Renal Articles 2017 Flashcards
What is the somatic nerve involvement of micturition
Peudendal nerve S1-3
Striated muscle nicotinic cholinergic receptors
Contraction forms external sphincter
What is the PNS involvement in micturition
S1-3; Contraction of bladder wall, open bladder neck; relaxation of proximal urethral sphincter
What is the SNS involvement in micturition
D L1-4, C L2-5 hypogastric
Beta receptors in the body of the bladder wall allow relaxation and stretch
Alpha receptors trigone proximal urethra cause constriction
Describe the difference between UMN and LMN bladder
L7 or higher; incomplete detruser contraction spasticity of urethral sphincter; urine retnetion
LMN Bladder sacral detrusor/urethral sphincter areflexia; large easy expressible dribble
How are skeletal muscle relaxants used with UMN bladders
Diazepam–modulates Gaba
Baclofen (1-2 mg/kg q 8rs) Activates gaba
Goal to relax external urethral sphincter
How has atricarium been used in UO
local infusions of dilute mixture of 0.5 mg/ml instilled into urethra. Reduced first attempt to placed u-cath
MOA of phenoxybenazime and use
Alpha antagonist
Decreased SVR & BP
Decreased internal urethral sphincter resistance
MOA of Prazosin and use
Selective sympatholytic
competively antagonizes alpha-1 receptors
Relaxes smooth muscle
MOA of tamsulosin and use
Selective alpha-1 receptor antagonist preferential for prostrate/urethra
Contains sulfa
accumulates for one day dosing; UMN bladders
MOA of bethanechol and use
Parasympathomimetic
Stimulates muscarinic receptors
Bladder contraction
MOA of phenylpropinalamine and use
Partial alpha-1 receptor agonist
causes internal urethral sphincter to contract
In a JVECC 2017 study what were the risk factors for fluid overload in UO cats. Did this alter outcome?
Fluid bolus on presentation and development of heart murmur or gallop
Did not increase mortality
In a JVECC 2017 study how did prazosin affect recurrent urethral obstruction
Did not decreased recurrence. Under powered.
0.25 mg/kg PO q 12 hrs
Used 3.5/5 Fr; Longer ucath place for placebo
In a JAVMA 2017 study what was the difference between pigtail stents and ureteral by pass device
SUB devices lower risk of complications and longer survival times
In a JAVMA 2017 study what are the limitations to using a POC urine culture system in dogs
Able to detect bacturia but not able to correctly identify bacteria or sensitivity results
In a JAVMA 2017 study is there an association between urolithasis and CKD in cats
Positive association between urolithasis and CKD:
Did not seperated out Ureteroliths and pyelo/acute on chronic
AJVR 2017 what storage conditions affect UPC
Okay to store for one year at -20C and -80C
What are the pitfalls of using creatinine as an indicator of GFR
Creatinine affected by muscle mass
75% kidney damage prior to serum increase
Does not represent severity of renal damage until steady state reached.
Reflects GFR changes but not tubular damage
What are useful biomarkers for AKI / CKD in dogs
Dogs: plasma NGAL increases predicts progressive CKD; Heat Shock protein 27/UCr ratio higher in non survivors with AKI; Fibroblast growth factor 23 increased with progressive CKD
Vet Journal 2017 What is the seasonality in the northern US for UO in cats
Northeaster US has March-May
Northwestern no seasonality however when combined maintained the March-may timeframe
JVIM 2017 UPC measured free catch vs cystocentesis
Comparitive.
Older dogs in study 19% had protienuria
JVIM 2017 Darbopotien in dogs for CKD
> 21 day dosing frequency inefffective
effective for treatment of anemia
anemia is normochromic, normocytic, nonregenerative
JVIM 2017 6% HES 130/0.4 on creatinine and AKI in critically ill non azotemic cats findings
Did not increase serum creatinine or result in AKI.
