Case Study

Pyelonephritis in an 11 year old FS Jack Russell Terrier

An 11-year-old FS Jack Russell Terrier dog was presented with a history of intermittent vomiting and bloody diarrhea over several weeks. Halitosis, ulceration of the lower lip margins, vulva, and periorbital regions, and erythema mucous membranes were present on physical examination. Urine was cloudy with trace proteinuria, 2+ hematuria, leukocyturia, and 2+ bacteriuria was evident. Urine protein/creatinine ratio was low. Blood chemistry showed hypoalbuminemia, hyperglobulinemia, mild hypocalcemia, and hyperamylasemia.

Sonographic Differential Diagnosis

Pyelonephritis renal presentation. Ill-defined corticomedullary junction may be consistent with lupus disease or other immune mediated glomerulonephropathy. Infectious nephritis also possible. Biopsies would be necessary to confirm.

Image Interpretation

The kidneys presented hypertrophic cortices and mild to moderate hyperechoic parenchyma. A moderate amount of pyelectasia and medullary debris was noted. No calculi were noted in the ureters. This is most consistent with nephritis/pyelonephritis, but concurrent glomerulonephritis is possible.

DX

Pyelonephritis

Outcome

The patient was treated with for pyelonephritis with Zenequin antibiotics. On recheck urinalysis the prior abnormalities had resolved and repeat ANA titer was negative. The patient resolved the urinary issues but continued to have unrelated gastrointestinal issues.

Comments

At last communication, the patient was stable at home.

Clinical Differential Diagnosis

Gastrointestinal symptoms – IBD, ulceration, dietary hypersensitivity, neoplasia, foreign body, parasites. Cystitis. Dermatopathy – immune-mediated disease, drug reaction, neoplasia (mast cell, lymphoma), bacterial infection/hypersensitivity.