Urinary Flashcards
What are the features of acute renal failure?
Good body condition Enlarged kidneys Severe clinical signs related to bloodwork Normal to increase PCV Normal to increase K More severe metabolic acidosis
What are the features of chronic renal failure?
Poor body condition Small kidneys Mild clinical signs related to bloodwork (BUT higher BUN and creatinine) Nonregenerative anemia Normal to decrease K Less severe metabolic acidosis Long standing PU/PD
Renal aplasia/agenesis
Absence of one or both kidneys
Renal hypoplasia
Kidneys smaller than normal (contralateral one may be hyperplastic)
Horseshoe kidney
Kidneys fused at pole (normally function fine)
What is PKD? What breed does it mainly affect?
Polycystic kidney disease
Persian cats (also Himalayans, British Shorthairs)
How is PKD inherited in this breed?
Autosomal dominant defect in PKD1 gene
When do animals typically exhibit evidence of renal dysfunction and renal failure in PKD?
Renal dysfuntion: 3-10 years of age
Renal failure: > 7 years of age
What are the lesions of PKD?
Lots of cysts on the kidney
Sometimes get hepatic cysts
From what part of the nephron do cysts develop in PKD?
Can arise from ANY segment of nephron
What shape are renal infarcts and why are they this shape?
Wedge shaped
Because the kidney blood supply shapes wedges
Administration of which drugs is associated with papillary necrosis?
NSAIDS
What is the pathogenesis of papillary necrosis?
NSAIDS prohibit PGE2 –> PGE2 isn’t there to vasodilate the arterioles in juxtamedullary nephrons (by pelvis) –> infarct and ischemia occurs
What do hydronephrosis and hydroureter occur secondary to?
Obstruction
What structures can be altered in GN?
Basement membrane
Mesangial cells
Mesangial matrix
Immune complex deposition
What is the pathogenesis of immune complex GN?
Circulating immune complexes deposited in glomerular basement membrane OR antibodies formed against glomerular basement membrane –> complement fixation and leukocyte infiltration –> production of inflammatory mediators –> filtration barrier compromised –> protein loss
What are conditions commonly associated with immune complex GN?
Chronic inflammatory stimuli:
Viral diseases Chronic bacterial infection Parasitic and protozoal disease Autoimmune disease Neoplasms
Are underlying conditions often identified at the time the animal is symptomatic for renal disease in immune complex GN?
NO
The initial inciting cause is often not determined
What is the urinalysis finding that is most suggestive of glomerular disease? What is the most sensitive way to measure it?
Proteinuria (WITH absence of hemorrhage or inflammation)
Urine protein to urine creatinine ratio
What type of amyloid is most commonly present in glomerular amyloidosis?
Serum amyloid A (SAA), an acute phase protein associated with chronic inflammation
Which animals have systemic reactive amyloidosis?
Most commonly in Shar Pei’s and Abyssian cats, but has been described in multiple breeds
What histochemical stain would you use to confirm material in the glomeruli is amyloid?
Congo red
What effect does amyloid deposition have on glomeruli and what does this lead to?
Decreases function of filtration barrier
Leads to progressive renal insufficiency and proteinuria
What happens to tubules with significant glomerular disease?
They get damaged
Vacuolization and necrosis
Where in the kidney do bacteria most commonly lodge in septicemic processes?
Glomerular and peritubular capillaries (so mostly in the cortex)
Which bacteria most commonly cause embolic glomerulitis in horses? In pigs? In cattle?
Horses: Actinobacillus equuli
Pigs: Erysipelothrix rhusiopathiae
Cattle: Trueperella pyogenes
What causes ischemic tubular necrosis?
Hypotension (shock)
Which part of the nephron is most significantly affected in ischemic tubular necrosis?
Primarily proximal tubules (have the highest energy)
Can basement membranes be preserved in ischemic tubular necrosis, and why is this important?
Yes if it’s not severe, so the tubules can regenerate
Which part of the nephron is most significantly affected by nephrotoxic acute tubular necrosis?
Proximal tubules
Can basement membranes be preserved in nephrotoxic acute tubular necrosis, and why is this important?
Yes, so the tubules can regenerate
Better chance of preservation than ischemic tubular necrosis
What is pyelonephritis? How do these infections typically reach the kidney?
Inflammation of renal pelvis and parenchyma
Results from ascending infections from lower urinary tract infection
What are the histologic lesions in pyelonephritis, and which portions of the kidney are most severely affected?
Neutrophils
Renal tubules
What is the kidney worm in swine, and where is the worm located?
Stephanurus dentatus
Located in renal pelvis
Which species are affected by Dioctophyma renale?
Piscivorous mammals (mink, dogs, cats)
Where are the Dioctophyma renale worms located?
Renal pelvis
What are the lesions associated with Dioctophyma renal?
Progressive destruction of renal parenchyma
What is the most common primary renal tumor in pigs? Dogs? Cattle? Horses?
Pigs: Nephroblastoma
Dogs: adenocarcinoma
Cattle: adenocarcinoma
Horses: adenocarcinoma
What is an ectopic ureter?
Ureters empty where they’re not supposed to: bladder neck, urethra, vagina, vas deferens, seminal vescicles
What is a patent urachus? In which species is it most common?
Failure of closure of the urachral lumen, resulting in dribbling urine
Most common in foals
What are predisposing factors for urolithiasis?
Urine pH (precipitation) Water intake Hereditary factors (dalmatians) Dietary factors UTIs
Males more likely to obstruct
What are predisposing factors for cystitis?
Female Loss of normal voiding mechanisms Loss of acidic urine pH (carnivores) Glucosuria Proteinuria Mucosal trauma
What is the cause of enzootic hematuria?
Chronic ingestion of bracken fern
What lesions are seen in enzootic hematuria?
Mature cattle with persistent hematuria with hemorrhage and/or neoplasms in lower urinary tract
Where do transitional cell carcinomas most commonly occur?
Bladder neck and trigone
What are common presenting clinical signs for TCCs?
Straining to urinate
Hematuria
UTI
