Investigation of Polyuria & Polydipsia

Question 1

what is hyposthenuria urine

Answer 1

1.000-1.008

Question 2

what is isothenuria

Answer 2

1.008-1.012

Question 3

what is minimally concentrated urine

Answer 3

1.013-1.030

Question 4

what is hypersthenuria

Answer 4

1.030-1.055

Question 5

what are ddx for PUPD in the dog (9)

Answer 5

1. diabetes mellitus
2. renal failure
3. hyperadrenocorticism
4. hypercalcemia
5. neoplasia
6. liver failure
7. pyogenic foci
8. diabetes insipidus
9. others (hypoadrenocortcisim, pyschogenic polydipsia)

Question 6

what are the ddx of PUPD in the cat (7)

Answer 6

1. renal failure
2. hyperthyroidism
3. diabetes mellitus
4. pyogenic foci (CBA)
5. liver failure
6. neoplasia
7. others (hypercalcemia, diabetes insipidus)

Question 7

what is polyuria

Answer 7

increase in both frequency and volume of urine

Question 8

what should you pay particular attention to when doing a clinical exam in a PUPD patient (6)

Answer 8

1. lymph nodes
2. dermatological changes
3. purulent discharges
4. abdominal palpation
5. rectal examination
6. thyroid palpation (cats

Question 9

what are causes of hyposthenuria (4)

Answer 9

1. loss of concentration gradient (diuresis, hypoadrenocorticism)
2. loss of ADH or its receptors (primary diabetes insipidus)
3. antagonism of ADH )hyperadrenocorticism)
4. excessive water consumption

Question 10

what are causes of isothenuria

Answer 10

1. loss of nephrons (renal failure)
2. normal

Question 11

what are causes of hypersthenura

Answer 11

1. decreased renal perfusion

Question 12

what USG value excludes PUPD

Answer 12

greater than 1.035

Question 13

what USG value will exclude diabetes insipidus

Answer 13

1.008-1.035

Question 14

what excludes diabetes mellitus on urinalysis

Answer 14

no glucose in urine

Question 15

what are causes of mild hyperglycemia

Answer 15

stress

Question 16

what are causes of severe hyperglycemia

Answer 16

diabetes mellitus

Question 17

what are the causes of hypercalcemia

Answer 17

malignancy and others

Question 18

when would urea and creatinine be decreased

Answer 18

liver disease

Question 19

when would urea be increased

Answer 19

GI hemorrhage

Question 20

what would cause hypokalemia

Answer 20

renal failure

keotacidosis

Question 21

what would hyperphosphatemia be caused by

Answer 21

renal failure

Question 22

what would hypophosphatemia be caused by

Answer 22

ketoacidosis

Question 23

what would hyperglobinemia be an indicator of

Answer 23

inflammatory process

Question 24

what would a neutrophilia with a left shift indicate

Answer 24

pyogenic focus

Question 25

what would a neutrophilia and lymphopenia indicate

Answer 25

stress leukogram, hyperadrenocorticism

Question 26

how do you exclude hyperadrenocorticism

Answer 26

ACTH stimulation test

Question 27

what are the two tpes of diabetes insipidus

Answer 27

1. central (ADH responsive)
2. nephrogenic (not ADH responsive)

Question 28

what can cause central diabetes insipidus

Answer 28

neoplasia, congenital , trauma, inflammation

Question 29

what can cause nephrogenic diabetes insipidus

Answer 29

lack of ADH receptors

juvenile nephropathies

Question 30

what are the indications of a water deprivation test

Answer 30

used as a last resort when all other causes of PUPD have been ruled out

diagnose diabetes insipidus (central vs nephrogenic)

severe PUPD

nromal renal function

not hypercalcemia

not hyperglycemia

not hypercortisolemic

Question 31

what must be excluded before you perform a water deprivation test

Answer 31

renal disease must be excluded

Question 32

how is a water deprivation test done

Answer 32

phase 1: water restriction

phase 2: empty bladder and weigh every 2 hours, check urea and creatinine every 2 hours, preserve urine and plasma samples

Question 33

when should you stop a water deprivation test

Answer 33

urine SG greater than 1.025

5% body weight loss

dog becomes azotemic or appears depressed