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*Hereditary predisposition, bacterial and viral infections as well as autoimmune conditions have all been implicated in glomerulonephritis.  
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==Introduction==
:'''Hereditary''' - Dogs such as the Doberman, Elkhound and Samoyed. Finnish Landrace sheep.
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The term glomerulonephritis refers to '''primary inflammation of the glomeruli'''. Glomeruli might also suffer damage secondary to tubular disease or pyelonephritis.
:'''Bacterial''' - pyometra and endocarditis
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:'''Viral'''
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Glomerulonephritis is generally a diffuse condition affecting most if not all glomeruli in the kidney, although not all glomeruli are affected to the same extent.
::Dogs -  [[Viruses#Adenoviridae|Infectious Canine Hepatitis]]<br /br>
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::Cats -  [[Feline Infectious Peritonitis|Feline Infectious Peritonitis]], [[Viruses#Retroviridae|Feline Leukaemia]] <br /br>
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In the early stages, the changes are confined to the glomeruli and associated with the '''deposition of immune complexes''' in the basement membrane. In some cases, proliferative changes in the mesangium and wall of the Bowman's capsule may accompany it.
::Ox -    Bovine Virus Diarrhoea <br /br>
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::Pig -  Swine Fever <br /br>
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This gives rise to the two types of pathology generally encountered in the various species: '''membranous and membrano-proliferative'''.
:'''Autoimmune''' - Systemic Lupus Erythematosus
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*Glomerulonephritis most often results from immune mediated mechanisms. Two main types exist: one in which immune complexes from in the glomerulus and one in which antibodies are produced against the glomerular basement membrane.   
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The membranous form is seen predominantly in '''cats''', and the membrano-proliferative form is the most common form in '''dogs'''.
**Immune complex glomerulonephritis is characterised by the deposition of immune antigen-antibody complexes in the glomeruli and followed by complement fixation and neutrophil [http://www.cellsalive.com/chemotx.htm| chemotaxis]. It is seen mostly in cats, dogs and horses and is associated with many diseases including FeLV, FIP, pyometra, autoimmune conditions and coccidiosis. Severity is variable and it can be acute or chronic. 
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**The formation of antibodies against the glomerular basement membrane can occur and is most often seen in primates.
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Glomerulonephritis can be found on histopathological examination of '''ruminants and horses''' but it is only rarely a cause of clinical disease.
*Can lead to nephrotic syndrome due to sustained loss of protein in the urine.
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====Pathology====
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==Aetiology==
'''Gross'''
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The aetiology is often '''obscure''', but its incidence has increased in recent years due to better recognition of the disease and a reduction in the incidence of chronic interstitial nephritis in dogs due to vaccination. It has also been suggested that the '''increased use of modified live vaccines''' may produce a sustained low level stimulation of the antigenic response in vaccinated individuals.
*Acute glomerulonephritis is characterised by swollen,tense kidneys with pinpoint red dots in the cortex representing individual glomeruli.  
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*In chronic glomerulonephritis, the kidneys are shrunken,pitted and have a granular appearance.  Cortical thinning and fibrosis also occur.
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Various other causes have been implicated:
'''Histopathology'''
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*Changes include adhesions between the glomerular tuft and Bowman's capsule, increased cellularity in the glomerulus and thickening of the capillary basement membrane.
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'''Hereditary/familial aetiology''':
*If there is severe, prolonged damage, glomerulosclerosis may occur. Lesions involve fibrosis, shrinking and hyalinisation of the glomeruli.
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dogs: Samoyed, Elkhound and Doberman (expressed as renal failure in 4-14 months)
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sheep: Finnish Landrace Sheep
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'''Viral''':
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dogs: [[Viruses#Adenoviridae|Infectious Canine Hepatitis]]
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cats: [[Feline Infectious Peritonitis|Feline Infectious Peritonitis]], [[Viruses#Retroviridae|Feline Leukaemia]]
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ox: [[Bovine Viral Diarrhoea Virus|Bovine Viral Diarrhoea]]
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pig: [[Classical Swine Fever|Classical Swine Fever]]
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'''Bacterial''':
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Pyometra and endocarditis
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'''Autoimmune diseases'''
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Systemic Lupus Erythematosus
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==Clinical signs and Pathology==
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Animals with idiopathic glomerulonephritis (>50% of cases) usually have '''signs of renal disease''', whereas secondary glomerulonephritis is often a relatively minor part of a '''more serious disease'''.
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'''Gross pathology''': acute cases have swollen, tense kidneys with pinpoint red dots in the cortex representing individual glomeruli. Chronic cases have shrunken, pitted kidneys with a granular appearance.
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'''Histopathology''': ''Membranous glomerulonephritis'': diffuse and even thickening of the basement membrane
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''Membranoproliferative'': thickening of the basement membrane and proliferation of the mesangial cells and the parietal epithelium (crescent formation) with adhesions between the vascular tuft and Bowman's capsule.
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The glomerulus becomes '''progressively obliterated''', accompanied by periglomerular fibrosis. Reduction in blood supply to the nephron also causes damage to the tubules and provokes an '''interstitial nephritis''' in the later stages.
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There is persistent proteinuria and the '''nephrotic syndrome''' can develop as a consequence.
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==Diagnosis==
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Diagnosis of the condition is by '''renal biopsy''' in the live animal, or '''histopathology''' of the kidney at post-mortem examination
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A careful search should be made for an '''inciting disease process'''. Abdominal and thoracic radiographs, ultrasonography, and specialized serologic tests can rule out various inflammatory, infectious, and neoplastic diseases. In dogs this includes tests for SLE (eg, antinuclear antibody titre) and appropriate antigen or antibody screening tests for other infectious agents; in cats, tests for infection with FeLV, FIV, FIP and SLE should be included.
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==Treatment==
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If a '''cause''' for immune-complex disease can be identified it should be treated.
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If the '''nephrotic syndrome''' is manifest, it should be treated with diuretics and through dietary salt restriction.
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'''Antithrombotics''' may have to be considered in those animals with a very low albumin.
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If no known cause of the glomerulonephritis is found, efforts should be made to reduce the magnitude and consequences of immune-complex deposition, and '''immuno-suppressive drugs''' such as azathioprine, cyclophosphamide and chlorambucil can be considered in dogs, although results are variable.
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'''Chronic kidney disease''' when it develops should be managed in accordance to the stage of the disease.
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'''Prognosis''' for animals with glomerulonephritis is '''poor''', with a mean survival time of 87 days in dogs.
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==References==
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Kahn, C. (2005) '''Merck Veterinary Manual''' ''Merck and Co''
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Carlyle Jone, T. (1997) '''Veterinary Pathology''' ''Wiley-Blackwell''
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Smythe, B. (2009) '''Urogenital System, urinary tract pathology''' ''Royal Veterinary College student notes''
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[[Category:To Do - Manson]]
 
[[Category:To Do - Manson]]
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[[Category:To Do - Helen]]
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[[Category:To Do - Review]]
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