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Y4 exotics > Renal Disease > Flashcards

Renal Disease Flashcards

1
Q

Proctodeum

A
  • last part of the cloaca where things are stored before being passed out of the body
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2
Q

Urodeum

A
  • where the urinary and reproductive tract empty into
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3
Q

Coprodeum

A
  • where the colon and GIT empties into
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4
Q

Why is bird and reptile urine not a good representation of the function of kidneys like in mammals?

A
  • urine can be modified by the bladder/colon
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5
Q

Clinical signs of renal disease in birds

A
  • early signs of dz are often subtle
  • signs of advanced dz are often non-specific, e.g. fluffed-up, lethargic, anorexic, dehydration
  • PUPD
  • unilateral or bilateral himblimb paresis/paralysis (due to proximity of nerves)
  • haematuria
  • feather plucking over kidneys
  • articular (& visceral gout) -> swollen painful joints
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6
Q

Clinical signs of renal disease in reptiles

A
  • early signs of dz often subtle
  • signs of advanced dz are often non-specific e.g. lethargy, anorexia, weight loss, dysecdysis, abnormal thermoregulation/behaviour
  • hindlimb weakness
  • constipation (renomegaly in pelvic canal)
  • gout (articular or visceral)
  • oedema (nephrotic syndrome)
  • PUPD are not usually a feature of reptile renal dz
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7
Q

Dysecdysis

A
  • problem shedding
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8
Q

Clinical exam

A
  • assess pt from afar
  • inspect cage, droppings, food, etc
  • thorough history
  • birds may need to be placed in a warm, humidified oxygen cage first
  • reptiles: ensure pt is warm
  • hr, rr slows, less alert if cold so can misinterpret CE if cold
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9
Q

Assume all ‘sick’ birds and reptiles are … dehydrated

A
  • 5-10%
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10
Q

Signs of dehydration in birds

A
  • mouth: can’t do CRT in these spp but may look dry
  • skin: skin tent elasticity is not a reliable indicator in birds
  • eyes: dull and sunken (wrinkled skin around the eye)
  • circulation: basilic wing vein refill time is a good indicator
  • weight loss (esp if sudden)
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11
Q

Signs of dehydration in reptiles

A
  • skin: dry, wrinkled or puckered skin, loss of skin elasticity and flexibility, dysecdysis. skin tent is never an indicator of hydration status in reptiles
  • eyes: sunken, receded eyes
  • MSK: generalised weakness and lethargy
  • mouth: tacky or dry mm, thick saliva
  • coelomic: doughy on palpation, constipation or infrequent defaecation
  • weight loss (esp if sudden)
  • appearance of urates and urine
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12
Q

Common causes of primary renal dz in birds

A
  • inadequate diet
  • hypovitaminosis A
  • hypervitaminosis D3
  • lipidosis
  • heavy metal toxicity
  • infection (primary or secondary from a systemic infection causing nephritis)
  • neoplasia
  • amyloidosis
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13
Q

What is hypovitaminosis A thought to cause?

A
  • metaplasia of the renal tubules and urethral epithelium
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14
Q

What does hypervitaminosis D3 cause?

A
  • hypercalcaemia
  • soft tissue mineralisation (can be within the kidneys)
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15
Q

Causes of lipidosis

A
  • high fat, low protein diet
  • period of starvation
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16
Q

Relevance of lipidosis to the kidneys

A
  • lipid deposits happen in the kidneys
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17
Q

Which bird spp are renal tumours common in?

A
  • budgies
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18
Q

How do renal tumours often present?

A
  • lameness in 1 leg due to the tumour pressing on the nerve plexus
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19
Q

When does amyloidosis generally occur?

A
  • after a period of chronic inflammation, e.g. pododermatitis
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20
Q

Why does amyloidosis cause renal dz?

