ISSN 2398-2950      

Pyelonephritis

ffelis

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

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

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).

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!