JPC SYSTEMIC PATHOLOGY
URINARY SYSTEM
January 2018
U-T07

Signalment (JPC Accession # 2026604):  A five-month-old beagle

HISTORY: This beagle had a fever of 105o F and was treated with gentamicin.  It died 14 days after treatment began.

HISTOPATHOLOGIC DESCRIPTION:  Kidney:  Diffusely within the cortex, in approximately 50% of the renal proximal tubules, there is complete loss of tubular epithelium, with lumens that contain amphophilic granular necrotic  debris, or cellular casts composed of sloughed epithelial cells that are shrunken with hypereosinophilic cytoplasm and karyorrhectic or karyolytic nuclei (necrosis). Multifocally, cortical tubules are ectatic with attenuated epithelium and lumina are infrequently expanded by granular, basophilic, acellular material (mineral).  Multifocally within less affected renal tubules, epithelium are swollen with vacuolated to granular eosinophilic granular cytoplasm and loss of cellular detail (degeneration), or is piled up with a moderate amount of amphophilic cytoplasm and large, irregularly round, more densely basophilic nuclei with rare mitotic figures (regeneration).  Multifocally, medullary collecting ducts contain a moderate amount of eosinophilic, globular material (proteinosis).  Diffusely, Bowman"s space is expanded, and multifocally, glomeruli are mildly congested. 

MORPHOLOGIC DIAGNOSIS:  Kidney, cortex, tubules:  Degeneration and necrosis, subacute, diffuse, severe with granular and cellular casts, beagle, canine.

ETIOLOGIC DIAGNOSIS:  Toxic nephrosis

CAUSE:  Aminoglycoside antibiotic

CONDITION:  Nephrotoxic tubular necrosis

GENERAL DISCUSSION:

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS: 

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ULTRASTRUCTURAL FINDINGS: 

ADDITIONAL DIAGNOSTIC TESTS:

DIFFERENTIAL DIAGNOSIS:

Other nephrotoxic agents: 

COMPARATIVE PATHOLOGY:

References:

  1. Alden CL, Frith CH. Urinary system. In: Haschek WM, Rousseaux CG, eds. Handbook of Toxicologic Pathology. San Diego, California: Academic Press; 1991:333-335,356-357.
  2. Breshears MA, Confer AW. The urinary system, In: Zachary JF, ed. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier; 2016:656-657.
  3. Cheville NF. Cytopathology of toxic disease. In: Cheville NF, ed. Ultrastructural Pathology: An Introduction to Interpretation. Ames, Iowa: Iowa State University Press: 1994:147, 834-836.
  4. Cianciolo RE, Mohr FC. Urinary system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer"s Pathology of Domestic Animals. 6th ed. Vol 2. Philadelphia, PA: Elsevier Saunders;2016:424.
  5. Davies C, Forrester SD, Troy GC, Saunders GK, Shell LG, Johnston SA. Effects of a prostaglandin E1 analogue, misoprostol, on renal function in dogs receiving nephrotoxic doses of gentamicin. Am J Vet Res. 1998; 59:1048-1054.
  6. Mingeot-Leclercq MP, Tulkens PM. Aminoglycosides: Nephrotoxicity. Antimicrob Agents Chemother. 1999;43:1003-1012.
  7. Sasaki A, Sasaki Y, Iwama R, Shimamura S, Yabe K, Takasuna K, Ichijo T, Furuhama K, Satoh H. Comparison of renal biomarkers with glomerular filtration rate in susceptibility to the detection of gentamicin-induced acute kidney injury in dogs. J Comp Pathol. 2014; Aug-Oct;151(2-3):264-70.
  8. Schnellmann RG. Toxic responses of the kidney. In: Klaassen CD, ed. Casarett and Doull"s Toxicology: The Basic Science of Poisons. 6th ed. New York, New York: McGraw-Hill; 2001:510.
  9. Wallig MA, Haschek WM, Rousseaux CG, Bolon B, Mahler BW. Fundamentals of Toxicologic Pathology. 3rd ed. San Diego, CA: Academic Press; 2018:249.

 

 

 

 


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