left K9). The vet believes the lymphoma might have been the cause of her dental problem.

I dont want her to suffer and if the chance of recovery is small then I dont want to put her through a million painful tests.

Looking for a second opinion obviously, and maybe some fresh ideas if they exist. What course of action should I take? I have the money if needed for medical help...if it is worth it

Online vet, Dr. Marie

Dr. Marie replied:

Oh, I am sorry to hear that this is happening. I'll give you my thoughts on what you have written.

There are a few things that can cause a cat's kidney to be enlarged. Some cats will naturally have a kidney that is bigger than the other. However, your vet likely would have picked this up if this were the case.

The next possibility is indeed lymphoma which is a cancer in the kidney. There are chemotherapy protocols that can be used for lymphoma, but if Pebbles is very sick then these may be difficult.

I have also seen large kidneys if a cat has had an urethral obstruction, but this would not cause just one kidney to be large.

There are other cancers that can affect the kidney as well.

There are some more rare conditions such as a renal pseudocyst or polycystic kidney that can cause a big kidney. These can "sort of" be treated. Sometimes we can remove fluid from around the kidney or even remove a kidney to help cats with this problem.

If your vet has access to ultrasound this may help get a more concrete diagnosis. If the ultrasound shows fluid then it is possible the fluid could be drained.

With all of this being said,lymphoma or some other cancer is the most likely diagnosis.

If you are not certain about the decision to euthanize, one thing you could do is ask your vet for a referral to a veterinary oncologist (cancer doctor). This vet will likely be more experienced with this type of situation and can give you a better idea of treatment options and prognosis.

I'm not sure if I've really answered your question, so let me know if you have more concerns.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thanks for the reply,

How quick is the onset of renal pseudocyst or polycystic kidneys? She had the tooth removed just over a week ago and they did not feel anything at the time. Is it possible the vet did not feel anything at the time because they were not looking for an issue in that area? I brought her in thinking she was constipated or maybe infected. That led the vet to feel the area. She felt the large kidney but wasn't sure if it was not a fecal mass. The xray showed no fecal mass and more density around the kidney.

Would I be smart to go for a ultrasound without the biopsy just in case?

If it is lymphoma, what is the likelihood of recovery assuming it has not spread from the kidneys?

Im not in the best frame of mind so I apologize for my incoherency at times.

Online vet, Dr. Marie

Dr. Marie replied:

There is definitely no need to apologize.

Cystic problems with the kidneys would not be likely to pop up all of a sudden. However, it is possible that the kidney was large before and was simply missed.

The prognosis for renal lymphoma really depends on a number of factors. It depends on how sick the cat is and whether or not the lymphoma has spread to other organs. Some cats can live for a year or more quite happily with treatment. Other cats don't do well at all.

If this was my case I would definitely be wanting to do an ultrasound. There is no guarantee that it will give us a diagnosis, but there is a good chance that you will have more information that you can use to make your decisions.

Is Pebbles really unwell right now? If she is only a little bit unwell, I wouldn't jump to euthanasia right away without having a diagnosis. If she is extremely sick, not eating, and very unwell, then I would be leaning towards euthanasia. If you are not sure, it is definitely okay to seek out a second opinion. Or, better yet, and opinion of a veterinary oncologist.

I really hope she is okay!

Customer reply:

She is not doing very well at all. She is not the same cat right now. She is listless, uncoordinated and severely dehydrated.

She has only eaten small bite fulls a few times a day and its hard to gauge her water intake because she does drink but she is not peeing much. Its hard to tell if her tooth extraction is still bothering her (looks good). Like I said this all started immediately after her dental surgery. She doesn't purr, or vocalize like she did prior as well.

This last week has been hell for her so my biggest concern is her well being. I dont want to rush into stressful tests if shes just going to spend her last days under duress in addition to her condition. More of a moral delema I need to figure out I guess.

Hopefully the Sub Q fluid helps. I will talk to the vet again tomorrow.

Online vet, Dr. Marie

Dr. Marie replied:

What you are describing doesn't sound good. I think we definitely have to be prepared for euthanasia. Again, if an ultrasound is available this may help. But she definitely does not sound well.

Dr. Marie.

Customer reply:


I just read on your website that there could be a link between injected metacam and renal failure.

She was given a shot after her dental and I gave her oral metacam for 2 days after the surgery. Could this have anything to do with what I am seeing?

Customer reply:

in addition to this I gave her the metacam with very little food as her appitite was small. I also, did NOT mix it with the food but I gave it to her straight.

Online vet, Dr. Marie

Dr. Marie replied:

There have been some unusual cases where a Metacam injection has lead to renal failure. We don't know what the cause of this is. However, renal failure on its own would not cause an enlarged kidney. The enlarged kidney is likely the cause of the problem and not the result of something else.

Customer reply:

If hey kidneys were in the early stages of kidney disease instead of lymphoma being present, would it be possible for Metacam to aggravate the preexisting condition and lead to the enlargement?

Sorry if im playing Dr here and taking up your time but I just want to make sure everything is accounted for, even if its only for my benefit.

Online vet, Dr. Marie

Dr. Marie replied:

No worries. In theory, yes, if the kidneys were just hanging on the edge of illness, a Metacam injection could put them over the edge. I really would expect that there would be some evidence on the presurgical bloodwork if this was the case.

I think if this was something that was "made worse" by Metacam then it was only a matter a time before it would have been evident on its own. It really doesn't look like a Metacam reaction to me.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.