Outcomes Of CKD And Acute On Chronic Uremic Crisis

Question 1

Cats have _____ progression of CKD

Dogs have ______ progression of CKD

Answer 1

Slower

Faster

Question 2

In both cats and dogs, _______ and ______ worsen survival chance.

Answer 2

Proteinuria and hyperphosphatemia

Question 3

Predictors of Mortality in cats:

1. Proteinuria
2. _______
3. Low BCS
4. ________
5. ________

Answer 3

Hyperphosphatemia

Anemia

Uremic toxins

Question 4

Predictors of mortality in dogs:

1. Proteinuria
2. ____________
3. ____________
4. Hypertension
5. Low BCS
6. Low muscle mass
7. FGF-23
8. __________

Answer 4

Hyperphosphatemia

Hypoalbuminemia

Uremic toxins

Question 5

Hypertension worsens rates of CKD survival in dogs. True or false?

Answer 5

TRUE

Question 6

Poor BCS and MCS _______ prognosis in dogs

Answer 6

Worsens

Question 7

Lower weight in cats with CKD = _____ survival time

Answer 7

Shorter

Question 8

Creatinine is a muscle breakdown product

Low creatinine in a skinny a cat with CKD, why is it low?

Answer 8

No muscle mass = no creatinine

Question 9

Pooplets = tiny little fecal balls outside of litter box

What is this a sign of?

Answer 9

Constipation

Question 10

How does hypokalemia contribute to constipation?

Answer 10

Potassium is needed for colonic motility

(Gastrocolic reflex)

Question 11

If cat with acute on chronic uremic crisis isn’t eating and has hyperphosphatemia, should you give a phosphate binder?

Answer 11

NO

It tastes terrible, focus on getting cat to eat then worry about phosphate binders later

Question 12

Fluoroquinolines if used inappropriately can cause _____ ______ in cats

Answer 12

Retinal degeneration
(Blindness!!!)

Question 13

What is the most common mistake with IV fluid administration in patients with CKD?

Answer 13

IV Fluid overload

patient is used to a state of chronic dehydration; their kidneys can’t handle large amounts of fluids anymore! You need to use judicious fluid rates

Question 14

A _____ ______ can develop in CKD cats given IV fluid therapy.

If you note this in a hospitalized CKD cat in uremic crisis, what are you going to do?

Answer 14

Gallop rhythm

Stop fluids or back rate down

Question 15

If a cat is constipated, what should you try to do before treating constipation?

Answer 15

Hydrate the cat!

Question 16

After discharging a CKD cat from an acute uremic crisis, it’s ideal to have owner give:

Answer 16

SQ fluids at home until recheck
Want to ensure cat doesn’t get dehydrated as soon as they aren’t on IV fluids anymore

Question 17

Pyleonephritis requires tx with antibiotics for how long?

Answer 17

Varies but ideally you will need to go longer with course compared to a typical UTI
(2-8 weeks)