Lapis ISSN 2398-2969

Kidney: nephritis

Synonym(s): Renal disease, Glomerulonephritis, Interstitial nephritis, Pyelonephritis

Contributor(s): Lesa Longley, Anna Meredith, Sarah Pellett

Introduction

  • Nephritis is inflammation of the kidney.
  • Cause: infectious agents, metabolic, toxins, drugs.
  • Signs: three main syndromes are recognized, although the etiologies and clinical features are often mixed:
    • Acute nephritis with moderate proteinuria, hematuria, edema, oliguria and a degree of renal failure.
    • Nephrotic syndrome long illness with edema, proteinuria, and renal failure.
    • Serious renal failure acute (within a few weeks or months) with uremia, or chronic (after several years) with hypertension and death due to vascular complications or uremia.
  • The site of inflammation is usually described:
    • Glomerulonephritis glomeruli (most commonly affected).
    • Interstitial or tubulo-interstitial spaces between renal tubules.
    • Pyelonephritis renal pelvis affected.
  • Diagnosis: clinical examination, urine analysis, catheterization, blood pressure monitoring, hematology, biochemistry, abdominal radiography, abdominal ultrasound, renal biopsy.
  • Treatment: as for renal disease; supportive care, fluid therapy, 
  • Prognosis: guarded; depends on response to initial therapy.

Presenting signs

  • Disease may be subclinical in some animals.
  • Changes in thirst or urine output.
  • Vague signs of illness (detailed below).

Acute presentation

  • Urine output alterations, eg proteinuria, hematuria and oliguria.

Age predisposition

  • Rabbits often over 2 years of age for inflammatory etiologies.
  • Infectious or toxic agents may affect any age of rabbit.

Breed predisposition

  • Some rabbit breeds farmed in large quantities for meat are predisposed to infection with Encephalitozoon cuniculi Encephalitozoon cuniculi.

Public health considerations

  • Most causes of nephritis are not a public health risk.
  •  E. cuniculi is zoonotic, predominantly causing disease in immunosuppressed individuals.
  • Leptospirosis is zoonotic and has been reported in various species of lagomorph, including rabbits.

Cost considerations

  • Investigations may be expensive.
  • Treatments are inexpensive but most are required intermittently or permanently for the rest of the rabbits life, so the total cost may be significant.

Special risks, eg anesthetic

  • Certain drugs are metabolized or excreted by the kidneys, eg ketamine Ketamine and tiletamine. These should be avoided in rabbits with nephritis.
  • Intravenous fluids should be administered in the peri-anesthetic period to optimize renal perfusion.

Pathogenesis

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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.
  • Pellett S (2016) Encephalitozoon cuniculi in rabbits: an overview. Comp Anim 21 (5), 300-305 VetMedResource.
  • Cray C, McKenny S, Perritt E et al (2015) Utility of IgM titers with IgG and C-reactive protein quantitation in the diagnosis of suspected Encephalitozoon cuniculi infection in rabbits. J Exotic Pet Med 24 (3), 356-360 VetMedResource.
  • Graham J E, Garner M M, Reavill D R (2014) Benzimidazole toxicosis in rabbits: 13 cases (2003-2011). J Exotic Pet Med 23 (2), 188-195 ResearchGate.
  • Harcourt-Brown F M (2013) Diagnosis of renal disease in rabbits. Vet Clin Exot Anim 16 (1), 145-174 PubMed.
  • Mancinelli E, Shaw D J & Meredith A L (2012) γ-Glutamyl-transferase (GGT) activity in the urine of clinically healthy domestic rabbits (Oryctolagus cuniculus). Vet Rec 171 (19), 475 PubMed.
  • Sieg J, Hein J, Jass A et al (2012) Clinical evaluation of therapeutic success in rabbits with suspected encephalitozoonosis. Vet Parasitol 187 (1-2), 328-332 PubMed.
  • Reusch B, Murray J K, Papasouliotis K et al (2009) Urinary protein: creatinine ratio in rabbits in relation to their serological status to Encephalitozoon cuniculi. Vet Rec 164 (10), 293-295 PubMed.
  • Balakrishnan G, Roy P, Govindarajan R et al (2008) Occurrence of subclinical leptospirosis in rabbits. Indian Vet J 85 (8), 890 ResearchGate.
  • Csokai J, Gruber A, Künzel F et al (2008) Encephlitozoonosis in pet rabbits (Oryctolagus cuniculus): pathohistological findings in animals with latent infection versus clinical manifestation. Parasitol Res 104 (3), 629-635 PubMed.
  • Rampin F, Piccirillo A, Schiavon E et al (2007) Detection of pathological lesions in slaughtered rabbits. Ital J Anim Sci 7 (1), 105-112 ResearchGate.
  • Suter C, Müller-Doblies U U, Hatt J M et al (2001) Prevention and treatment of Encephalitozoon cuniculi infection in rabbits with fenbendazole. Vet Rec 148 (15), 478-480 PubMed.
  • Erlich J H, Holdsworth S R & Tipping P G (1997) Tissue factor initiates glomerular fibrin deposition and promotes major histocompatibility complex class II expression in crescentic glomerulonephritis. Am J Pathol 150 (3), 873-880 PubMed.
  • van den Buuse M & Malpas S C (1997) 24-hour recordings of blood pressure, heart rate and behavioural activity in rabbits by radiotelemetry: effects of feeding and hypertension. Physiol & Behaviour 62 (1), 83-89 PubMed.
  • Shotts E B Jr., Andrews C L, Sulzer C et al (1971) Leptospires in cottontail and swamp rabbits of the Mississippi Delta. J Wildlife Dis 7 (2), 115-117 PubMed.

Other sources of information

  • Mancinelli E & Lord B (2014) Urogenital System and Reproductive Disease. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 191-204.
  • Varga M (2014) Infectious Diseases of Domestic Rabbits. In: Textbook of Rabbit Medicine. 2nd edn. Butterworth Heinemann Elsevier, UK. pp 435-471.
  • Varga M (2014) Urogential Disease. In: Textbook of Rabbit Medicine. 2nd edn.  Butterworth Heinemann Elsevier, Uk. pp 405-424.
  • Keeble E & Benato L (2013) Urinary Tract Surgery. In: BSAVA Manual of Rabbit Surgery, Dentistry and imaging. Eds: Harcourt-Brown F & Chitty J. BSAVA, UK. pp 190-211.
  • Keeble E & Meredith A (2006) Self-Assessment Colour Review of Rabbit Medicine & Surgery. Manson Publishing, UK.
  • Reusch B (2006) Urogenital System and Disorders. In: Manual of Rabbit Medicine and Surgery. 2nd edn. Eds: Meredith A & Flecknell P. BSAVA, UK. pp 85-95.
  • Paré J A & Paul-Murphy J (2004) Disorders of the Reproductive and Urinary Systems. In: Ferrets, Rabbits and Rodents: Clinical Medicine and Surgery. 2nd edn. Eds: Quesenberry K E & Carpenter J W. Saunders, USA. pp 183-193.
  • Harcourt-Brown F (2002) Urinogenital diseases. In: Textbook of Rabbit Medicine. Butterworth-Heinemann, UK. pp 335-351.
  • Doxey D L (1983) The Urinary System. In: Clinical Pathology and Diagnostic Procedures. 2nd edn. Baillière Tindall, Eastbourne, East Sussex. pp 133-153.


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