Glomerular Disease

Question 1

What are the most common glomerular diseases in dogs?

Answer 1

1. immune complex glomerulonephritis
2. amyloidosis
3. glomerulosclerosis

Question 2

What’s the most important determinant of filtration at the glomerulus?

Answer 2

size

Question 3

what are the 3 layers that filtrate need to pass through?

Answer 3

1. fenestrated endothelium
2. glomerular basement membrane
3. visceral epithelial cells or podocytes

Question 4

What’s the hallmark of glomerular disease?

Answer 4

proteinuria

Question 5

Why is there increased cast in glomerular disease?

Question 6

Define nephrotic syndrome.

Answer 6

• hypoalbuminemia
• proteinuria
• hypercholesterolemia
• edema

Question 7

What’s the pathogenesis of membranoproliferative glomerulonephritis?

Answer 7

usually secondary to infection –> immune complex accumulation –> cytokine activation –> inflow of leukocytes

Question 8

How is membranoproliferative glomerulonephritis treated?

Answer 8

treat the underlying cause
- immunosuppressant
- anti-platelet therapy

Question 9

What’s the prognosis of membranoproliferative glomerulonephritis?

Answer 9

specific data lacking

Question 10

What’s the most common glomerular disease in cats?

Answer 10

membranous nephropathy

Question 11

What’s typical signalment of membranous nephropathy?

Answer 11

• male dogs/ cats overrepresented
• massive proteinuria
• young (<4y)

Question 12

What’s the pathogenesis of membranous nephropathy?

Answer 12

likely immune-mediated
- the immune complex is deposited on the urinary side of the glomerular basement membrane

Question 13

how is membranous nephropathy treated?

Answer 13

immunosuppressant
can recur

Question 14

What’s the prognosis of membranous nephropathy?

Answer 14

progressive, but slow
- many can live a relatively normal life

Question 15

Which breeds (dog/ cat) can amyloidosis be more commonly seen?

Answer 15

Shar Pei
Abyssinians

Question 16

What are some features of amyloidosis?

Answer 16

• female
• massive proteinuria
• nephrotic syndrome

Question 17

How is amyloid A formed?

Answer 17

• polymerization of the amino terminal portion of the serum amyloid A protein (it’s an acute phase protein)

Question 18

How is amyloidosis developed?

Answer 18

defect in the 2-step degradation process of amyloid A

Question 19

Which interleukin stimulate amyloid A synthesis and release?

Answer 19

IL-6

Question 20

What are some treatment options for amyloidosis?

Answer 20

• colchicine
• DMSO

Question 21

What’s the prognosis for renal amyloidosis?

Answer 21

generally poor

Question 22

What’s the cause of hereditary nephritis?

Answer 22

defect in collage type IV (basement membrane collagen defect)
- English Cocker and English Springer spaniels
- Bull Terrier, Dalmatian

Question 23

What are the 3 features of hereditary nephritis?

Answer 23

1. proteinuria
2. hematuria
3. progressive glomerular disease

Question 24

How is hereditary nephritis diagnosed?

Answer 24

need TEM

Question 25

How is hereditary nephritis treated?

Answer 25

no specific treatment
- treat for kidney disease
- ACEi

Question 26

What’s the prognosis?

Answer 26

Samoyed, English Cockers = die <2y
Dalmatians, Bull terriers = up to 10y

Question 27

Which diuretic could be used for pulmonary edema or hyperkalemia? which should be used for ascites or pleural effusion?

Answer 27

Furosemide = pulmonary edema/ hyperkalemia
Spironolactone = ascites/ pleural effusion

Question 28

What’s the treatment options for hypercoagulability?

Answer 28

Aspirin or clopidogrel