Renal injury in female dogs with pyometra

Abstract

Pyometra is a common disease in intact female dogs and can cause glomerulopathy and tubular injury. This study aimed to evaluate kidney injury in female dogs with pyometra, as well as progression of the injury during treatment and the markers of this condition. This study analyzed 20 intact female dogs with both clinical and sonographic diagnosis of pyometra. Dogs were treated with intravenous fluids and antibiotics, and an ovariohysterectomy was performed. The following parameters were assessed at eight separate time points: blood pressure; serum creatinine, phosphorus, and urea levels; urinalysis and urinary biochemical parameters [urinary gamma-glutamyl transferase (uGGT) and urinary protein-to-creatinine ratio (UPCR)]; glomerular filtration rate (GFR); and urine output. All dogs showed some degree of kidney injury at the time of pyometra diagnosis. This was transient in most animals, resolving with treatment of the pyometra. Measurement of uGGT and UPCR identified renal parenchymal injury, helping to determine the prognosis of the animals analyzed in the present study.

Renal biomarkers, clinical parameters, and renal Doppler velocimetry in bitches with cystic endometrial hyperplasia–pyometra complex

“…These results are similar to Figueiredo et al. (2017), who stated that patients with CEH–pyometra had an acute injury even without changes in creatinine. It justifies that, even animals with creatinine within the reference limits, may have unidentified acute kidney injury, as also stated by Dahlem et al.…”

“…Even in animals considered NAZO, SDMA values increased, as only 33.3% of the bitches had creatinine measurements above the stipulated limits. These results are similar to Figueiredo et al (2017), who stated that patients with CEH-pyometra had an acute injury even without changes in creatinine. It justifies that, even animals with creatinine within the reference limits, may have unidentified acute kidney injury, as also stated by Dahlem et al (2017), who concluded that serum SDMA is a positive biomarker of acute kidney injury.…”

“…The toxic effects of bacteria associated with pyometra can result in poor renal perfusion and decreased glomerular filtration rate, culminating in acute kidney injury (Ahuja et al., 2019; Figueiredo et al., 2017; Kumar et al., 2016; Trautwein et al., 2018). Furthermore, glomerular and tubular dysfunction in the kidneys can lead to azotemia in patients with CEH–pyometra (Heiene et al., 2007; Sant'Anna et al., 2019).…”

Evaluation of kidney injury through early markers in canine pyometra

“…Regarding liver enzymes, significantly higher concentrations of ALT and ALP were observed at T2 than at T0 and T1, similar to a previous study (Figueiredo et al, 2017). The change in the levels suggests liver damage from pyometra, which can be justified by hepatocellular lesions due to toxemia (sepsis) caused by the anti-inflammatory response to arterial hypotension and intensified by cellular hypoxia from dehydration and anemia.…”

“…Renal and hepatic complications, aggravated by sepsis, culminated in the dog's death 25 days after being diagnosed with pyometra (T0). This shows the importance of regularly monitoring dogs with pyometra to assess acute insult or chronic damage and urinary markers to diagnose elevated concentrations up to 60 days after OH (Figueiredo et al, 2017).…”