A
  • amyloid deposits can damage the glomerulus
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21
Q

Common causes of primary renal dz in reptiles

A
  • inadequate husbandry (low humidity, temperature, diet [high protein], hypovitaminosis A, hypervitaminosis D3)
  • chronic dehydration
  • bacterial infection (primary or secondary from a systemic infection causing nephritis)
  • neoplasia
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22
Q

Why can too high temperature cause renal dz in reptiles?

A
  • too high temp -> dehydration
  • chronic dehydration -> underperfusion of the kidneys
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23
Q

Why can low humidity cause renal dz in reptiles?

A
  • linked to temperature but also causes dehydration if less droplets are in the environment
24
Q

What is gout a sign of in birds and reptiles?

A
  • renal failure
25
Q

Visceral gout

A
  • accumulation of urate (uric acid) deposits in soft tissues, e.g. liver, pericardium & kidney
26
Q

Articular gout

A
  • accumulation of urate (uric acid) deposits in and around joints e.g. often feet and hocks
27
Q

When does gout occur?

A
  • when uric acid secretion is decreased
  • +/- when uric acid production is increased
28
Q

Cause of increased uric acid production

A
  • excess dietary protein
29
Q

Causes of decreased uric acid secretion

A
  • pre-renal: dehydration (causing underperfusion of the kidneys)
  • renal: renal tubular dz, hypovitaminosis A, infection/inflammation
  • post-renal: obstruction e.g. uroliths, egg binding
30
Q

Biochemistry (urea) use in birds and reptiles

A
  • birds: may help assess dehydration but NOT kidney dysfunction
  • reptiles: may be elevated in dehydration or anorexia. renal dz likely if uric acid also raised
31
Q

Biochemistry (creatinine) use in birds and reptiles

A
  • not very useful in birds or reptiles
32
Q

Biochemistry (uric acid) use in birds and reptiles

A
  • elevated only when >70% kidney function is lost
  • mild to no elevation in dehydration
  • post-prandial rise in carnivorous birds and reptiles: fast carnivorous birds for 24h before sample, fast carnivorous reptiles for 24-36h before sample (most presented anorexic)
33
Q

Biochemistry (phosphorous) use in birds and reptiles

A
  • birds: may be elevated in renal failure (& haemolysis)
  • reptiles: may be elevated, renal failure more likely if phosphorous higher than total calcium
  • hyperphosphataemia is often the 1st biochemistry abnormality
34
Q

Biochemistry (potassium) use in birds and reptiles

A
  • elevated in acute renal failure (& haemolysis)
35
Q

Biochemistry (sodium) use in birds and reptiles

A
  • birds: hypernatraemia in dehydration and hyponatraemia in renal failure
36
Q

Urinalysis use

A
  • difficult to obtain pure/sterile sample (hard to avoid faecal contamination)
  • normal urine contains crystals and bacteria
  • look for renal casts, abnormal cells, glucose (birds), Hexamita parasite (reptiles)
  • urine can be modified after the kidneys in many exotic species therefore not a good indicator of renal function
37
Q

Urinalysis use in birds

A
  • USG range 1.005-1.020 but is species specific
  • USG not very helpful in most cases
38
Q

Urinalysis use in reptiles

A
  • pH may change from normal alkaline to acidic in anorexic herbivores and post-hibernation
  • USG range 1.003-1.014 may elevate slightly in dehydration
  • USG not very helpful in most cases
39
Q

Murexide test

A
  • test used to confirm gout
  • sample of material (e.g. joint aspirate) is mixed with nitric acid and dried over flame
  • add 1 drop of concentrated ammonia
  • if turns mauve = uric acid
  • rarely done in practice
40
Q

Radiography in birds

A
  • 2 views: ventrodorsal and lateral (wings and legs extended)
  • under GA
  • normal kidneys difficult to see esp on VD view
  • gonad and pelvic may obscure lateral view
  • small rim of air dorsal to the kidneys on lateral view, this is absent in renomegaly
  • look for changes in size, density & contour, eggs, cloacaliths, evidence of gout (white deposits within soft tissues / joints) and whole of body
41
Q

