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Small Animal Surgery > Kidney > Flashcards

Kidney Flashcards

1
Q

What is the most common type of nephrolith?

A

Ca oxalate

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2
Q

What are the clinical signs of nephrolithiasis?

A
  • can be absent

- depression, anorexia, hematuria, pain

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3
Q

How is nephrolithiasis diagnosed?

A
  • radiographs

- ultrasound

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4
Q

When is surgery indicated for nephrolithiasis?

A
  • obstruction

- infection associated with the calculi

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5
Q

Describe a nephrolithotomy

A
  • ventral midline celiotomy
  • retract mesocolon
  • isolate and temporarily occlude vessels
  • mobilized kidney
  • make sagittal incision and remove stone
  • flush pelvis/ureter
  • catheterize ureter
  • close
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6
Q

What are the closure options for a nephrolithotomy?

A
  • sutureless closure (hold for 5 minutes to form fibrin seal, suture capsule only)
  • horizontal mattress
  • nephropexy
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7
Q

How long can you clamp tissue/vessels before damage occurs?

A

20 minutes

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8
Q

When is a pyelolithotomy done?

A

to remove calculi when proximal ureter and renal pelvis are dilated

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9
Q

What are the advantages of doing a pyelolithotomy?

A
  • does not require occlusion of blood supply

- does not damage nephrons

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10
Q

How is renal trauma diagnosed?

A
  • contrast excretory urography
  • ultrasound
  • exploratory
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11
Q

What are the indications for a nephroureterectomy?

A
  • severe infection or trauma
  • obstructive calculi with persistent hydronephrosis
  • neoplasia
  • transplant
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12
Q

Describe the nephroureterectomy technique

A
  • mobilize the kidney from attachments
  • identify vessels and ligate separately
  • separate and ligate ureter at vesicoureteral junction
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13
Q

Why would a partial nephrectomy be indicated?

A

when there is compromised GFR in the other kidney

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14
Q

Describe the partial nephrectomy procedure

A
  • occlude blood supply
  • incise and peel back capsule
  • pass suture with straight needle
  • divide into thirds and tighten
  • close capsule
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15
Q

What is hydronephrosis?

A

progressive dilatation of the renal pelvis and atrophy of the renal parenchyma

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16
Q

What are the clinical signs of hydronephrosis?

A

unilateral - abdominal distention, palpable mass

bilateral - severe azotemia, death

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17
Q

How is hydronephrosis diagnosed?

A
  • abdominal radiographs
  • excretory urogram
  • ultrasound
18
Q

How is hydronephrosis treated?

A
  • eliminate cause

- if non-functional or severe damage: nephroureterectomy

19
Q

What is pyelonephritis?

A

a complication of obstructive uropathy

- ascending hematogenous infection

20
Q

What is the name of the giant kidney worm?

How is it treated?

A
  • Dictophyma renale

- neproureterectomy or nephrotomy

21
Q

What is the most common benign renal neoplasm?

A

renal adenoma

22
Q

What is the most common malignant renal neoplasm in dogs?

A

renal cell carcinoma

23
Q

What is the most common renal neoplasm in cats?

A

renal lymphoma

24
Q

What is a nephroblastoma?

A
  • a congenital neoplasia associated with hypertrophic osteopathy
  • arises from embryonic tissue
25
Q

What are the clinical signs associated with renal neoplasia?

A
  • hematuria
  • abdominal distension
  • anorexia, weight loss
  • depression
  • abdominal pain
26
Q

How is renal neoplasia diagnosed?

A
  • abdominal palpation
  • abdominal radiographs
  • ultrasound
  • IV urography, CT, MRI
27
Q

How is renal neoplasia generally treated?

A
  • exploratory laparotomy

- unilateral nephroureterectomy

28
Q

What are the indications for a renal biopsy?

A
  • suspected neoplasia
  • nephrotic syndrome
  • renal cortex disease
  • non-diagnosed ARF
29
Q

What are the contraindications for a renal biopsy?

A
  • coagulopathies
  • hypertension (risk of hemorrhage)
  • severe chronic hydronephrosis
30
Q

Describe the percutaneous approach to a kidney biopsy

A
  • for small dogs and cats (can palpate kidneys well)
  • secure kidney against abdominal wall
  • blind technique
31
Q

Describe the ultrasound guided approach to a kidney biopsy

A
  • preferred method
  • advance needle into prepared area
  • penetrate capsule
32
Q

Describe the keyhole approach to a kidney biopsy

A
  • modified surgical flank approach

- secure kidney to incision

33
Q

Describe the laparoscopic approach to a kidney biopsy

A
  • forceps hold kidney

- needle placement through skin incision

34
Q

Describe the wedge or incisional approach to a kidney biopsy

A
  • ventral midline celiotomy
  • occlude renal vessels
  • crescent shaped sample
  • close with mattress suture
35
Q

What are possible complications with kidney biopsy?

A
  • severe hemorrhage (hypertension, NSAID within 5 days, coagulopathy)
  • hematuria (resolves)
  • hydronephrosis
36
Q

What are the indications for a renal transplant?

A
  • irreversible acute renal failure
  • decompensated chronic renal failure
  • polycystic disease
37
Q

How is an animal screened for a renal transplant?

A
  • CBC/Chem (PCV 30%, BUN < 8)
  • urinalysis and culture
  • ab radiographs, US, echo
  • FeLV, FIV, toxoplasmosis
38
Q

Under what conditions would a patient be rejected for renal transplant?

A
  • viral positive
  • cardiac disease
  • neoplasia
  • fractious
39
Q

What is done pre-op for a renal transplant?

A
  • dialysis
  • erythropoietin
  • immunosuppression
40
Q

What are possible complications for a renal transplant?

A
  • acute rejection
  • infection
  • chronic rejection

Small Animal Surgery (26 decks)

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