SA Hypertension, Proteinuria, Glomerular and Tubular Disorders

Question 1

Describe the two causes of systemic hypertension.

Answer 1

Increased sympathetic nervous system, increases RAAS, leading to vasoconstriction.
RAAS increases sodium retention and volume expansion.

Question 2

Which breeds have a higher systemic blood pressure normally?

Answer 2

Sight/deerhounds - 10-20mmHg higher.

Question 3

What is the gold standard method of measuring blood pressure?

Answer 3

Arterial catheterisation

Question 4

What is the first choice treatment of hypertension in cats and how does it work?

Answer 4

Amlodipine. Calcium channel blocker, causing vasodilation.

Question 5

What is the first choice treatment of hypertension in dogs and how does it work?

Answer 5

Benazepril. ACE inhibitor

Question 6

How does telmisartan work to reduce blood pressure?

Answer 6

Angiotensin receptor blocker

Question 7

How should you quantitatively diagnose proteinuria?

Answer 7

Urine protein:creatinine ratio

Question 8

What is renal proteinuria due to?

Answer 8

Protein losing nephropathy, due to glomerular disease.

Question 9

What are the four features of nephrotic syndrome?

Answer 9

Proteinuria
Hypoalbuminaemia
Oedema
Hypercholesterolaemia

Question 10

What causes secondary glomerular disease?

Answer 10

Inflammatory or neoplastic disease elsewhere in the body leading to immune complex formation/deposition or amyloid deposition.

Question 11

Which breed is affected by renal amyloidosis and where does the deposition predominate?

Answer 11

Chinese Shar Pei
Medullary deposition predominates

Question 12

List four types of drug that may trigger glomerular disease.

Answer 12

Steroids
Antibiotics - TMPS
Immunomodulators - oclacitinib
CHemotherapeutics - mastitinib/toceranib

Question 13

What is the first line therapy for proteinuria?

Answer 13

ACE inhibitors

Question 14

What is the second line therapy for proteinuria?

Answer 14

Angiotensin receptor blocker

Question 15

List 6 adjunctive therapies you should use in all glomerular disease patients

Answer 15

Renal diet
Omega-3 PUFAs (polyunsaturated fatty acid)
Anti-platelet therapy
Oedema management: light exercise
Manage hypertension
Management of CKD as and when develops

Question 16

When is the prognosis for glomerular disease poor?

Answer 16

Poor when presenting with azotemia and nephrotic syndrome

Question 17

How may you diagnose proximal tubular disease?

Answer 17

Glucosuria in the absence of hyperglycaemia.

Question 18

What is the name of the syndrome associated with proximal tubular disease?

Answer 18

Fanconi syndrome

Question 19

Which breed is susceptible to fanconi syndrome?

Answer 19

Basenjis

Question 20

List three ways to develop aquired Fanconis syndrome

Answer 20

Copper hepatopathy
Leptospirosis
Chinese jerky treats