This cutie here is Tanner. She had been dealing with on and off GI upset and bladder stones for a couple weeks, but suddenly got worse and wound up in the emergency room at a neighboring hospital. Tanner had a fever and evidence of a urinary tract infection. She was started on supportive care and an ultrasound was performed. The findings were unusual – Tanner had an irregularly shaped left kidney and there was free fluid in her abdomen. A sample of the fluid revealed white blood cells and bacteria in it, which indicates a bacterial infection causing inflammation (septic abdomen). Tanner was transferred to our hospital for surgery to explore the cause of her septic abdomen and have her bladder stones removed.
During surgery we found a lot of inflamed tissue around Tanner’s left kidney and the kidney itself was bruised and abnormal looking. Her other kidney and the rest of her organs were normal, but showed evidence of irritation from the inflammation being caused by the septic process. It looked like Tanner’s left kidney was the source of the septic process and in order to save her life we elected to remove that kidney; a decision not made lightly. It was a long and delicate process, but Dr. Griffin, one of our amazing surgeons, was able to remove the kidney (and Tanner’s bladder stones).
A culture of the fluid in Tanner’s abdomen, as well as a culture of her urine grew the same bacterial organism with the same antibiotic sensitivity – this confirmed that it was the urinary system that was the source of Tanner’s septic abdomen. Her kidney was sent to the lab for a pathologist to look at and the kidney had so much bacteria and infection in it that it was becoming necrotic (dead tissue). We think that Tanner’s UTI, which commonly occurs secondary to bladder stones, ascended into her left kidney where it caused significant inflammation and damage until the kidney itself became so damaged that it leaked that infected material into the abdomen resulting in sepsis. While ascending UTIs affecting the kidneys are not unheard of, this was a very unusual presentation of a septic abdomen. In dogs, the majority of the time the source of a septic abdomen is perforation of the GI tract and leakage of intestinal contents. Only about 10% of the time is the source of a septic abdomen reported to be from the urinary system and even then it is more common to occur from rupture of lower urinary structures, like the bladder or urethra, leaking infected urine into the abdomen. So, the fact that Tanner’s kidney was what leaked was very unusual.
Tanner spent a few days recovering and receiving supportive care in our ICU and then was able to be discharged home, where we’re happy to report she is doing well 🙂