Small Animal Urinary Tract Medicine Flashcards
What are the functions of the kidney?
What is azotaemia?
What is uraemia?
Functions- excretion of waste, control of fluid balance, Endocrine (renin, erythropoeitin, calcitrol)
Azotaemia- increased urea, creatine and other nitrogenous compounds in the blood
Uraemia- clinical syndrome that results from loss of kidney function
What is the difference between pre-renal, renal and post-renal azotaemia?
Pre-renal- hypovolaemia, heart failure
Renal- not enough functioning nephrons
Post renal- urethral obstruction, rupture
What is the difference between acute kidney injury and chronic kidney disease?
Acute kidney injury- rapid loss of kidney function
Leptospirosis, ethylene glycol, NSAIDs toxicity
Chronic kidney disease- structural or functional abnormalities of one or both kidneys that have been there for 3 months or longer
What are the clinical signs of urinary tract disease?
- PUPD- increased drinking and urinating- increased filtered load per nephron
- Nausea and vomiting- uraemic toxins act on chemoreceptor trigger zone
- Anorexia- oral pain, nausea, gastritis, acidosis, hypokalaemia
- Distrubed water and electrolyte balence- hypertension, increase/decrease sodium, potassium, calcium, increased phosphate
- Anaemia- deficiency in EPO, GI blood loss
- 4 end organs- CNS, kidneys, retina, heart
What history should be required with possible urinary tract disease?
What core tests can be used for diagnosis?
History-
Drinking and urination changes- PUPD, pollakuria, stranguria, dysuria
Haematuria- when?
Tests-
Haematology
Biochemistry
Urinalysis
Urine culture +/-
What could be the DDXs if there if no polyuria?
Urinary incontinence
Cystitis
Submissive urination
Marking behaviour
What will show changes outside the reference range for haematology for an animal with urinary tract disease?
How will biochemistry differ?
- Haematocrit
- Haemaglobin
- RBC
- Total wbc (infection)
Biochem
Urea and creatine mainly
Albumin
Potassium
Phosphorus
Calcium
How can urine be collected for urinalysis?
Free catch midstream- not sterile
Cystocentesis- sterile
Catheterisation- not sterile, transfer bacteria from LUT
What can be identified from gross urinalysis?
What is concentrated (hypersthenuric), dilute (hyposthenuria) specific gravity in dogs and cats?
Gross-
Colour- pale yellow to amber normal, red to brown haematuria, dark yellow/brown- bilirubinuria
Turbidity- normal is clear
Hypersthenuric- SG >1.030 in dogs, >1.035 in cats
Hyposthenuria- 1.001 - 1.007
What can be identified in urine sediment examination?
Cells- struvite
Struvite crystals- coffin lids
Calcium oxalate- envelope
Urine casts- kidney tubule problem
Culture- cystocentesis samples
What imaging can be used for diagnosis of urinary tract disorders?
Radiography
Ultrasound
