MT 2 pqs Flashcards
What parameters change with the portosystemic shunt and why?
-Incr. bile acid level - absorbed bile acids bypass the tissue.
-Increased basal NH3, bypass the liver and does not go through the ornithine cycle.
-Ammonia tolerance test: when the suspect of portosystemic shunt is strong and the basal NH3 value doesn’t show any alteration. After 24h starvation and pretreatment w. neomycin (in order to reduce bacterial NH3 prod. in the intestines) we take a basal blood sample, and give NH4Cl in 5%-water solution, then blood samples are taken 30/45 min after treatment.
If liver function is normal: ammonia cc. is <120 μmol/l in dogs, and <175 μmol/l in cats.
How to measure total protein/total creatinine ratio and what are the causes?
Provides information about the severity of proteinuria if the urine-sediment don’t show evidence of inflammation(WBC), since creatinine excretion is stable and is not reabsorbed in tubules. Convert both parameters to same unit before calculation. Creatinine is µmol/l, to convert it to g/l, multiply with 0.000113.
Measurements:
1. Electrophoresis
2. Immune electrophoresis
3. Western Blot analysis
Causes: (phys. value: < 1)
- > 1: pre-renal proteinuria, high fever, incr. BP
- 1-5: pre-renal proteinuria, some renal diseases like glomerulonephropathy
- > 5: other renal diseases like tubulonephropathy
-Normal value in dogs: < 0.078. If the ratio is more than 0.131, there is pathological proteinuria.
What is the values for ALT and AST and how is it measured and in what species?
ALT: 7-55 U/L (less than 60 IU/L)
- Absorbancy reduction: prod. piruvic acid is converted to lactic acid by LDH that is in the reagent. This process causes transformation that causes discoloration of a chromophor.
- Species specific in carnivores.
- AST: 8-48 U/L (less than 30 IU/L)
- AST enzyme with L-aspartate and ά-ketoglutarate produces oxalic-acetate and L-glutamate. Oxalic-acetate with NADH+H+ and malate-DH (in the reagent) prod. malate and NAD+. This change cause absorbancy reduction. The speed of it is in correlation with AST activity.
- Species specific in herbivores (liver)
What are the semiquantitiative methods for urinary protein measurement and what changes can be seen?
- Test strip: brome-phenol-blue (semi-quant. in-house test). Most sensitive to albumin, not Bence-Jones proteins. Phys. result: negative. Not specific.
- Sulphosalicylic acid test: (semi-quant. in-house test, by side of animal) coagulation: higher prot. cc. -> more opaque. Not specific.
- Heller/Gmelin test: HNO3 (rough in-house test). Show bile-pigment metabolites and proteins the urine. Semi-quantitative scale.
Changes:
List the causes for hematuria
- Lower UTI
- Trauma (urinary bladder, urethra, urether, kidney - contusion, rupture, external impact or can be caused by urinary calculi in urolithiasis)
- Genital tract injury, tumor or inflam. e.g. endometritis, prostatitis, hypertrophy of the prostate gland
- Infectious or non-infectious inflam. process in the lower or higher urinary tract
- Renal infarction
- Thrombocytopenia, coagulopathy
What is the values for ALKP, how is it measured, score, in what species and causes of variation of ALKP?
-Values: less than 200 IU/L
-4-nitrophenil phosphate and H2O is converted to 4-nitrophenol and phosphate ion. Produced 4-nitrophenol is yellow and can be detected spectrophotometrically.
-Every cell membrane, produced by different organs
-Only hepatic and bone origin appears in blood
-Only in dog, swine (and cat if acute)
Causes of increased activity:
-bone origin: young dogs, pregnant animals, bone tumours, osteomyelitis, bone fractures, healing of fractures,
-paraneoplastic proc. (lymphoid, lung, and hepatic tumours)
-liver originated: liver cirrhosis!, cholestasis, bile acids, acute hepatic necrosis, intra- or extrahepatic biliary obstruction, cholangiohepatitis, hepatic lipidosis, barbiturates, salicilates
-in connection with incr. SIAP synt.: hyperadrenocorticism, iatrogenous or endogenous (Cushing disease), chronic stress
Urinary specific gravity: methods and causes of variations
- Measured by:
1. Urinometer: Most accurate, easy and cheap. Urine poured into glass cylinder, urinometer placed inside. Requires a lot of urine.
