Lecture 4

Question 1

Causes of prerenal azotemia

Answer 1

Dehydration
GI fluid loss
Acute blood loss
Hypotension
Endotoxemia

Question 2

What will you see with pre-renal azotemia

Answer 2

Anything that causes inadequate renal perfusion

Usg greater than 1.025 if azotemic
FC(na) less than 1%
Greater than 50% reduction in azotemia after 24 hours of fluid therapy

Question 3

Causes of intrinsic renal azotemia

Answer 3

AKI- abrupt decrease in GFR

Acute tubular necrosis- most common cause

Question 4

Describe ischemia

Answer 4

“Vasomotor nephropathy”
Prolonged hypotension
Blood loss

Question 5

What does aminoglycoside toxicity cause

Answer 5

Proximal tubular epithelial cell damage

Aminoglycosides= neomycin, kanamycin, gentamicin, amikacin, streptomycin

Question 6

Describe pigment nephropathy

Answer 6

Pigments cause vasoconstriction and therefore ischemia
Obstruct tubules with protein casts
Make hydroxyl radicals

Question 7

How are animals exposed to lepto

Answer 7

Urine

Aborted fetuses

Question 8

Clinical syndromes of lepto

Answer 8

AKI
Tubulointerstitial nephritis
Uveitis
Abortion, stillbirths, neonatal death

Question 9

Clin path of AKI

Answer 9

Increased BUN, cr, K, and P
Decreased Na, Cl, Ca

UA- blood, protein, casts, glucose, increased GGT and FC(na)(P)

Question 10

Treatment of AKI

Answer 10

Discontinue nephrotoxic drugs
Treat concurrent dz
Correct volume deficits and establish diuresis
Monitor for urination and edema
Treat hyperkalemia

Question 11

AKI prognosis

Answer 11

Varies with underlying cause

Of oliguria persists more than 72 hr, prognosis is guarded

Question 12

Causes of AKI

Answer 12

Prerenal or post renal azotemia
Ischemia
Aminoglycosides
Oxytetracycline, polymixin B, amphotericin B
NSAIDs
Pigment nephropathy
Leptospira interrogans
Acute glomerulonephritis

Question 13

Describe chronic kidney disease

Answer 13

Acquired- glomerular (glomerulonephritis, amyloidosis); tubular (chronic interstitial nephritis, incomplete recovery from ATN, pyelonephritis, obstructive disease)

Congenital- renal hypoplasia, dysplasia, PKD

Question 14

Clinical signs of CKD

Answer 14

Uremia
Chronic weight loss
Rough hair coat
Poor athletic performance
Anemia
PU/PD
Ventral edema
Ulcers, halitosis, tartar

Question 15

Describe clin path findings of CKD

Answer 15

BUN:Cr > 10:1

Increased Ca and lipids
Decreased P, Na, and Cl
Metabolic alkalosis
Non regenerative anemia
Isosthenuria

Question 16

Treatment of CKD

Answer 16

Treat acute exacerbation as AKI
Abx if pyelonephritis
Discontinue any nephrotoxic drugs, alfalfa, and legumes
Maintain normal protein intake and BCS

Question 17

Describe AKI (table)

Answer 17

Good BCS
Normal hematocrit
Kidney size normal to increased
Kidney consistency normal to soft
Recent association with disease or drugs
BUN:Cr less than 10:1
HypoCa, hyperP
Normal or hypoechoic on US

Question 18

Describe CKD (table)

Answer 18

Poor bcs/ weight loss
Anemia
Kidney size normal to decreased
Kidney consistency normal to firm
No recent history of other disease
Hyperechoic on US
BUN:Cr greater than 10:1
HyperCa, hypoP