Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지
DOI QR코드

DOI QR Code

Imaging Diagnosis of Emphysematous Pyelonephritis in a Non-Diabetic Dog

  • Kim, Heesu (College of Veterinary Medicine, Kangwon National University) ;
  • Lee, Kija (College of Veterinary Medicine, Kyungpook National University) ;
  • Chung, Jinyoung (College of Veterinary Medicine, Kangwon National University) ;
  • Ahn, Jinok (College of Veterinary Medicine, Kangwon National University) ;
  • Park, Inchul (College of Veterinary Medicine, Kangwon National University) ;
  • Choi, Sooyoung (College of Veterinary Medicine, Kangwon National University)
  • Received : 2019.07.08
  • Accepted : 2020.08.18
  • Published : 2020.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

An 11-year-old, 4.3 kg, mixed breed, intact female dog exhibiting vomiting and a reduced appetite was presented. On physical examination, palpation of the right kidney elicited discomfort. Blood analysis revealed leukocytosis with neutrophilia, and elevation of alkaline phosphatase and blood urea nitrogen. Escherichia coli was detected in urine culture, whereas urine analysis showed absence of glucose. Radiography and ultrasonography suggested that there was gas in the right renal parenchyma, and computed tomography was performed while the dog was awake to investigate the suspected gas in the right kidney. After unilateral ureteronephrectomy, a histological diagnosis of right emphysematous pyelonephritis (EPN) was made. EPN refers to a severe necrotizing infection of the renal parenchyma with gas accumulation in the tissue. It is rare in both human and veterinary medicine, and almost all EPN patients have uncontrolled diabetes mellitus. This case report describes the imaging-based diagnosis of a rare occurrence of unilateral EPN in a non-diabetic dog.

Keywords

References

  1. Dhabalia JV, Nelivigi GG, Kumar V, Gokhale A, Punia MS, Pujari N. Emphysematous pyelonephritis: tertiary care center experience in management and review of the literature. Urol Int 2010; 85: 304-308. https://doi.org/10.1159/000315056
  2. Falagas ME, Alexiou VG, Giannopoulou KP, Siempos II. Risk factors for mortality in patients with emphysematous pyelonephritis: a meta-analysis. J Urol 2007; 178: 880-885. https://doi.org/10.1016/j.juro.2007.05.017
  3. Gould EN, Cohen TA, Trivedi SR, Kim JY. Emphysematous pyelonephritis in a domestic shorthair cat. J Feline Med Surg 2016; 18: 357-363. https://doi.org/10.1177/1098612X15600481
  4. Huang JJ, Tseng CC. Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med 2000; 160: 797-805. https://doi.org/10.1001/archinte.160.6.797
  5. Khaira A, Gupta A, Rana DS, Gupta A, Bhalla A, Khullar D. Retrospective analysis of clinical profile prognostic factors and outcomes of 19 patients of emphysematous pyelonephritis. Int Urol Nephrol 2009; 41: 956-966.
  6. Lim JS, Yoon Y, Jung D, Yeon S, Lee H. Emphysematous pyonephrosis associated with extrahepatic portosystemic shunt in a dog. J Vet Med Sci 2016; 78: 697-700. https://doi.org/10.1292/jvms.15-0181
  7. Michaeli J, Mogle P, Perlberg S, Heiman S, Caine M. Emphysematous pyelonephritis. J Urol 1984; 131: 203-208. https://doi.org/10.1016/S0022-5347(17)50309-2
  8. Moon R, Biller DS, Smee NM. Emphysematous cystitis and pyelonephritis in a nondiabetic dog and a diabetic cat. J Am Anim Hosp Assoc 2014; 50: 124-129. https://doi.org/10.5326/JAAHA-MS-5972
  9. Ngwenyama TR, Herring JM, O'Brien M, Hartman SK, Galloway KA, O'Brien RT. Contrast-enhanced multidetector computed tomography to diagnose pulmonary thromboembolism in an awake dog with pyothorax. J Vet Emerg Crit Care 2014; 24: 731-738. https://doi.org/10.1111/vec.12235
  10. Oliveira CR, Mitchell MA, O'Brien RT. Thoracic computed tomography in feline patients without use of chemical restraint. Vet Radiol Ultrasound 2011; 52: 368-376. https://doi.org/10.1111/j.1740-8261.2011.01814.x
  11. Oliveira CR, Ranallo FN, Pijanowski GJ, Mitchell MA, O'Brien MA, McMichael M, Hartman SK, Matheson JS, O'Brien RT. The VetMousetrap: a device for computed tomographic imaging of the thorax of awake cats. Vet Radiol Ultrasound 2011; 52: 41-52.
  12. Root CR, Scott RC. Emphysematous cystitis and other radiographic manifestations of diabetes mellitus in dogs and cats. J Am Vet Med Assoc 1971; 158: 721-728.
  13. Shanaman MM, Hartman SK, O'Brien RT. Feasibility for using dual-phase contrast-enhanced multi-detector helical computed tomography to evaluate awake and sedated dogs with acute abdominal signs. Vet Radiol Ultrasound 2012; 53: 605-612. https://doi.org/10.1111/j.1740-8261.2012.01973.x
  14. Somani BK, Nabi G, Thorpe P, Hussey J, Cook J, N'Dow J. Is percutaneous drainage the new gold standard in the management of emphysematous pyelonephritis? Evidence from a systematic review. J Urol 2008; 179: 1844-1849. https://doi.org/10.1016/j.juro.2008.01.019
  15. Stadler K, O'Brien R. Computed tomography of nonanesthetized cats with upper airway obstruction. Vet Radiol Ultrasound 2013; 54: 231-236. https://doi.org/10.1111/vru.12019
  16. Tang HJ, Li CM, Yen MY, Chen YS, Wann SR, Lin HH, Lee SS, L iu Y C. C linical c haracteristics o f emp hysematous pyelonephritis. J Microbiol Immunol Infect 2001; 34: 125-130.
  17. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases. BJU Int 2007; 100: 17-20.
  18. Tsu JH, Chan CK, Chu RW, Law IC, Kong CK, Liu PL, Cheung FK, Yiu MK. Emphysematous pyelonephritis: an 8-year retrospective review across four acute hospitals. Asian J Surg 2013; 36: 121-125. https://doi.org/10.1016/j.asjsur.2013.01.003
  19. Ubee SS, McGlynn L, Fordham M. Emphysematous pyelonephritis. BJU Int 2011; 107: 1474-1478. https://doi.org/10.1111/j.1464-410X.2010.09660.x
  20. Wan YL, Lee TY, Bullard MJ, Tsai CC. Acute gas-producing bacterial renal infection: correlation between imaging findings and clinical outcome. Radiology 1996; 198: 433-438. https://doi.org/10.1148/radiology.198.2.8596845