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Archive Case #205: Bovine Pyelonephritis

Cattle veterinary case - Medium - September 24, 2026

Clinical Clues

  1. Cow 38, usually first into the milking parlour, is eating less and has dropped sharply in milk yield.
  2. Six weeks after calving, she repeatedly strains and passes small amounts of blood-tinged urine.
  3. She has a mild fever and appears uncomfortable when urinating.
  4. Urinalysis finds numerous white blood cells and bacteria, supporting urinary infection.
  5. Rectal examination finds an enlarged, painful left kidney and a thickened ureter.
  6. Ultrasound shows an enlarged left kidney with fluid and debris in a dilated renal sinus. A catheter-collected urine sample yields significant bacterial growth.

Diagnosis

Bovine Pyelonephritis

The crucial step is localisation. Blood and pus in urine could occur with cystitis, but renal pain and collecting-system changes point to pyelonephritis. The palpable left kidney supplies an important clue in an adult cow. Remember: An infected urine sample identifies a urinary problem; kidney findings help establish that it is an upper-tract infection.

Learning review

Review the case evidence

Use the paired clues to explain how the evidence in this cattle case supports the provided diagnosis, Bovine Pyelonephritis, then compare your reasoning with the case explanation.

Evidence checkpoints

Clues 1-2

  1. Clue 1: Cow 38, usually first into the milking parlour, is eating less and has dropped sharply in milk yield.
  2. Clue 2: Six weeks after calving, she repeatedly strains and passes small amounts of blood-tinged urine.

Clues 3-4

  1. Clue 3: She has a mild fever and appears uncomfortable when urinating.
  2. Clue 4: Urinalysis finds numerous white blood cells and bacteria, supporting urinary infection.

Clues 5-6

  1. Clue 5: Rectal examination finds an enlarged, painful left kidney and a thickened ureter.
  2. Clue 6: Ultrasound shows an enlarged left kidney with fluid and debris in a dilated renal sinus. A catheter-collected urine sample yields significant bacterial growth.

Self-review prompts

  1. After clues 1-2, what evidence from this cattle case shaped your initial interpretation?
  2. When you compare clues 3-4 with clues 1-2, what changed in your reasoning about Bovine Pyelonephritis?
  3. How do clues 5-6 align with the case explanation for Bovine Pyelonephritis?

Educational Use

Vetdle archive cases are educational veterinary games for diagnostic reasoning practice. They do not provide veterinary advice, diagnosis, treatment, or professional medical guidance.