Investigation of Polyuria & Polydipsia Flashcards
what is hyposthenuria urine
1.000-1.008
what is isothenuria
1.008-1.012
what is minimally concentrated urine
1.013-1.030
what is hypersthenuria
1.030-1.055
what are ddx for PUPD in the dog (9)
- diabetes mellitus
- renal failure
- hyperadrenocorticism
- hypercalcemia
- neoplasia
- liver failure
- pyogenic foci
- diabetes insipidus
- others (hypoadrenocortcisim, pyschogenic polydipsia)
what are the ddx of PUPD in the cat (7)
- renal failure
- hyperthyroidism
- diabetes mellitus
- pyogenic foci (CBA)
- liver failure
- neoplasia
- others (hypercalcemia, diabetes insipidus)
what is polyuria
increase in both frequency and volume of urine
what should you pay particular attention to when doing a clinical exam in a PUPD patient (6)
- lymph nodes
- dermatological changes
- purulent discharges
- abdominal palpation
- rectal examination
- thyroid palpation (cats
what are causes of hyposthenuria (4)
- loss of concentration gradient (diuresis, hypoadrenocorticism)
- loss of ADH or its receptors (primary diabetes insipidus)
- antagonism of ADH )hyperadrenocorticism)
- excessive water consumption
what are causes of isothenuria
- loss of nephrons (renal failure)
- normal
what are causes of hypersthenura
- decreased renal perfusion
what USG value excludes PUPD
greater than 1.035
what USG value will exclude diabetes insipidus
1.008-1.035
what excludes diabetes mellitus on urinalysis
no glucose in urine
what are causes of mild hyperglycemia
stress
what are causes of severe hyperglycemia
diabetes mellitus
what are the causes of hypercalcemia
malignancy and others
when would urea and creatinine be decreased
liver disease
when would urea be increased
GI hemorrhage
what would cause hypokalemia
renal failure
keotacidosis
what would hyperphosphatemia be caused by
renal failure
what would hypophosphatemia be caused by
ketoacidosis
what would hyperglobinemia be an indicator of
inflammatory process
what would a neutrophilia with a left shift indicate
pyogenic focus
what would a neutrophilia and lymphopenia indicate
stress leukogram, hyperadrenocorticism
how do you exclude hyperadrenocorticism
ACTH stimulation test
what are the two tpes of diabetes insipidus
- central (ADH responsive)
- nephrogenic (not ADH responsive)
what can cause central diabetes insipidus
neoplasia, congenital , trauma, inflammation
what can cause nephrogenic diabetes insipidus
lack of ADH receptors
juvenile nephropathies
what are the indications of a water deprivation test
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
what must be excluded before you perform a water deprivation test
renal disease must be excluded
how is a water deprivation test done
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
when should you stop a water deprivation test
urine SG greater than 1.025
5% body weight loss
dog becomes azotemic or appears depressed
