kidney surgery Flashcards
what is the arterial and venous supply of the kidneys?
renal artery and renal vein
what are the most common nephroliths ?
calcium oxalate - most common and struvite
what clinical signs are seen with nephroliths?
they may be absent or non-specific like depression, anorexia, hematuria, pain
how do you diagnose nephroliths ?
- radiographs
- ultrasound
what parameters do you use to determine the best management for nephroliths?
- type of calculi
- location
- clinical effects
when is surgery for nephroliths indicated ?
- obstruction
- infection from the calculi
- peristent pain or hematuria
what are some treatment options for nephroliths?
- nephrolithotomy
- pyelollithotomy
- lithotripsy (shock waves)
what are the advantages and disadvantages of pyelolithotomy ?
- no occlusion of blood supply
- no nephron damage
what is pyelolithotomy ?
when calculi is in the renal pelvis and dilated
how do you close a nephrolitotomy?
- sutureless closure to form a fibrin seal
- then suture the capsule only
what instruments can you use in a nephrolithotomy to occlude the renal vessels?
- bulldog vascular clamp
- rumel torniquet
how long can you occlude the renal vessels for during a nephrolitotomy ?
20 minutes
what is the post operative management of nephrolithotomy ?
- post op rads to check for calculi
- monitor renal enzymes/electrolytes
- monitor urine output
- provide diuresis
how do you diagnose renal trauma?
- contrast excretory urography
- ultrasound
- exploratory
how do you treat renal trauma?
- minor cases: conservative treatment
- moderate cases: surgery to repair like omental patching
- major trauma: partial nephrectomy or nephroureterectomy
when would you use a nephroureterectomy in cases of renal trauma?
when there is severe parenchymal or vascular damage
what is hydronephrosis ?
progessive dilation of the renal pelvis and atrophy of renal parenchyma
what are the two ways of acquiring hydronephrosis and examples?
- acquired: neoplasia, cyst, stone
- congenital: torsion, stenosis, atresia
what are the clinical signs of hydronephrosis?
unilateral - abdominal distention and palpable mass
bilateral - severe azotemia and death
how do you diagnose hydronephrosis?
- abdominal rads
- excretory urogram
- ultrasound
how do you treat hydronephrosis?
- eliminate cause
- nephroureterectomy
what is the giant kidney worm called?
dioctophyma renale
what is the most common kidney neoplasia of dog ?
renal cell carcinoma
what is the most common kidney neoplasia of the cat?
lymphoma
