Abstract. Renal papillary necrosis was diagnosed during postmortem examination of a juvenile whitetailed deer (Odocoileus virginianus) from Oklahoma. The deer was surgically treated for a Salter Harris type II fracture of the proximal tibia of the left hind limb. The animal was administered multiple nonsteroidal antiinflammatory drugs (NSAIDs), including meloxicam, flunixin meglumine, and ketoprofen for pain management. At postmortem examination, gross lesions included a proximal tibial Salter Harris type II fracture with an associated fibrinonecrotizing myositis and bilateral renal papillary necrosis. Histologically, the kidneys exhibited coagulation necrosis of the renal medulla and renal papilla, thrombosis of renal blood vessels, and interstitial medullary edema. The gross and microscopic lesion coupled with the clinical history of multiple NSAID administration suggests NSAID-induced renal papillary necrosis.Key words: Deer; nonsteroidal anti-inflammatory drugs; renal papillary necrosis.A juvenile, 9.6-kg, female white-tailed deer (Odocoileus virginianus) was presented to Oklahoma State University Boren Veterinary Medical Teaching Hospital (Stillwater, Oklahoma) for suspected vehicle trauma. On admission, the deer had a heart rate of 168 beats/min, showed signs of discomfort, and was mildly dehydrated. Physical examination indicated a fracture of the left hind limb, and radiographs confirmed a Salter Harris type II fracture of the proximal tibia. The left hind limb was bandaged, and the animal was given a single intravenous dose of 2.2 mg/kg of ketoprofen. aThe following day, the animal was in pain, and surgical repair of the fracture was performed. The left hind limb was aseptically prepared according to standard hospital procedure. A 10-cm incision was made over the medial aspect of the proximal tibia centered over the fracture site. Open reduction of the fracture was performed, and the fracture was stabilized with the use of a cross-pinning technique with Kirschner wires. After pin placement, the fracture was deemed to be stabilized by manual manipulation of the fracture site. The subcutaneous tissues were sutured in a simple continuous pattern with 3-0 PDS* II. b The skin was then closed with 3-0 nylon suture material b in a cruciate pattern. Postoperative radiographs revealed that the pin placement was satisfactory, and the fracture was reduced. Recovery from anesthesia was uneventful.Postoperatively, the deer was given a single intravenous dose of 1.1 mg/kg of flunixin meglumine c and a constantrate infusion of 3.0 mg/kg of fentanyl per hour b ; the fentanyl was discontinued the next day. Additional pain medications administered to the deer for the 2 days after surgery included 1 daily oral dose of 0.2 mg/kg of meloxicam d and multiple subcutaneous doses of 0.3 mg/kg of morphine. d Various drugs were given for pain management in this case because of the availability of drugs and changes in administration route, depending on the stress level of the animal. The deer did not show any clinical signs of imp...