PU/PD - Dowers

Question 1

How do you determine when a patient is PU/PD?

Answer 1

• put on the list if O reports it
• inappropriate isosthenuria/hyposthenuria
• 1st morning urine is inappropriately concentrated

Question 2

Should we withhold water to determine if pt is truly PU/PD

Answer 2

No! There are other ways we can determine if PU/PD is true

Question 3

If USG is > 1.030/1.035 can they be PU/PD?

Answer 3

No

Question 4

If USG is < 1.030/1.035 are they be PU/PD?

Answer 4

Maybe, do a USG on 1st morning sample…

• concentrated –> not pu/pd
• can’t concentrate –> pu/pd

Question 5

How can we categorize PU/PD?

Answer 5

• Central DI
• Primary PD (psychogenic, liver, hyperthyroid)
• Primary nephrogenic DI - rare
• Secondary nephrogenic DI - lots!
• Osmotic diuresis - eg hyperglycemia

Question 6

PU/PD in elderly cat

Answer 6

Diabetes, hyperthyroid, kidney

Question 7

PU/PD in “fat” dog

Answer 7

Cushings and Diabetes

Question 8

PU/PD in thin dog

Answer 8

Addison’s, Diabetes, Cancer Cachexia

Question 9

PU/PD in young dog

Answer 9

infectious dz, congenital

Question 10

PU/PD in breeding animal

Answer 10

intact female –> pyometra

Question 11

Hx - weight changes or appetite changes

Answer 11

Endocrinopathy

Question 12

Hx - travel history

Answer 12

Lyme dz, lepto

Question 13

Hx - access to drugs

Answer 13

Licking O’s arm that has cholicalciferol on it (e.g. Psoriasis tx)

Question 14

Hx - drugs

Answer 14

Steroids, anticonvulsants

Question 15

Hx - diet

Answer 15

canned, high salt, etc

Question 16

UA - what are we looking for?

Answer 16

USG - renal 
Proteinuria - losing protein through glomerulus 
Pyuria - pyelonephritis 
Bacteruria 
Bilirubinuria - liver dz

Question 17

What test should be done in all patients before instituting therapy?

Answer 17

Urine culture! Don’t want to miss something simple

Question 18

Should we do a bile acids test if Tbilirubin is elevated?

Answer 18

No, redundant… waste of money