EXPRESS: Serum amyloid A: A biomarker to aid in assessing cats with acute pyelonephritis and monitoring response to antibiotic therapy.

SAA elevation supports APN diagnosis; serial monitoring may assess treatment response in cats.

This multicentre study evaluated serum amyloid A (SAA) as a biomarker for acute pyelonephritis (APN) in cats and its utility in monitoring antibiotic treatment response. Thirty client-owned cats were recruited: 10 with APN, 10 with stable chronic kidney disease (CKD), and 10 healthy controls. Cats with APN demonstrated significantly elevated median SAA concentrations (235.3 mg/L) compared to healthy cats (1.85 mg/L) and those with stable CKD (1.45 mg/L). Peak SAA levels occurred within 48 hours of presentation, with normalization to 3.1 mg/L within 14 days of antibiotic therapy initiation. Moderate correlation was observed between SAA concentrations and clinical scores (rs=0.650). The study cohort consisted primarily of older spayed females (9/10), with half having pre-existing CKD. Results support SAA as a diagnostic tool for identifying APN in cats and suggest serial monitoring may help assess treatment response and identify treatment failures, providing clinicians with an objective parameter to complement clinical assessment.

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