Faecal Occult Blood Test

Case of the Month (Emma Scurrell February 2013)

Glomerulonephritis in a dog

A 9-year-old Yorkshire terrier presented for acute haemorrhagic gastroenteritis that resolved on symptomatic treatment. A faecal culture at the time was positive for Campylobacter sp. Two weeks later, the dog re-presented with ascites and subcuticular oedema. Biochemical findings included a significant hypoalbuminaemia (7g/dL), hypoglobulinaemia, hypocholesterolaemia and azotaemia. The urine SG was 1.014. The urine protein: creatinine ratio was 52 (normal is less than 0.5). A renal biopsy was taken and the figures below focus on the glomerular lesions present.



Fig 1.  In the sections of renal cortex, the glomeruli are diffusely swollen and hypercellular (H&E x200).



Fig 2. Closer view of the glomerulus depicted in Fig 1.  There is global mesangial thickening with hyaline material and increased cellularity (H&E, x400)

 

Fig 3. Synechiae (arrow) are identified as adhesions between the glomerular tuft and the surrounding Bowman’s capsule.  







Final Diagnosis

Diffuse generalised membranoproliferative glomerulonephritis

Discussion

The membranoproliferative glomerulonephritis in this dog accounts for the marked proteinuria and azotaemia. It is not aetiologically specific however such lesions typically reflect the deposition of immune-complexes or activation of complement within glomeruli. The initiating cause in this case is speculative but given the clinical history and sequence of events, a postinfectious glomerulonephritis is suspected. Interestingly, in human patients, acute postinfectious glomerulonephritis associated with Campylobacter jejuni enteritis has been published and this organism's potential to trigger immune-mediated renal disease is recognised.

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011
"Lung-digit" syndrome in a cat April 2011
Hepatic amyloidosis in a cat May 2011
Haemophagocytic histiocytic sarcoma June 2011
Alternaria spp. infection in an immunocompromised dog July 2011
Ocular manifestation of lymphoma in a cat  August 2011
Kerion dermatophytosis in a Cocker spaniel September 2011
Subcuticular coenurus in a rabbit  October 2011
Optic nerve glioma in a dog November 2011
Malignant transformation of a viral papilloma in a dog  December 2011
Uveodermatological syndrome in an Akita
January 2012
Cutaneous angiostomatosis in a dog  February 2012
Transitional cell carcinoma in a dog  March 2012
Corneal inclusion cysts in a dog   April 2012
Extraskeletal osteosarcoma in a dog  May 2012
Subungual melanoma in a dog  June 2012
Retrobulbar grass seed in a dog   July 2012
Lungworm infection associated with hypercalcaemia in a dog  August 2012
Conjunctival melanoma in a dog  September 2012
Pneumocystis infection in a Cavalier King Charles Spaniel  October 2012
Fungal keratitis and secondary endophthalmitis in a horse November 2012
Myeloid leukaemia with lymph node invasion in a dog    December 2012
Cutaneous toxoplasmosis in a cat   January 2013



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Faecal Occult Blood Test