Lecture 1 & 2: assessment of the UT and lower UTD

Question 1

what is the signifcance of post renal?

Answer 1

after kidneys = most common

urine concentrated
interference with excretion
kidneys may be normal

Question 2

what is the relationship between GFR and filtration?

Answer 2

they are proportional - so as one decreases, the other decreases

Question 3

what is the most common GFR estimate?

Answer 3

BUN and Crt

Question 4

what is significant about Crt?

Answer 4

it is produced by muscle so its affected by muscle mass

• excreted by filtraiton
• neither secreted nor re-absorbed

Question 5

what is the significance of BUN?

Answer 5

it is produced by the liver

• excreted via filtration
• it IS secreted and reabsorbed and is therefore more variable than Crt. this means it is dependent on flow rate of blood and tubular fluid flow rate.

Question 6

what are the clinical signs of uremia?

Answer 6

clinical manifestation of kidney failure: loss of appetite, vomiting, oral ulcers, uremic breath

Question 7

Fanconi syndrome

Answer 7

• in Basenji’s
• renal threshold of glucose is lower than normal so they may get glucosuria while being euglycemic which can cause acute renal failure and tubular necrosis.

Question 8

what are the 3 chemicals that make up ketones? which chemical is picked up by reagent strips?

Answer 8

ketones = beta-hydroxybutyric acid (78%) + acetoacetic acid (20%) + acetone (2%)

reagent strips are much more sensitive for acetoacetic acid.

Question 9

is bilirubinuria in cats normal?

Answer 9

yes; they have a much lower renal threshold

Question 10

how do casts form in urine? what is associated with?

Answer 10

results from formation of firbrils of Tamm-Horsfall protein.

it is commonly associated iwth proteinuria

Question 11

what are the clinical signs of a lower UTD?

Answer 11

dysuria
incontienence
periuria = inappropriate urination
pigmenturia

NOT PU/PD!

Question 12

what are feline LUTDs often called?

Answer 12

feline idiopathic cystitis

Question 13

does FIC heal on its own?

Answer 13

yes often in 2 - 7 days although there is 40 - 55% recurrence which is what we worry about

Question 14

what are the causes for FIC?

Answer 14

we dont really know but the following are suggested:

• increased uroepithelial permeability
• alteration of mucosal glycosaminoglycan layer
• necrogenic dysfunction

Question 15

what is the treatment of FIC?

Answer 15

can choose to do nothing. if you choose to do something the most important thing is to increase water consumption. other things include:

• dietary modification
• MEMO - multi-modal environmental enrichment
• phermones (Feliway)
• amitriptyline
• glycosaminoglycans
• analgesics

Question 16

amitriptyline

Answer 16

most widely used anti-depressant used for FIC

• decreases anxiety, inflammation and pain
• possible rebound effect; can become pro-inflammatory

Question 17

glycosaminogycans

Answer 17

evidence of efficacy for cats with FIC is lacking

Question 18

should you use antibiotics for cats with FIC?

Answer 18

no! not unless they have a bacterial infection in which case you should culture

Question 19

what is the significance of a pre-renal disorder? what does it do and what is the effect?

Answer 19

pre-renal = before kidneys

it decreases renal perfusion which causes dehydration, heart failure and hypotension.

it increases urine production