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SAM Final > 34. Acute kidney diseases in dogs and cats > Flashcards

34. Acute kidney diseases in dogs and cats Flashcards

1
Q

General Clinical signs of renal diseases

A

Anorexia
Weightloss
Vomitting
Immunosuppresion
Anaemia
Dehydration
Oedema
PU/PD
Anuria
Uraemic coma
Uraemic Pneumonia
Resp signs
CNS signs
Blindness

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2
Q

What is the 3 legged chair for renal diagnosis

A

Blood test
Imaging
Urinalysis

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3
Q

How to assess glomerular filtration

A

GFR
Urinary protein - dipstick

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4
Q

How to assess tubular function

A

SG
Urine sediment - glycosuria, proteinuria

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5
Q

Glomerular filtration rate involves

A

Urea, creatinine, SDMA measurement
Clearance testing

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6
Q

UPC parameters

A

Normal - <0.2
Borderline 0.2 — .4
Proteinuria >0.4 (.5 in dogs)

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7
Q

SG measurements

A

Isosthenuria = 1.008 - 1.012
Hypersthenuria = >1.030
Hyposthenuria = <1.007

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8
Q

Clinical syndromes associated with renal disorders

A

Kidney disease
azotaemia
Uraemia
Renal failure

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9
Q

Types of Azotaemia

A

Pre/ extra renal Azotaemia
Renal Azotaemia
Post renal Azotaemia

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10
Q

Pre renal Azotaemia

A

Haemodynamic, transient & fluid responsive
Very common, curable
Decreased GFR due to dehydration

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11
Q

Aetiology of pre renal Azotaemia

A

heart failure
diuuretic/ vasodilator use

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12
Q

What can long term pre renal Azotaemia lead to

A

kidney injury in > 1 days

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13
Q

Renal Azotaemia

A

infectious
Ischaemic
Toxic causes

can lead to AKI

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14
Q

Post renal Azotaemia

A

Lower urinary tract
obstruction/ leakage into abdomen

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15
Q

Diagnosis of post renal Azotaemia

A

imaging
Abdo fluid creatinine: blood creatinine = >2.1
Abdo fluid K&raquo_space;> Blood K

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16
Q

Which Azotaemias are treatable

A

Prerenal Azotaemia
Postrenal Azotaemia
AKI due to these

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17
Q

Non treatable Azotaemias

A

CKD & prerenal/ postrenal cause
CKD & end stage kidney failure

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18
Q

Acute Nephrosis & Nephritis

A

Acute tubular cell injury & death —-> nephron dysfunction —-> decreased GFR & AKI

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19
Q

Nephrotoxic causes of Acute Nephrosis & Nephritis

A

Abx (Gentamycin)
Ethylene Glycol
Lilies (Fe. only)
Myoglobin
IV Xray contrast fluid
Heavy metals
Hypercalcaemia
Anaesthetic
Haemoglobin
Grapes/Raisins
Chemotherapy

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20
Q

Ischaemic causes of Acute Nephrosis & Nephritis

A

Hypotension
Sepsis
Hypercalcaemia
Trauma
Hypovolaemia
NSAIDS
Deep anaesthesia
Hypothermia
Hyperthermia
Burns

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21
Q

How to avoid renal ischaemia

A

IVFT during GA to prevent hypotension and hypothermia
No NSAIDS use opioids instead

22
Q

Infectious causes of Acute Nephrosis & Nephritis

A

Pyelonephritis
Leptospirosis

23
Q

Obstructive causes of Acute Nephrosis & Nephritis

A

Ureteric obstruction

24
Q

Phases of Acute Kidney Injury

A
  1. Initiation
  2. Extension
  3. Maintenance
  4. Recovery
25
Q

Initiation phase of AKI

A

kidney injury

26
Q

Extension phase of AKI

A

inflammation, vasoconstriction, coagulopathy, microvascular obstruction, Increased ROS

27
Q

Maintenance phase of AKI

A

differentiation, migration, proliferation of new cells
Death of animal

28
Q

Recovery phase of AKI

A

redifferentiation & repolarisation –> complete regeneration/ partial regeneration –> CKD

29
Q

Grade I AKI

A

no azotaemia

30
Q

Grade II AKI

A

Mild azotaemia

31
Q

Grade III, IV, V AKI

A

Moderate to severe AKI

32
Q

Clinical signs of AKI

A

Lethargy
Anorexia
Diarrhoea
Dull consciousness
Dehydration
Hyperhydration
Oliguria
Anuria
Painful kidneys
Halitosis
Vomiting
Polyuria
Seizures
Uraemic ulcers
Hypertension

33
Q

Diagnosis of AKI

A

Lab D - biochem, bloods, urine
US - cortical hypertrophy

34
Q

Biochem of AKI

A

Hypovolaemia
Hypervolaemia
Metabolic acidosis
Hyperkalaemia
Toxic metabolic products

35
Q

Bloods of AKI

A

Azotaemia
Increased Urea, creatinine
Haemoconcentration

36
Q

Urine of AKI

A

Iso/ Hyposthenuria
Sediment
Glucosuria
Proteinuria

37
Q

Early Diagnosis of AKI

A

urine production
USG
sediment
plasma creatinine

38
Q

Aim of Treatment of AKI

A

Maintain adequate perfusion
Increased GFR
Avoid nephrotoxins
Maintain urine output
Acid Base balance
Electrolyte balance
Treat underlying disease
Optimise nutrition

39
Q

what to give in case of hypotension

A

Norepinephrine

40
Q

What to give in case of hypertension

A

Amlodipine

41
Q

Indications for dialysis

A

Anuria
Hyperkaelamia
Fluid overload
Severe metabolic acidosis

42
Q

Progenosis of AKI

A

Grade I — II = after a few days of treatment, normal kidney function may return
Grade III — V = After a few weeks of treatment, normal kidney function may return
Grade IV — V = the animal may die

43
Q

How quickly is ethylene glycol absorbed

44
Q

Pathogenesis of ethylene glycol toxicosis

A

ethylene glycol —-> glycoaldehyde —> glycocolic acid —-> glyoxylic acid —-> oxalic acid —-> calcium oxalate crystals

45
Q

What do calcium oxalate crystals cause

A

nephrotoxicity
Neurotoxicity

46
Q

Clinical signs of ethylene glycol toxicosis

A

Phase I (30min - 12hrs) = depression, vomiting, salivation, pu/pd

Phase II (12-24hrs) = acidosis

Phase III (36-72hrs in dogs) = AKI, oliguria, anuria, painful kidneys
(12-24hrs in cats_

47
Q

Diagnosis of ethylene glycol toxicosis

A

Anamnesis
CLinical signs
Lab D
US – halo signs in corticomedullary region

48
Q

Lab D of ethylene glycol toxicosis

A

hypokalaemia
Hypocalcaemia
met acidosis

49
Q

Urinalysis of ethylene glycol toxicosis

A

Isothenuria
Calcium Oxalate monohydrate crystals can appear from 6hrs

50
Q

Treatment of ethylene glycol toxicosis

A

Early diagnosis is NB
Within 1-2hrs —> emesis, gastric lavage

51
Q

Antidotes of ethylene glycol toxicosis

A

Fomepizole
Ethyl Alcohol

52
Q

cause of Haemoglobin Nephrosis

A

Haemolytic disorders
IMHA
Babesia

SAM Final (48 decks)

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