Med. Weter. 82 (10), 481-487, 2026
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| HAYET REMICHI, MYRIEM REBOUH, SOFIANE BOUDJELLABA, CHABHA BEN MOHAND, RIMA HAFIZA BOUATTOURA, FAIROUZ HADDADJ3, SARA ZAIDI, NORA MIMOUNE |
| Acute Kidney Injury in Queens with Pyometra: Prevalence, Severity and the Prognostic Role of Cervical Status |
| This retrospective group study characterised the prevalence and severity of acute kidney injury (AKI) in 92 queens with pyometra. They were diagnosed on the basis of a combination of consistent clinical signs, laboratory findings and ultrasonographic evidence of a fluid-filled, enlarged uterus, with particular attention to the prognostic role of cervical status. AKI was defined and staged using modified IRIS criteria. Among the 92 queens, 55 (60.0%) met the criteria for AKI, while 37 (40.2%) had normal renal function after rehydration. Among the AKI queens, closed-cervix cases (n = 29) presented exclusively with IRIS Stage III or IV AKI, whereas open-cervix cases (n = 26) were confined to Stages II and III. The odds ratio for creatinine exceeding 500 μmol/L in closed- versus open-cervix queens was 5.13 (95% CI: 1.41-18.63, p = 0.006), and day-15 mortality was 34.5% in closed-cervix AKI queens versus 15.4% in open-cervix AKI queens. The odds ratio for death or euthanasia in AKI versus non-AKI queens was 12.3 (95% CI: 1.54-98.1, p < 0.001). Serum lactate, globulins and UPC ratios were significantly higher in closed-cervix pyometra. Abdominal ultrasonography confirmed the characteristic uterine changes in all 92 cases. OHE was performed in 87.0% of cases; medical management was attempted in 12 open-cervix queens, with a 41.7% failure rate (defined as the need for secondary OHE due to a lack of clinical improvement or worsening of the condition). AKI is a frequent and severe complication of feline pyometra and is substantially worse in closed-cervix presentations. Cervical status is the dominant prognostic determinant and should drive immediate triage and treatment decisions. Systematic renal assessment at admission and structured post-discharge follow-up are mandatory in all affected queens. |
| Keywords: acute kidney injury, cat, cervical status, IRIS staging, pyometra |