Kapitel 114 – Kidneys Flashcards
What is the function of the macula densa?
group of cells that help maintain autoregulation of renal blood flow.
Give examples of conditions glomerular disease can result in
a. edema formation
b. systemic hypertension
c. thromboembolism
d. hyperlipidemia
e. protein malnutrition
f. immunosuppression
g. changed pharmacokinetics of excreted drugs
h. endocrine abnormalities.
What is the normal urine production in dogs and cats?
20-45 ml/kg/d
What diagnostic tests should be taken before renal surgery?
a. complete blood count
b. biochemistry
c. coagulation panels
d. urinalysis, urine culture
e. blood pressure
f. Buccal mucosal bleeding time is recommended in animals with uremia (impairs platelet adhesion and aggregation)
g. Cross-match in cases of coagulopathy, anemia or in which excessive bleeding is expected.
What diagnostic imagine tool can be used to determine glomerular filtration rate?
Scintigraphy
What is Tc-DTPA?
a. A radiopharmacutical used in scintigraphy to determine
i. quantify renal function
ii. determine total glomerular filtration rate
iii. quantify subclinical renal disease by allowing earlier evaluation before biochemical evidence of renal dysfunction.
What is the most common renal calculi in cats?
Calculi made of calcium salts (Calcium oxalate or calcium phosphates)
What are the treatment options for renal caluculi and when is treatment recommended?
a. extracorporeal shock wave lithotripsy
b. nephrotomy
c. pyelolithotomy
d. endoscopic nephrolithotomy (intracorporeal lithotripsy)
e. Nephrectomy should be considered in animals with a unilateral severely hydronephrotic, infected, or nonfunctional kidney.
f. treatment should be considered if nephroliths are causing ureteropelvic junction obstruction that decreases renal function; associated with severe hematuria, pain, or persistent urinary tract infection; or increasing in size and damaging renal tissue despite appropriate medical therapy
what is the most common primary renal tumor in cats and dogs?
Cats: Lymphoma
Dogs: Renal cell carcinoma
What’s is the mean survival time for dogs with carcinomas, sarcomas and nephroblastoma respectively not receiving treatment?
a. Carcinoma: 16 month
b. Sarcomas: 9 month
c. Nephroblastoma’s: 6 month
What is the treatment for kidney worm (Dioctophyma renale)?
Ureteronephrectomy since there is currently no medical treatment effective.
List contraindications for renal biopsy
a. uncontrolled coagulopathy or hypertension
b. large or multiple renal cysts or abscesses
c. extensive pyelonephritis
d. ureteral obstruction
e. severe hydronephrosis
For how long can the renal artery be occluded during surgical procedures of the kidney?
20 min
What are the two dissection techniques during nephrotomy? What are ther advantages and disadvantages?
a. bisectional nephrotomy – sharp incision from pole to pole with a scalpel. It is easier and faster but might result in more bleeding. Still the recommended method
b. intersegmental nephrotomy – blunt separation of the parenchyma using a Freer periosteal elevator, scalpel blade handle, or similar instrument. This technique reduces intraoperative hemorrhage by allowing identification and ligation or cauterization of arcuate vessels before transection and lessens parenchymal damage to the kidney. More technically demanding and slower than bisectional nephrotomy, offers no difference in post-op GFR.
When preforming a nephrectomy on a neoplastic kidney, in what order it is theoretically advantageous to ligate the vessels? Why?
a. to ligate the renal vein before the renal artery: ligation of the vein first will permit continued arterial flow into the kidney without exit of blood that potentially contains neoplastic cells.
b. (however many surgeons do the opposite way, as recommended in a non neoplastic kidney. It is likely that, if there were neoplastic cells that could be shed during arterial ligation, they were probably already being shed during preligation renal manipulation and dissection)
