title: Diagnosis and treatment of presumptive pyelonephritis in an Asian elephant (Elephas maximus).
abstract: A 37-yr-old female Asian elephant (Elephas maximus) presented with anorexia, restlessness, and dark-colored urine. Urinalyses showed hematuria, leukocyturia, isosthenuria, proteinuria, granular casts, and no calcium oxalate crystals. Bloodwork revealed azotemia. Urine culture revealed a pure growth of Streptococcus zooepidemicus resistant to sulfamethoxazole-trimethoprim but susceptible to cephalosporins. A presumptive diagnosis of pyelonephritis was made based on bloodwork, urinalysis, and urine culture. The animal was treated with intravenous ceftiofur, and intravenous and per rectum fluids were given for hydration. The elephant's attitude and appetite returned to normal, the abnormal blood parameters resolved, and urinary calcium oxalate crystals reappeared after treatment, supporting presumptive diagnosis. Follow-up ultrasonography revealed an abnormal outline of both kidneys with parenchymal hyperechogenicity and multiple uterine leiomyomas.
authors.affiliation: Smithsonian National Zoological Park, 3001 Connecticut Avenue NW, Washington, D.C. 20008-2598, USA.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Sanchez
authors.forename: Suzan
authors.initials: S
authors.lastname: Murray
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Montali
authors.forename: Lucy H
authors.initials: LH
authors.lastname: Spelman
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002129:Calcium Oxalate / Q000652:urine; D002511:Cephalosporins / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004606:Elephants / Q000097:blood / Q000652:urine; D005260:Female; D005440:Fluid Therapy / Q000662:veterinary; D007668:Kidney / Q000000981:diagnostic imaging; D018231:Leiomyomatosis / Q000150:complications / Q000175:diagnosis / Q000662:veterinary; D011704:Pyelonephritis / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D018502:Streptococcus equi / Q000187:drug effects / Q000302:isolation & purification*; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis / Q000662:veterinary
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002129:Calcium Oxalate; C053503:ceftiofur