23 – Examination of the Urinary System Flashcards
1
Q
Renal disease
A
- Functional or morphological impairment in one or both kidneys (regardless of extent of disease)
- Morphological abnormalities: UTI, neoplasia, infarct, etc
- Functional abnormalities: nephrogenic diabetes insipidus, crystinuria
- *disease may regress, remain stable or progress
o May or may not lead to renal insufficiency or failure
2
Q
Renal insufficiency
A
- Existence of impaired renal function due to disease
- Any one of a number of renal functions may be impaired
- *if urine concentrating ability is affected this means that 2/3 of the functional nephrons are damaged
3
Q
Renal failure
A
- Clinical syndrome that occurs when the kidneys are NO longer able to maintain their regulatory, excretory and endocrine functions
- *implies ¾ of nephrons nonfunctional or lost
- Clinically:
o Azotemia: retention of nitrogenous wastes results
o Derangements in fluid, electrolyte, and acid-base balance
4
Q
What is the minimum data base you want/need for evaluating a patient with a suspected urinary problem?
A
- Relevant info from signalment
- History and physical exam
- CBC
- Serum biochemistry
- Urinalysis
- *make a problem list, rank DDx +/- therapeutic plan
5
Q
Signalment: breed
A
- Familial or congenital renal disease
- Ex. renal agenesis and polycystic kidney disease
- Renal dysplasia: Lhasa Apsos, Shih Tzu, Cocker Spaniels
6
Q
Signalment: age
A
- Chronic renal failure and most neoplasms are more prevalent in OLDER animals
7
Q
Signalment: gender
A
- Female dogs more prone to UTI than males
8
Q
Signalment: environment
A
- Animals that roam free have a greater risk of exposure to toxins
- Ex. E. coli
9
Q
Signalment: diet
A
- May influence formation of some uroliths or lead to tubular disease or AKI in renal cases
10
Q
What are some aspects of urinary tract specific history?
A
- Changes in the pet’s pattern or frequency of urination
o NEED to differentiate b/w pollakiuria, incontinence and polyuria
o Need to differentiation oliguria from anuria
11
Q
Pollakiuria
A
- Frequent voiding of small volumes of urine
- Suggests: cystitis, urethritis, urolithiasis
12
Q
Incontinence
A
- Loss of voluntary control of micturition vs. urge incontinence
13
Q
Polyuria
A
- Normal to increased frequency with large volumes of urine
- *>2mL/kg/hr
14
Q
Anuria
A
- Need to differentiate lack of urine production (acute renal failure) from the inability to urinate
- Ex. urolithiasis, traumatic bladder rupture
15
Q
Oliguria
A
- Decreased urine production
- *1-2mL/kg/hr
- Ex. renal failure or inability to completely urinate (partial urinary obstruction, reflex dyssynergia)
16
Q
Polydipsia
A
- Increased water intake (>100ml/kg/day in dogs, >45ml/kg/day) may be noticed BEFORE polyuria
o Especially if pet urinates outdoors and is unobserved
17
Q
What are the 3 most common causes of red coloured urine?
A
- Hematuria: blood in urine
- Pigmenturia: hemoglobinuria or myoglobinuria
- Pseudohematuria/pigmenturia
18
Q
What does foul smelling urine suggest?
A
- UTI
- Alkaline urine
- Ketonuria: patient’s breath may have slight sweet smell
19
Q
Painful kidneys
A
- Pyelonephritis
- Acute glomerulonephritis
- Obstructive uropathy
- Renoliths
20
Q
Small kidneys
A
- Chronic renal insufficiency or failure
21
Q
Large kidneys=renomegaly
A
- Neoplasia
- Renal cysts
- Hydronephrosis
- Acute renal failure
- Acute glomerulonephritis
- Granulomatous disease (FIP)
- Obstructive uropathy
22
Q
What are the signs of uremia?
A
- Poor body condition: muscle wasting
- Dehydration
- Oral ulceration, tongue tip necrosis, halitosis
- Hypothermia
- Bony changes associated with renal secondary hyperparathyroidism
- Pale mucous membranes from anemia
23
Q
Paraneoplastic syndromes from urological malignancies
A
- Typically caused by secretion of a hormone or hormones
- Ex. paraneoplastic hypercalcemia: PTHrP or localized osteoclastic effects
- Ex. syndrome of inappropriate growth factor production