2. Refractometer: Easy and one drop enough. Not reliable when urin is not transparent.
3. Test strip: not very useful for SG meas. in animals.
a) Hyposthenuria: <1,008. - Physiol. if incr. water intake.
- Hyperadrenocorticism
- Decreased ADH-prod. (CDI)
- Resistance to ADH (PDI or NDI)
- Renal tubular damage and PP.
- Also hypoadrenocorticism, liver disease and prolonged fluid therapy - due to medullary washout.
b) Isosthenuria: 1.008-1.012 - Physiol. if incr. water intake
- Severe tubular damage
- Medullary washout
- CDI, NDI or PP
c) Hypersthenuria: >1.012 (normal urine) - Decreased water intake
- Substantial water loss (vomiting, diarrhoea, excessive exercise: panting-dog, sweating-horse)
- Acute kidney failure (oliguria).
- May also be incr. in DM.
Alkalytic urine in carnivores
- Feeding in Ca: transient postprandial alkalization of urine. Highly acidic gastric juice is secreted in the stomach after feeding resulting in slight metabolic alkalosis, which is compensated in kidneys by incr. HCO3
- excretion. - UTI caused by urease-prod. bacteria like Proteus spp. and Staphylococcus spp.
- Metabolic and respiratory alkalosis
- Alkalizing substances, overload of bicarbonate- or lactate containing infusion
- Long storage time: causes urea decomposition
to ammonia - eg. urinary tract obstruction
Causes of bilirubinuria in cat, horse and human
- Bilirubinuria appears in jaundice: pre-hepatic (incr.), hepatic (decr.), post-hepatic. (incr.
- Urine test strip (diazo), Gmelin test
The value of bile salt, measurements, causes and indicate it´s values
-Normal value (fasting): 6 µmol/l (carnivores) 20-30 µmol/l (other animals).
-HPLC, RIA and total bile acids - spectrophotometry
Causes of incr. levels in blood:
- liver injury, hepatic cell damage
- bile duct obstruction or bile endothelial cell damage
- decr. liver function (therefore decr. uptake of them)
- biliary stasis (cholangiohepatitis, cirrhosis, hepatic or pancreatic neoplasm, pancreatitis)
- portosystemic shunt
Causes of decreased levels in blood:
- decr. abs. from intestines
- intestinal wall damage
- surgical removal of ileum
- lymphangiectasia
- severe liver cirrhosis (or other severe liver cell damage)
Semi quantitative measurements of UBG and glucose in urine, and the cause of changes in them.
Glucose:
-Urine test strip (GOD/POD)
UBG:
1. Urine test strip - Diazo
-2. Ehrlich test: Put some drops of Ehrlich reagent (2 g p-dimethyl-amino-benzaldehyde in 100 ml 20% HCl) into 2 ml urine sample:
Normal:
-colour by looking the tube from above - mild reddish discolouration
-colour by looking the tube from the side - no colour change
Abnormal:
-colour from above - intensive red colour
-colour from the side - mild or intense red
-colour change
3. (Gmelin test - layers in the tube:
condensed material on surface - acidic urea
yellow - urine itself
white (opaque) – protein
purple - indicane (indol-sulphate)
green – biliverdin
brown - urobilinogen (UBG)
HNO3)
What causes acidic urine in herbivores?
- metabolic and respiratory acidosis - increase of H+
excretion in the kidney - in vomiting (paradoxical aciduria) Na+ is reabs. with HCO3-, due to decr. HCO3 - excretion urine pH becomes more acidic
- in hypokalaemia there is increased H+ excretion in exchange to reabsorbed K+
- treatment with acidifying drugs (e.g. NH4Cl).
- distalis renalis tubularis acidosis (decr. HCO3-excretion)
- abomasal displacement
- toxicosis with acidifying substances (ethylene glykol, metaldehyde)
