Canis ISSN: 2398-2942

Kidney: pyelonephritis

Contributor(s): Astrid van Dongen

Introduction

  • Inflammation of renal parenchyma and pelvis.
  • Cause: usually bacterial infection ascending from lower urinary tract (but can have other infectious etiologies, eg fungal).
  • Signs: often preceded or accompanied by dysuria/stranguria with signs of systemic illness: pyrexia, acute abdominal pain, lethargy and inappetence, vomiting; occasionally insidious onset.
  • Diagnosis: ultrasound, urinalysis, aspiration biopsy pelvis (including bacterial culture), histopathology.
  • Treatment: prolonged antimicrobials, preferably based on sensitivity.
  • Prognosis: good if early treatment, otherwise permanent and often progressive renal damage or even septicemia.

Pathogenesis

Etiology

  • Ascending bacterial infection.
  • Hematogenous spread of infection or embolus.

Predisposing factors

General
  • Incontinence, eg due to abnormal anatomy: ectopic ureter, or function; sphincter incompetence.
  • Lower urinary tract infection Cystitis.
  • Vesico-ureteral reflux.
  • Bacterial endocarditis Endocarditis: bacterial.
  • Renal scarring.
  • Systemic immunosuppression, eg chemotherapy, glucocorticoids or hyperadrenocorticism.

Pathophysiology

Timecourse

  • Days (but may be weeks).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Weese J S , Blondeau J M, Boothe D, Breitschwerdt E B, Guardabassi L, Hillier A, Lloyd D H, Papich M G, Rankin S C, Turnidge J D, Sykes J E (2011) Antimicrobial use guidelines for treatment of urinary tract disease in dogs and cats: antimicrobial guidelines working group of the international society for companion animal infectious diseases. Vet Med Int 2011, 263768 PubMed.
  • Kolbjørnsen O, Heggelund M, Jansen J H (2008) End-stage kidney disease probablt due to reflux nephropathy with segmental hypoplasia (Ask-Upmark kidney) in young Boxer dogs in Norway. A retrospective study. Vet Pathol 45 (4), 467-474 PubMed.
  • Szatmári V, Osi Z & Manczur F (2001) Ultrasound-guided percutaneous drainage for treatment of pyonephrosis in two dogsJAVMA 218 (11), 1796-1799 PubMed.
  • Gookin J L, Stone E A, Spaulding K A, Berry C R (1996) Unilateral nephrectomy in dogs with renal disease: 30 cases (1985-1994). JAVMA 208 (12), 2020-2026 PubMed.
  • Ginder D R (1974) Urinary tract infection and pyelonephritis due to Escherichia coli in dogs infected with canine adenovirus. J Infect Dis 129 (6), 715-719 PubMed.


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