This report emphasizes the clinical presentation, hematological and biochemical changes, and ultrasonographic and pathologic findings in a caprine buck with bilateral suppurative pyelonephritis. A 9-month-old male caprine buck was referred for examination. Two blood samples were collected on EDTA and heparin. The main clinical presentation of the case under investigation included anorexia, diarrhea, abdominal distension, and intermittent dribbling of discolored urine during the last three weeks. The buck has been admitted in a depressed state, head lowering, and abdomen distended. Voided urine was centrifuged, and hematuria was proved upon getting urine sedimentation. Results of acidbase balance and blood gases included metabolic acidosis. The PO2, BE, HCO3, TCO2, and sO2 were low while the Anion Gap was high compared to reference ranges. The tested hematological parameters red blood cells, hematocrit, hemoglobin, mean corpuscular volume and mean corpuscular hemoglobin were low while total white blood cells and neutrophils were high, and lymphocytes were low. The most important biochemical findings included hyperproteinemia, hyperglobulinemia, hyperglycemia, and marked elevation in blood urea nitrogen and creatinine concentrations. During abdominal ultrasonography, a massive amount of peritoneal effusion was found in the peritoneal cavity and the urinary bladder appeared severely distended with echogenic urine. Renal scanning revealed the kidney architecture was misshaped, the renal pelvis was dilated, and the cortex and medulla could be differentiated. All these findings were confirmed postmortem. On histological examination of renal specimens, the renal cortex, and medulla showed diffuse suppurative pyelonephritis. Conclusively, ultrasound was very useful in the verification of pyelonephritis in the buck. It was especially helpful in scanning the renal parenchyma and detecting the abnormal architecture and misshaping of the kidneys. It also revealed severe urinary bladder distension with echogenic urine sediments as well as considerable amounts of peritoneal effusions. In spite of all these results, the histological examination of the kidneys remains the final and decisive diagnosis in such cases.