Felis ISSN 2398-2950

Pyelonephritis

Contributor(s): Penney Barber, Samantha Taylor, Melissa Wallace

Introduction

  • Inflammation of renal pelvis and parenchyma.
  • Cause: usually ascending bacterial infection from lower urinary tract.E.colicommonly isolated.
  • Signs: pyrexia, acute abdominal pain, lethargy and inappetence, occasionally insidious onset, can be clinically silent.
  • Diagnosis: microbiology, histopathology.
  • Treatment: antimicrobials.
  • Prognosis: good if early treatment, otherwise septicemia and severe renal damage.

Pathogenesis

Etiology

Predisposing factors

General

  • Low urine specific gravity, eg CKD Hyposthenuria.
  • Lower urinary tract infection.
  • Vesico-ureteral reflux.
  • Disorders of micturition, eg urinary retention.
  • Systemic immunosuppression, eg chemotherapy, glucocorticoids or hyperadrenocorticism.
  • Bacterial endocarditis Endocarditis.
  • Pre-existing renal disease.

Pathophysiology

  • Ascending bacterial infection from the lower urinary tract or bacteremia and sequestration of bacterial emboli in kidney.
  • Bacterial infection of renal pelvis   →    inflammation   →   renal failure chronic Kidney: chronic kidney disease or acute Kidney: acute renal failure via a number of mechanisms:
    • E. Coli Escherichia coli infection can   →   vasoconstriction and ischemia.
    • White cell infiltration   →   lysosomal enzymes release and renal damage.
    • Chronic damage may   →   nephrolithiasis or chronic kidney disease.
      Pyelonephritis Pyelonephritis is a common cause of acute renal disease.

Timecourse

  • Days to weeks for acute course.
  • Months for chronic or recurrent disease.

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.
  • Lister A, Thompson M, Moss S et al (2011) Feline bacterial urinary tract infections: an update in an evolving clinical problem. Vet J 187 (1), 18-22 PubMed.
  • Lunn K F (2011) The kidney in critically ill small animals. Vet Clin North Am Small Anim Med 41 (4), 727-744 PubMed.

Other sources of information

  • BSAVA Manual of Canine and Feline Nephrology and Urology (2007) Elliott J & Grauer G (eds).


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