Radiography in reptiles

A
  • 2/3 views: ventrodorsal, horizontal-beam lateral +/- horizontal-beam craniocaudal (Chelonia)
  • kidneys often difficult to see unless enlarged or increased density
  • look for changes in size, density & contour, eggs, uroliths, gout and bone density (MBD)
42
Q

MBD in reptiles radiographic findings

A
  • decreased bone density (look at digits)
  • pathological fractures
  • constipation secondary to hypocalcaemia
  • MBD could be RSHP (renal) or NSHP (nutritional)
43
Q

Tx for birds (what all sick birds require)

A
  • keep warm, quiet, away from predators
  • fluid therapy
  • commence oral fluids once birds is more stable
  • crop feed once birds tolerates oral fluids (build up) (due to increased risk of aspiration in really sick birds)
44
Q

Fluid therapy in birds

A
  • SC, IV, IO depending on severity of dehydration, the birds demeanour and whether the GIT is functional
  • use CE, PCV & TP to determine dehydration %
  • 50mg/kg/day for maintenance + 50% of the fluid deficit daily
  • high risk of fluid overload esp in smaller birds so calculate deficit
45
Q

Antibiotics in birds

A
  • aminoglycosides are nephrotoxic
  • TMPS can potentially be nephrotoxic if a bird is severely dehydrated
46
Q

Allopurinol in birds

A
  • = xanthine oxidase inhibitor
  • used to reduce uric acid in the blood and body
  • care as some animals have a sensitivity to it (red tail hawks)
  • don’t use in chickens: licensing not allowed for FPA (even if pet)
47
Q

Metoclopramide in birds

A
  • 0.5-1mg/kg IM q8-12h if crop stasis
  • don’t use in chickens: licensing not allowed for FPA (even if pet)
48
Q

Tx for reptiles (what all sick reptiles require)

A
  • heat: pts should be kept at POTZ
  • light: appropriate UVB light for the spp
  • ensure correct humidity and appropriate access to water, eg. bath, spray
49
Q

Bathing reptiles

A
  • should be performed daly in all inpatients
  • encourages drinking, voiding urine/faeces and some can suck fluid into the cloaca/bladder
  • can add meds or supplements to the bath e.g. Reptoboost
  • close monitoring is essential to prevent drowning even in aquatic spp
50
Q

Oesophageal/stomach tubing in tortoises

A
  • oesophagus on left side of the neck, stomach also on the left side
  • keep upright to prevent immediate regurgitation
51
Q

Antibiotics in reptiles

A
  • most infections are caused by gram-negative bacteria
  • aminoglycosides are nephrotoxic
  • ceftazadime is commonly used
52
Q

Allopurinol in reptiles

A
  • = xanthine oxidase inhibitor
  • may help reduce hyperuricaemia
53
Q

Prevention of renal dz (husbandry)

A
  • correct temp, humidity, lighting, etc
  • fed the correct, balanced diet
  • correct use of supplements in insectivore reptiles to correct the Ca:P imbalance
  • keep hydrated by offering daily fresh water correctly
  • bathe reptiles regularly
54
Q

Hypovitaminosis A prevention

A
  • give balanced diet with multivitamins such as Nutrobal by Vetark (calcium, A, C, E, D3, K3 and group B vitamins)
55
Q

Hypovitaminosis A

A
  • typically an issue in omnivore or carnivore species (carnivores have to get vitamin A from animal sources (e.g. liver))
  • will generally have other nutritional deficiencies as well due to imbalanced die t- so diet always needs correcting
56
Q

Can herbivores convert vitamin A from plant material/

A

yes

57
Q

When to use vitamin A to tx hypovitaminosis A

A
  • only use if severe, due to risk of over-dosing (toxicity)

Y4 exotics (9 decks)

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