NEPHRITIS (BRIGHTS DISEASE)
Definition
IS DEFINED AS INFLAMMATION OF KIDNEY ( RENAL CELLS ) CHARACTERISED BY RENAL COLIC AND WHICH RESULTS IN DELETERIOUS EFFECT ON HEALTH OF ANIMAL.
DOG, ONCE EFFECTED WITH NEPHRITIS, SEQUELAE IS DEATH.
YOUR URINE VOLUME NOT ONLY ESTIMATES YOUR WATER INTAKE BUT ALSO KIDNEY FUNCTION
ONCE IT GET DIFFICULT TO URINATE , NEEDS HIGH CARE AND ATTENTION
KEEP IN MIND THAT MALE DOG USED TO URINATE BY LIFTQING ONE OF THE HIND LIMB AND PREFER TO URINATE IN A JET FASHION OVER ANY TREE WALL BITCHES URINATE IN SQUATTING POSTURE
Classification
IT IS OF TWO TYPES
- SUPPURATIVE: PYEMIC-NEPHRITIS AND PYELO-NEPHRITIS
- NON SUPPURATIVE: GLOMERULAR NEPHRITIS, TUBULAR NEPHRITIS AND INTERSTITIAL NEPHRITIS
IN CASE OF DOG OR PETS INTERSTITIAL AND GLOMERULAR ARE COMMONLY SEEN
ETIOLOGY :
- FOOD AND WATER QUALITY
- BACTERIA : E.COLI, LEPTOSPIRA
- VIRUS: ICH
- PARASITE: DIACTOPHYMA RENALE
- OTHERS: METRITIS, PYOMETRA, BRONCHOPNEUMONIA, CYSTITIS, PROSTATITIS, CHRONIC PERITONITIS, AND CHRONIC INFECTIONS.
- DRUGS: AMINOGLYCOSIDES, NEPHROTOXIC AGENTS, LEAD, ARSENATE, SULPHONAMIDE, MERCURY, AMPHOTERICIN B, AND PARACETAMOL
PATHOGENESIS :
GLOMERULAR NEPHRITIS:
- INFECTION MAY SPREAD FROM DESCENDING AND ASCENDING SITE
- STASIS OF URINE RESULTS IN ACCUMULATION OF MICROBES ALONG URINARY TRACT
- THROUGH EMBOLI OR BLOOD BORNE , IT MAY RESULTS IN OCCURENCE OF NEPHRITIS
- MAYBE DUE TO AUTOIMMUNE ACTIVITY
INTERSTITIAL NEPHRITIS:
- INTERSTITIAL NEPHRITIS: VERY COMMON
- CHRONIC FORM IS ALWAYS SEQULAE TO ACUTE FORM
- PATHOGENESIS: PERIVASCULAR PERIGLOMERULAR INTERTUBULAR INFILTRATIONS,
- KIDNEY PARENCHYMA UNDERGOES INFLAMMATORY CHANGES,
- BLOCKS TUBULES OF KIDNEY WITH CELLULAR INFILTRATIONS
CLINICAL SIGNS :
GLOMERULAR NEPHRITIS:
- INFLAMMATION OF GLOMERULI LEADS TO CHRONIC RENAL FAILURE.
- DULL AND DEPRESSED
- SLIGHT RISE OF TEMPERATURE.
