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URI2 > Exotics > Flashcards

Exotics Flashcards

1
Q

Briefly describe avian renal anatomy

A
  • large pair of lobulated kidneys surrounded by abdominal air sac
  • Reptilian and mammalian nephrons
  • No urinary bladder, empty into cloaca
  • Reflux of urine into coprodeum and colon aids water reabsorption
  • Ischiatic (and others) nerves run through and dorsal to kidneys
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2
Q

List the common causes of primary renal disease in birds

A
  • Hypervitaminosis A
  • Hypervitaminosis D3
  • Dehydration
  • Heavy metal toxicity
  • Infection (e.g. extension of air sacculitis, systemic spread, ascending infection)
  • Neoplasia
  • Amyloidosis and lipidosis
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3
Q

What condition may lead to amyloidosis in birds?

A

Bumblefoot

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4
Q

Compare the types of nephrons found in the avian kidney

A
  • Reptilian: no LoH, cortex only

- Mammalian: LoH, extends from cortex to medulla

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5
Q

Compare visceral and articular gout

A
  • Visceral: uric acid tophi in soft tissues e.g. liver, pericardium, kidney
  • Articular: uric acid tophi in and around joints, often feet and hocks
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6
Q

Describe the development of gout in birds and reptiles

A
  • Decreased uric acid secretion: dehydration, renal tubular disease, hypovit A, infection/inflammation, post-renal obstruction
  • Increased uric acid production: excess dietary protein
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7
Q

Outline the typical presentation of avian renal disease

A
  • early signs often subtle
  • Advanced signs: non-specific, fluffed up, lethargic, eyes closed
  • More specific signs: PUPD, uni or bilateral HL paresis, haematuria, feather picking over kidneys, gout, leaning when standing
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8
Q

What factors is the level of dehydration in a bird assessed on?

A
  • PCV/TS
  • Skin elasticity
  • MM moisture
  • Brightness of the eye
  • Ulna refill time
  • Most sick birds are 5-10% dehydrated at presentation
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9
Q

List the diagnostic tests that may be used in the investigation of urinary tract disease in birds

A
  • Uric acid
  • Blood biochem and haematology
  • Urinalysis
  • Murexide test
  • Radiogaphy
  • Ultrasound
  • Endoscopy
  • (MRI/CT)
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10
Q

Outline the interpretation of haem and biochem in a bird with urinary tract disease

A
  • Uric acid: elevated once >70% renal function lost, post-prandial rise in carnivores
  • Urea as indicator of dehydration only
  • Creatinine not useful
  • Phosphorous: may be elevated in renal failure (and haemolysis)
  • Calcium: reduced in renal failure
  • Potassium: elevated in acute renal failure
  • Sodium: hyper in dehydration, hypo in renal failure
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11
Q

Discuss the use of urinalysis in the investigation of urinary tract disease in birds

A
  • Difficult to obtain pure sample
  • Normal urine contains crystals and bacteria
  • Look for renal casts, abnormal cells, glucose etc.
  • USG species specific (aroun 1.005-1.020)
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12
Q

Outline the murexide test in birds

A
  • Confirmation of gout
  • Sample of material e.g. joint aspirate mixed with nitric acid and dried over flame
  • Add 1 drop concentrated ammonium
  • Mauve = uric acid (positive)
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13
Q

Outline the use of radiography in the investigation of urinary tract disease in birds

A
  • VD and lateral, wings and legs extended
  • Normal kidneys difficult to see, but have small rim of air dorsal to kidneys on lateral view (absent in renomegaly)
  • May see eggs, cloacaliths, evidence of gout in rest of body
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14
Q

Evaluate the use of ultrasonography in the investigation of urinary tract disease in birds

A

Useful to look at architecture of kidney but often severely hampered by air sacs

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15
Q

Evaluate the use of endoscopy in the investigation of urinary tract disease in birds

A
  • Most useful to visualise and biopsy kidneys
  • Can assess most other organs at the same time
  • Requires specific training and expertise
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16
Q

Outline the supportive care for the average sick bird

A
  • Keep warm (29-30˚C)
  • Quiet, away from predators
  • Dim lighting
  • Oxygen
  • Nebulise saline for 20-30mins
  • Fluid therapy (SC, IV, IO but not humerus or femur)
  • metoclopramide 0.5-1mg/kg IM q8-12hours if ileus
17
Q

Outline a basic fluid therapy plan for a bird

A
  • Maintenance fluids ~50ml/kg/day
  • Rehydrate over 48 hours
  • Day 1 and 2: maintenance + half calculated rehydration fluids
  • Day 3: maintenance fluids
18
Q

List the treatment factors that should be considered for a bird with urinary tract disease

A
  • General supportive care
  • Assessment of dehydration
  • Fluid therapy
  • Food
  • Antibiotics
  • Allopurinol
19
Q

Outline the nutrition for a bird with urinary tract disease

A
  • High fat and carb, lower protein
  • Ensure balanced diet for species
  • Vitamin supplementation may be needed in some
20
Q

