JPC SYSTEMIC PATHOLOGY
URINARY SYSTEM
December 2017
U-B06

Signalment (JPC #1545652):  A lamb

HISTORY:  A rapidly growing lamb found dead in its pasture.  Petechiae were noted on most serous surfaces and fluid was found in the pericardial sac.

HISTOPATHOLOGIC DESCRIPTION:  Kidney:  Affecting approximately 90% of the cortical tubules, there is coagulative necrosis characterized by retention of cellular architecture, poorly defined epithelial cell borders, loss of differential staining, and loss of nuclear detail or fragmentation of nuclei (karyolysis).  Tubular epithelial cells are often detached from the intact basement membranes.  Few remaining tubules within the cortex, and tubules within the medulla, are lined by necrotic epithelial cells with hypereosinophilic cytoplasm and pyknosis, karyorrhexis, or karyolysis.  Multifocally, glomeruli contain small foci of eosinophilic cellular and karyorrhectic debris (lytic necrosis) admixed with fibrin and/or are segmentally to globally congested.  Multifocally within the interstitium in the cortex and medulla, there is mild hemorrhage, edema and congested blood vessels.  Occasionally, medullary tubules contain small amounts of amorphous intensely basophilic mineral.  There is undulation of the capsular connective tissue.  Interstitial blood vessels have thickened walls with edema and fibrin accumulation, degeneration and/or necrosis of endothelium and vascular smooth muscle, and perivascular edema and hemorrhage.

MORPHOLOGIC DIAGNOSIS:  Kidney, tubules:  Necrosis, coagulative, diffuse, with multifocal mild interstitial hemorrhage and fibrinoid vascular necrosis, breed unspecified, ovine.

ETIOLOGIC DIAGNOSIS:  Enterotoxemic nephrosis

CAUSE:  Clostridium perfringens Type D

SYNONYMS:  Enterotoxemia; pulpy kidney disease; overeating disease; braxy-like disease.

GENERAL DISCUSSION:

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ULTRASTRUCTURAL FINDINGS:

ADDITIONAL DIAGNOSTIC TESTS:

DIFFERENTIAL DIAGNOSIS:

For sudden death in lambs:

COMPARATIVE PATHOLOGY:

Diseases caused by C. perfringens:

 

Clostridium perfringens - Types, toxins and diseases

 

Type

Toxin

Diseases

Alpha

Beta

Epsilon

Iota

A

++

-

-

-

Gas gangrene

Food Borne Illness - humans

Necrotic enteritis - chickens

Gastroenteritis - ferrets

Yellow lamb disease - enterotoxemia, western US

Canine hemorrhagic gastroenteritis

Hemorrhagic bowel syndrome - dairy cattle

Equine colitis

Necrotizing enterocolitis-piglets

Enterotoxemia-calves and lambs

B

+

++

+

-

Lamb dysentery

Hemorrhagic enteritis - calves, foals, guinea pigs - UK, S. Africa, Middle East

Hemorrhagic enterotoxemia-sheep

C

+

++

-

-

Enterotoxic hemorrhagic enteritis - neonatal lambs, goats, cattle, pigs

Struck - Adult sheep, hemorrhagic enteritis and peritonitis, UK

Necrotic enteritis-birds

D

+

-

++

-

Overeating disease/pulpy kidney - Sheep, cattle, goats

Enterocolitis-goats

Focal symmetric encephalomalacia – Sheep, goats

E

+

-

-

++

Enterotoxemia - calves, lambs. guinea pigs, rabbits

Canine hemorrhagic gastroenteritis

Enteritis-lagomorphs

Table adapted from Barker et al, 1993 p.237 & Jones et al, 1997 p. 421

 

REFERENCES:

  1. Finnie JW, Manavis J, Blumbergs PC. Aquaporin-4 in acute cerebral edema produced by Clostridium perfringens type D epsilon toxin. Vet Pathol. 2008;45:307-309.
  2. Finnie JW, Manavis J, Casson RJ, Chidlow G. Retinal microvascular damage and vasogenic edema produced by Clostridium perfringens type D epsilon toxin in rats. J Vet Diagn Invest. 2014;26(3):470-472.
  3. Finnie JW, Manavis J, Chidlow G. Loss of endothelial barrier antigen immunoreactivity as a marker of Clostridium perfringens type D epsilon toxin-induced microvascular damage in rat brain. J Comp Pathol. 2014;151(2-3):153-156.
  4. Garcia JP, Giannitti F, Finnie JW, et al. Comparative Neuropathology of Ovine Enterotoxemia Produced by Clostridium perfringens Type D Wild-Type Strain CN1020 and Its Genetically Modified Derivatives. Vet Pathol. 2015; 52(3):465-475.
  5. Gelberg HB. Alimentary system and the peritoneum, omentum, mesentery and peritoneal cavity. In: Zachary JF, McGavin MD, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier; 2016:398.
  6. Jones AL, Dagleish MP, Caldow GL. Clostridium perfringens type-D enterotoxaemia in cattle: the diagnostic significance of intestinal episilon toxin. Veterinary Record. 2015;177(15):390.
  7. Lonchamp E, Dupont J-L, Wioland L, et al. Clostridium perfringens epsilon toxin targets granule cells in the mouse cerebellum and stimulates glutamate release. PLoS ONE. 2010;5(9):e13046.
  8. Scala C, Duffard N, Beauchamp G, et al. Antibody response to epsilon toxin of Clostridium perfringens in captive red deer (Cervus elaphus) over a 13 month period. Journal of Zoo and Wildlife Medicine. 2014;47(1):38-44.
  9. Summers BA, Cummings JF, de Lahunta A. Degenerative diseases of the central nervous system. In: Veterinary Neuropathology. St. Louis, MO: Mosby-Year Book, Inc.; 1995:269-270.
  10. Uzal FA, Plattner BL, Hostetter JM. Alimentary system. In: Maxie MG, ed. Jubb, Kennedy and Palmer’s Pathology of Domestic Animals. Vol 2. 6th ed. Philadelphia, PA: Elsevier Ltd; 2016:188-191.  
  11. Uzal FA, Kelly WR. Experimental Clostridium perfringen type D enterotoxemia in goats.  Vet Pathol. 1998;35:132-140.
  12. Uzal FA, Songer JG. Diagnosis of Clostridium perfringens intestinal infections in sheep and goats. J Vet Diagn Invest. 2008;20(3): 253-265.
  13. Uzal FA, Kelly WR, Morris WE, Bermudez J, Baison M. The pathology of peracute experimental Clostridium perfringens Type D enterotoxemia in sheep. J Vet Diagn Invest. 2004;16:403-411.
  14. Zachary JF. Mechanisms of microbial infections. In: Zachary JF, McGavin MD, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier; 2016:182.


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