Nursing the CKD Cat Flashcards
What is the management of CKD aimed at?
reducing the workload of the remaining nephrons and preventing further damage
What type of disease is chronic kidney disease?
funtional and/or structural which is gradual, progressive, irreversible and involves nehron loss
What can you do to prevent progression of the disease?
therapeutic intervention
What is polynephritis?
inflammation of the kidney and renal pelivs
What is ureterolithiasis?
post renal, causes renal damage
What are the majority of cases of CKD due to?
chronic interstitial nephritis
What is chronic interstitial nephritis?
inflammation of the renal interstitium
What can happen over time if asymptomamatic?
progressive nephron loss, progressive decreased glomerular filtration rate
What age does CKD usually occur?
mature-geriatric cats
Why might a younger cat be affected?
if it is congenital
What should you discuss with the owner about CKD?
- weight/condition changes
- drinking/urinating (PUPD)
- appetite
- demeanour, activity levels
- vomiting +/- diarrhoea +/- haematemsis/malaena
- constipation secondary to dehydration
- signs associated with hypertension (blindness, neurological)
- medication
What should you assess in the CKD cat?
- hydration status
- weakness (neck ventroflexion - hypokalaemic myopathy)
- uraemic ulcers +/- uraemic halitosis
- hypertensive retinopathy
- kidneys typically small or irregular on palpation
- rubber jaw (renal secondary hyperparathyroidism)
What tests can be done to diagnose CKD?
- urine specific gravity
- urine protein:creatinine ratio
- serum creatinine and urea
- glomerular filtration rate
- symmetric dimethylarginine (SDMA)
- diagnostic imaging - ultrasound and radiography
What is azotaemia?
increased urea and creatinine
What would a symmetic dimethylarginine (SDMA) do?
identify kidney disease earlier than elevated urea and creatinine
What would an ultrasound check for with CKD?
renal size and architecture
What would radiography check for?
(uretero)liths
What else can ultrasounds and radiography look for?
uretric obrstruction, pyelonephritis, lymphoma
What is the most common cause of CKS in cats and dogs?
hypertension
What can we do to reduce stress when taking blood pressure readings?
- use tail
- minimal restraint
- medication
- quiet room
- feliway plug
- patience
- feline friendly room
- headphones so don’t get scared by loud noise of doppler
What is rubber jaw?
demineralisation of the bones in the jawdue to increased PTH activity
What does CKD lead to
increased serum phosphate
What does increased serum phosphate lead to?
parathyroid hormone secretion leading to decreased phospate and increased calcium