- POLYDISPIA
- PUFFY EYELIDS
- MUSCLE WASTAGE
- PROTEINURIA
- VOMITING
- AZOTEMIA
- DRY SKIN COAT
INTERSTITIAL NEPHRITIS:
- LACK OF APPETITE
- POLYUREA AND POLYDISPIA
- BREATH IS UNPLEASANT
- TEETH, GUM, TONGUE COATED WITH REDDISH BROWN SCUM
- ARCHING OF BACK AND STIFF GAIT
- LUMBAR REGION PAIN
- PULSE IS QUICK BOUNDING
- CHRONIC CASES IT BECOME THIN AND EMACIATED
- SIGNS OF DEHYDRATION
- OCCASIONAL VOMITION
- SIGNS OF URAEMIA
DIAGNOSIS:
GLOMERULAR NEPHRITIS:
- examination of Urine
- PROTEINURIA
- Proper history
- Hematology: HYOPROTEINEMIA DUE TO HYPOALBUMINAEMIA, HYPERPROTEINAEMIA DUE TO HYPERGLOBINAEMIA, NORMOCYTIC NORMOCHROMIC ANAEMIA
- BIOCHEMISTRY : HYPERCHOLESTEROLEMIA, HYPERPHOSPHATEMIA
- AZOTEMIA
- URINE STUDY : PROTEINURIA
- PROTEIN INDEX : URINE = PROTEIN/ CREATININE RATIO>1 UPL = 1.42 + 22.12 × UP/C
- RENAL BIOPSY
INTERSTITIAL NEPHRITIS:
- POLYUREA AND POLY DYSPIA
- ACUTE: URINE HAVE HIGH SPECIFIC GRAVITY, ALBUMIN, RENAL EPITHELIAL CELLS, WBC, RBC, CASTS IN URINE.
- CHRONIC: LOW SPECIFIC GRAVITY, LESS CELLULAR DEPOSITION.
DIFFERENTIAL DIAGNOSIS:
GLOMERULAR NEPHRITIS:
- AMYLOIDOSIS: AMYLOID DEPOSITS WILL TAKE GREENISH APPEARANCE UPON STAINED WITH CONGORED
- NEPHRITIS : LUMOY BUMPY DEPOSITS OF Immuno Globulins & COMPLEMENTS MAY BE OBSERVED PROLIFERATION OF MESANGIAL CELLS HYPERCELLULARITY IN BASEMENT MEMBRANE GLOMERULUS SCLEROSIS
INTERSTITIAL NEPHRITIS:
| Chronic Interstitial nephritis | Diabetes mellitus | Diabetes insipidus |
| Kidney is affected | Islets of pancreas | post. pituitary gland |
| specific gravity is low | high | low |
| Casts- very few | nil | nil |
| Sugar- nil | present | nil |
| Uraemia- present | nil | nil |
Differentiation between glomerular and interstitial nephritis:
| Parameter | Glomerular Nephritis | Interstitial Nephritis |
| Urine Volume | Low | More |
| Specific Gravity | more | low |
| Urinary sediment | casts | few casts and WBC |
| Protein & Urea | More | Low |
| Anemia | Moderate | High |
TREATMENT:
GLOMERULAR NEPHRITIS:
- CASES WITHOUT NEPHROTIC SIGNS MAY BE OFFERED PROTEIN OF HIGHER BIOLOGICAL VALUES AND VITAMINS.
- SOME CASES MAY REQUIRE SPECIFIC RX: PYOMETRA, HEARTWORM
- COURSE OF ANTIBIOTICS
- IMMUNOSUPPRESSIVE DRUGS
- REGULAR MONITORING OF DEGREES OF PROTEINURIA
- LEVELS OF UREA AND CREATININE
- ANTIPLATELET THERAPY WITH ASPIRIN 5 MG /KG
INTERSTITIAL NEPHRITIS:
- Rest
- little exercise
- The protein of high Biological Value
- Drinking large amounts of quality water
- Dilution of urine is necessary as e.coli is well in conc.urine
- Antibiotics
- Dextrose
- B complex
- Antacids
- Corticosteroids
- the pH of the urine should be adjusted with appropriate measures
Note:
- DURATION OF TREATMENT FOR URINARY INFECTION IS 10-14 DAYS
- AMINOGLYCOSIDES CAUSES ACUTE TUBULAR NEPHROSIS
- ANTIBIOTICS AMOXICILLIN/AMPICILLIN +CLOXACILIN CEFTRIAXONE SHOULD BE FOLLOWED.
- ROBERTS TEST, MICROSCOPIC EXAMINATION, KIDNEY FUNCTION TEST HELPFUL IN DIAGNOSIS
- RENAL HEALTH DIET OF ROYAL CANIN SHOULD BE GIVEN
- LOW FAT AND SODIUM DIETS SHOULD BE GIVEN
Conclusion
Do regular deworming & Vaccination and check regularly Urination. Thank You.