Discuss the use of antibiotics in a bird with urinary tract disease

A
  • Aminoglycosides nephrotoxic

- TMPS and amoxyclav can be nephrotoxic if bird is dehydrated

21
Q

Discuss the use of allopurinol in a bird with urinary tract disease

A
  • Xanthine oxidase inhibitor
  • May help reduce hyperuricaemia, thereby reducing gout
  • BUT may worsen gout in some species e.g. Red tail hawk
22
Q

Briefly outline the reptilian renal anatomy

A
  • Renal portal system similar to birds
  • No LoH
  • Urinary bladder in chelonia and some lizards
  • Urine can be modified in bladder/colon
  • Salt glands present in some desert and aquatic species
23
Q

List the common causes of reptile renal disease

A
  • Inadequate husbandry: humidity, temp, diet, supplements
  • Chronic dehydration
  • Infection e.g. bacterial, parasitic
  • Neoplasia
24
Q

How might chronic dehydration occur in a reptile?

A

Some need to drink from droplets coming down, water bowl useless, will get dehydrated

25
Q

Outline the clinical signs of renal disease in reptiles

A
  • Early signs often subtle
  • Advanced signs: non-specific, lethargy, anorexia, weight loss, dysecdysis, abnormal thermoregulation
  • Other signs: HL weakness, constipation, gout, oedema
26
Q

List the diagnostic tests that can be used in the investigation of renal disease in reptiles

A
  • Blood biochem and haematology
  • Urinalysis
  • Murexide test
  • Iohexol excretion test
  • Radiography
  • Ultrasound
  • Endoscopy
  • (MRI/CT_
27
Q

Outline the interpretation of blood biochem and haematology in reptiles with renal disease

A
  • Uric acid elevated once >70% function lost, post-prandial rise with carnivores, little to no effect of dehydration
  • Urea: elevated in dehydration or anorexia, renal disease if uric acid also elevated, more useful in desert tortoises
  • Creatinine not very useful
  • Phos: may be elevated, renal disease more likely if phos > total calcium , may be elevated as a result of haemolysis
  • Calcium: reduced in CRF, normal or increased in ARF
  • Potassium elevated in ARF and haemolysis
28
Q

Outline urinalysis in the investigation of renal disease in reptiles

A
  • Try to avoid faecal contamination
  • Normal urine contains crystals and bacteria
  • Look for renal casts, cells, parasites e.g. Hexamita
  • pH may change from normal alkaline to acidic in anorexic herbivores and post hibernation
  • Normal USG: 1.003-1.014
29
Q

Describe the iohexol test used in the investigation of renal disease in reptiles

A
  • Excreted solely by glomerular filtration, good indicator of renal function
  • Inject iohexol IV, take blood 4, 8 and 24 hours later
  • Not routinely used
30
Q

Outline the use of radiogaphy in the investigation of renal disease in reptiles

A
  • 2-3 views, VD, horizontal beam lateral +/- horizontal beam craniocaudal (chelonia)
  • Kidneys often difficult to see unless enlarged or increased density
  • look for changes in size, density, contour
  • Eggs, uroliths, bone density also assessed
31
Q

Outline the basic treatment of all sick reptiles

A
  • Heat: keep at preferred body temp
  • Fluid: ensure correct humidity and appropriate access to water e.g. bath, spray
  • Light: appropriate supplementation for the species
32
Q

How can dehydration be assessed in reptiles

A
  • PCV/TS
  • Skin elasticity
  • MM moisture
  • Brightness of eye
  • Appearance of urine and urates
  • Assume most are 5-10% dehydrated or more at dehydration
33
Q

What fluids are used in reptiles?

A
  • Hartmann’s
  • 0.9% saline/electrolyte + amino acid at ratio 4:1
  • 2.5% dextrose in 0.45% saline OR 4% dextrose in 0.18% saline
  • 9:1 ratio of 5% glucose with 0.9% saline (9 parts) to sterile water (1 part)
34
Q

Outline the adminstration of fluids to reptiles

A
  • Warm fluids to upper level of POTZ
  • Rehydration may take up to 10-14 days
  • 10-30ml/kg/day for maintenance + 25% of fluid deficit
  • Lizards: cephalic, jugular, ventral tail vein
  • Chelonians: jugular
  • Snakes: jugular, intra-cardiac
  • All species: intracoelomic, subcut, oral routes
  • Intraosseous other than snakes
  • Daily bathing
35
Q

Discuss the nutritional managment of reptiles with renal disease

A
  • Oesophagostomy tube routine procedure, can be with local, sedation or GA but all need analgesia, can be left in place for years
  • Amount via O tube: Lizards: 10-20ml/kg, snakes 15-30ml/kg, tortoises 5-15ml/kg
  • Balanced diet for that species, generally high fat and carb, lower protein
36
Q

Discuss the use of antibiotics in the treatment of renal disease in reptiles

A
  • Most infections due to G-ve bacteria
  • Aminoglycosides are nephrotoxic
  • Fluoroquinolones and ceftazadime commonly used
37
Q

List adjunctive treatments that may be used for reptiles with renal disease

A
  • Allopurinol (may help reduce hyperuricaemia)
  • Anabolic steroids
  • B vitamins
  • Phosphate binders

URI2 (9 decks)

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