Student Case Presentation
Bilateral Pyelonephritis and Elevated Copper in a 4-year-old Brahman Cow.
| Date/Time: |
8/27/2026 4:00 PM
|
| Presenter: |
Sonali Puri |
| Veterinary School: |
TAM |
Abstract:
A 4-year-old Brahman cow was presented on emergency for recumbency, vaginal discharge, anorexia, and hematuria. Two days prior to admission she was dull, separated from the herd and shivering. On the day of admission, the cow was recumbent and unable to rise. Lab work performed by the rDVM revealed azotemia and hyperfibrinogenemia. At presentation the cow was recumbent and unable to rise. A blood-tinged vaginal discharge, enophthalmos, and prolonged skin tent were present. On rectal examination, a firm lobulated mass was present in the dorsal abdomen and pregnancy was confirmed. Urine passed during examination was red and when centrifuged had red blood cell sediment in addition to severe, persistent pigmenturia. Serum chemistry revealed azotemia, hyperglycemia, hyperglobulinemia, hyperkalemia, and elevated muscle enzymes. In an attempt to stabilize the patient overnight, an intravenous catheter was placed and intravenous fluids supplemented with dextrose initiated. Alpha-tocopherol and procaine-penicillin-G were administered that evening.
The following morning, signs of dehydration were resolved. The cow was tachycardic and blood clots were passed in the urine. On rectal examination, two large kidneys and dilated ureters could be palpated. At this time, the primary differential was pyelonephritis. Copper toxicity and myopathy were considered for the pigmenturia. Anemia with hyperproteinemia, hyperfibrinogenemia, and neutrophilia with toxic changes were present on CBC consistent with chronic active inflammation. Abdominal ultrasound was consistent with pyelonephritis. Urine culture and serum copper concentrations were submitted. The cow was started on IV ampicillin and maintained on IV fluids. Due to declining conditions over the next 24 hours, the owners elected euthanasia. Necropsy confirmed bilateral pyelonephritis caused by E. coli. Both antemortem blood and postmortem liver samples had elevated copper concentrations. This case demonstrates the challenges of bovine pyelonephritis in an adult pregnant beef cow and how concurrent mineral abnormalities can complicate clinical interpretation and herd-level management decisions.
