Investigating PU/PD Flashcards

1
Q

Whta is normal water intake in horse

A

20-30L/ day for a 500kg horse

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2
Q

define polydipsia in horse

A

> 70-100ml/kg/day
7-10% body weight

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3
Q

define polyuria in horse

A

> 50ml/kg/day (5%BWT)
Difficult to quantify!
24h urine collection impractical

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4
Q

List 4 physiological causes of PU/PD in horses

A

Excessive dietary protein
Excessive salt consumption
Drug administration
high enviornmental temp

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5
Q

List 3 drugs that can cause PU/PD

A

glucocorticoids
diuretics
a-2 agonists

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6
Q

List 8 pathological causes of PU/PD

A

Apparent Psychogenic polydipsia (APP)
PPID (Equine Cushings’ disease)
Chronic renal failure (CRF)
Hepatic insufficiency
Sepsis/endotoxaemia
Renal medullary solute washout
Diabetes Mellitus (DM)
Diabetes Insipidus (DI)

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7
Q

What is seen with Apparent Psychogenic Polydipsia (APP)

A

good BCS/ not azotaemic
Results in significant PU - often “flooded” stables

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8
Q

what causes Apparent Psychogenic Polydipsia (APP)

A

Reflection of change diet (excessive salt consumption), stabling, management, environment, meds

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9
Q

How to diagnose Apparent Psychogenic Polydipsia (APP)

A

by exclusion

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10
Q

how to manage Apparent Psychogenic Polydipsia (APP)

A

restrict salt intake
restrict water intake

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11
Q

Clinical signs of PPID

A

PU/PD
long curly coat
weight loss/ muscle wasteage

varied

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12
Q

How to diagnose PPID

A

resting ACTH

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13
Q

How to treat PPID

A

pergolide
dietary management

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14
Q

what is neurogenic DI

A

central- inadequate secretion of ADH

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15
Q

what is nephrogenic DI

A

Decreased sensitivity of epithelial cells on collecting ducts to circulating ADH

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16
Q

List the broad steps in investigating PU/PD in horses

A

history
confirm presence of PU/PD
Blood tests
Urinalysis

17
Q

what does history help to rule out in ases of PU/PD

A

iatrogenic cause- e.g. change in diet, drugs, fluid therapy

18
Q

How do we confirm PU/PD in horse

A

Verification and quantification of water intake
Over 24h period, horse must be stabled
Might repeat over few days??

19
Q

if you see polycythaemia in cases of PUPD what does this suggest

A

Dehydration suggesting PU is the primary problem rather than PD eg. DI

20
Q

if urine Hypothosthenuric and horse had PU/PD what does this mean

A

USG <1.008 - kidney actively excreting water –> DI and APP

21
Q

if urine isothenuric in horse with PU/PD what does this mean

A

USG 1.008-1.014 - kidney neither concentrating or diluting –> CRF

22
Q

If urine Hypersthenuric in horse with PU/PD what does this mean

A

USG >1.014 – kidney able to concente –> Normal

23
Q

what does water deprivation test differentiate between

A

APP from DI
APP cases can concentrate the urine
DI cases cannot concentrate the urine

24
Q

when should you not perform water deprivation test

A

in azotaemic horses with renal compromise

25
Q

DEcsribe how to perform water deprivation test

A
  1. Weigh horse
  2. Check serum urea and creatinine are normal (if not DO NOT proceed)
  3. Take baseline urine sample and measure SG (if >1.008, DO NOT proceed)
  4. Keep horse stabled and remove water
  5. Check serum urea and creatinine and USG q 6h and re-weigh
26
Q

List 5 reasons to stop water deprivation test

A

24h of water deprivation
5% reduction in body weight
Clinical signs of dehydration
Azotaemia develops
USG >1.020