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Equine Med & Surgery > Renal > Flashcards

Renal Flashcards

1
Q

Pre-renal azotemia

A

dehydration

hypotension

shock

blood loss

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2
Q

Most common cause of renal azotemia in horse?

A

tubular azotemia

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3
Q

Most common cause of post-renal azotemia in foals

A

ruptured bladder

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4
Q

Most common causes of post renal azotemia in adult horses

A

calculi

bladder atony

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5
Q

Clinical signs associated with lower urinary tract problems

A
  • alterations in micturition
  • not many systemic signs
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6
Q

Clnical signs associated with upper urinary tract problems

A
  • alterations in urine volume
  • azotemia
  • systemic signs
  • increased urine protein, glucose
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7
Q

renal glucose threshold in horses

A

180 g/dl

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8
Q

Horse urine is normally high in what?

A

Calcium carbonate and mucous; also triple phosphate and CaOx crystals can be seen

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9
Q

Acidic urine in horses may indicate?

A

infection

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10
Q

USG-adult horses vs. foals

A

adults: 1.020-1.050
foals: normally dilute (<1.008)

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11
Q

Most commonly diagnosed urinary system problems in horses

A
  • acute renal failure
    • usually tubular
    • usually due to dehydration, hypovolemia and/or nephrotoxic drugs
  • urolithiasis
  • bladder problems in addition to urolithiasis
    • bladder atony
    • sabulous bladder
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12
Q

Causes of acute tubular necrosis

A
  • renal ischemia most often
  • toxins
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13
Q

What are the most common agents associated with acute glomerulonephritis?

A
  • EIA
  • S. equi var equi
  • Lepto
  • EHV
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14
Q

Two pretty uncommon causes of ARF

A
  • abnormalities of hemostasis
  • acute interstitial nephritis
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15
Q

Most common nephrotoxic drugs in horse

A

NSAIDs, aminoglycoside abx

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16
Q

ARF clnical signs

A
  • depression
  • anorexia
  • changes in urine output
  • fluid retention->edema
  • “colic” pain
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17
Q

Acute renal failure-chemistry changes

A
  • Increased BUN/Creatinine
  • hyponatremia, hypochloremia
  • variable potassium (probably depleted if not eating)
  • metabolic acidosis
  • hyperphosphatemia
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18
Q

urine to serum creatinine of <37 indicates what?

A

renal injury

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19
Q

Factors that improve the prognosis of AFR

A
  • tubular basement membrane not disturbed
  • no oliguria
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20
Q

Treatment of ARF

A
  • treat underlying cause
  • discontinue (minimize) nephrotoxic drugs
  • fluid therapy-IV preferable; field situation may necessitate oral
  • diuretics, vasodilators (dopamine)
  • hemodialysis and peritoneal dialysis are described
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21
Q

CRF-causes

A
  • chronic tubular necrosis
  • urinary tract obstruction
  • chronic glomerulonephritis
  • pyelonephritis
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22
Q

CRF-clnical signs

A
  • weight loss
  • lethargy, exercise intolerance
  • rough hair coat
  • PU/PD
  • mild ventral edema
  • signs of uremia
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23
Q

signs of uremia in the horse

A
  • poor appetite
  • dark MM
  • oral erosions
  • vasculitis
  • soft feces
  • GI ulceration/bleeding/PLE, melena
  • dental tartar
24
Q

What should you follow up on if you see dental tartar in a horse?

A

check creatinine, look for kidney dz

25
Q

Chronic interstitial nephritis is usually secondary to:

A
  • ARF (tubular necrosis) that was undiagnosed/untreated
  • ascending UTI (pyelonephritis, pyelonephritis in association with urolithiasis)
26
Q

Rationale for feeding grass hays to horses with CRF

A

lower in calcium

27
Q

CRF prognosis

A

fairly poor

28
Q

Cystic calculi-clinical signs

A
  • dysuria
  • hematuria
  • pyuria
  • complaint of bloody urine after exercise or urinating frequently while being ridden
29
Q

Nephroliths-clinical signs

A
  • dysuria
  • hematuria
  • colic, abdominal pain
  • poor performance, lethargy
  • inappetance, weight loss
30
Q

Causes of urinary incontinence

A
  • cystitis
  • ectopic ureter
  • urolithiasis “sabulous bladder”
  • neurologic disease
  • vaginal injuries, polyps
31
Q

Make sure to perform _________ as diagnostics in cases of urinary incontinence

A

urinalysis & urine culture

32
Q

Causes of hematuria

A
  • UTI
  • urolithiasis
  • phenylbutazone
  • urinary tract neoplasia
  • nephrotoxicity
  • urethral defects/tears
  • idiopathic
33
Q

difficult or painful urination

A

dysuria

34
Q

slow and painful urination

A

stranguria

35
Q

unduly frequent passage of small amounts of urine

A

pollakiuria

36
Q

anuria

A

lack of urine production

37
Q

decreased urine production

A

oliguria

38
Q

Total protein and albumin may be decreased if _______

A

glomerular disease

39
Q

What causes false positives for protein when using dipstick? What are better tests?

A

alkaline urine; use SSA test or colorimetric assay instead

40
Q

Fractional excretion of electrolytes

A
  • clinically useful indicator of renal function in large animals
  • does not require collection of urine over time
  • blood and urine samples obtained at same time, before horse started on any fluid therapy
  • fractional excretion of sodium is indicative of renal tubular fxn; >1% indicates renal tubular dysfunction
41
Q

Increased [GGT] in the urine indicates ______?

A

renal tubular necrosis

42
Q

BUN/Creatinine ratio <10:1

A

prerenal or acute renal disease

43
Q

BUN/Creatinine ratio >15:1

A

chronic renal failure

44
Q

What are some things you may be able to detect by rectal palpation?

A
  • bladder stones, sludge
  • thickened bladder wall
  • dilated ureters
  • enlargement or atrophy of left kidney
  • irregularity of left kidney surface
45
Q

How do aminoglycosides cause renal toxicity?

A

damage cellular organelles of proximal renal tubular cells

46
Q

kidneys receive ____% of total cardiac output

A

20%

47
Q

What part of kidney is most susceptible to injury from toxins?

A

renal cortices

48
Q

The renal medulla is susceptible to what type of injury?

A

ischemic

49
Q

Three stages of ARF

A
  • induction: onset of injury to development of decreased GFR and azotemia
  • maintenance: period of azotemia
  • recovery: repair of damaged nephrons and hypertrophy of remaining functional nephrons to compensate
50
Q

Treatment of hyperkalemia

A
  • potassium free fluids (0.9% NaCl)-may be enough
  • NaHCO3 or calcium gluconate if K very high
51
Q

When might furosemide be ineffective?

A

if horse has marked decrease in GFR; must be filtered through glomeruli in order to reach site of action

52
Q

Renal neoplasia

A
  • rare
  • usually carcinoma
  • only affects one kidney; does not cause azotemia
53
Q

Mechanism of anemia seen with CRF

A

decreased erythropoietin, decreased RBC life span

54
Q

most common site of uroliths in horse

A

bladder

55
Q

Contributing factors to urolithiasis

A
  • concentrated urine
  • prolonged urine transit time
  • reduced inhibition of crystal growth
  • areas of tissue damage
56
Q

What are some neurologic causes of urinary incontinence?

A
  • spinal cord injuries
  • EPM
  • herpes myelitis
  • rabies
  • cauda equina syndrome
  • sorghum or sudan grass toxicity

Equine Med & Surgery (11 decks)

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