Urology (1-5) Flashcards
what is the normal daily water consumption for a dog
50-100 mL/kg
what is the normal daily water consumption for a cat
30-50 mL/kg
what is the normal daily urine production for a dog?
50 mL/kg
what is the normal daily urine production for a cat?
25-50 mL/kg
name 6 clinical signs of uraemia
- urine smelling breath
- oral ulceration
- anorexia
- vomiting
- malaise
- neurological signs
name 6 things that should be included in a clinical exam for an animal with urination problems
- hydration status
- body condition
- halitosis
- kidney and bladder palpation
- external genitalia
- rectal exam
what 6 key things do you want to look at on a urine dip stick
- pH
- blood (or pigment)
- ketones
- bilirubin
- glucose
- protein
what is the normal protein-to-creatinine (UP:C) ratio for cats and for dogs?
cats: <0.4
dogs: <0.5
this is a marker of concentration ability that is assessed with a refractometer
urine specific gravity
what is the specific gravity for hyposthenuria
< 1.007
what is the specific gravity for isosthenuria
1.008 - 1.012
what is the specific gravity for hypersthenuria
greater than 1.013
what is the adequate urine concentration for a dog
greater than 1.030
what is the adequate urine concentration for a cat
greater than 1.035
what 2 nitrogenous waste products would you expect to be elevated in the blood if an animal has azotaemia
- creatinine
- urea
what causes pre-renal azotaemia
reduced renal perfusion
name 4 causes of reduced renal perfusion leading to pre-renal azotaemia
- hypovolaemia
- dehydration
- cardiac disease
- hypotension
this is when blood flow reaches the kidneys but the kidneys are dysfunctional
renal azotaemia
name 2 causes of renal azotaemia
- acute kidney injury
- chronic kidney disease
what will the urine specific gravity usually be with pre-renal azotaemia
high
(>1.030)
what will the urine specific gravity usually be with renal azotaemia
isosthenuric
(1.007 - 1.012)
this is produced in all cells and is excreted by the kidneys;
can detect CKD when only 25% of function is lost
SDMA
(Symmetric DiMethylArginine)
what is the only part of the kidney that can be biopsied
cortex
name 3 risks of a kidney biopsy
- anaesthetic
- haemorrhage
- worsening azotaemia
what info can a kidney FNA provide/identify
limited;
may identify lymphoma
what info can a kidney biopsy provide/identify
protein losing nephropathies
how long must kidney disease be present for in order to be considered chronic kidney disease
at least 3 months
name 6 clinical signs of chronic kidney disease
- polyuria with compensatory polydipsia
- decr. appetite/anorexia
- weight loss
- vomiting
- muscle weakness
- constipation
name 7 differential diagnoses for polyuria/polydipsia
(besides chronic kidney disease)
- Diabetes mellitus
- Hypo/Hyperadrenocorticism
- pyometra
- hepatic disease
- hyperthyroidism
- medications (steroids, diuretics)
- Diabetes insipidus
name 3 diagnostics for identifying loss of kidney function
- reduced concentration ability
- azotaemia
- elevated SDMA
what 6 factors can be looked at to decide if kidney disease is acute or chronic?
- duration of clinical signs
- kidney signs
- renal pain
- body condition
- tolerance of azotaemia
- response to treatment
name 5 things that can cause acute worsening of a stable patient with chronic kidney disease
- dehydration
- hypokalaemia
- UTI
- hypertension
- anaemia
name 3 reasons for cachexia with chronic kidney disease
- inappetence/anorexia
- inflammation
- disuse atrophy
why is dehydration common with chronic kidney disease
even if not drinking anything, unable to conentrate urine to conserve water
why is hyperphosphataemia common with chronic kidney disease
decreased GFR
(1. insufficient PO4- excretion
2. PTH stimulation
3. calcium leaching from bone
4. secondary renal hyperparathyroidism)
what are the 2 steps for phosphate restriction to control renal secondary hyperparathyroidism
- dietary management
- phosphate binders
why is proteinuria common with chronic kidney disease
damage to glomeruli and tubules secondary to underlying inflammation
what effect do ACE inhibitors have on the efferent arteriole
dilation
(decr. filtration pressure & GFR)
this can be used as an alternative to ACE inhibitors;
avoids the locale ‘ACE escape’ that can occur where angiotensin continues to be produced via chymase rather than ACE
Angiotensin Receptor Blockers
name 2 reasons for hypertension with chronic kidney disease
- altered renal blood flow
- focal infarction/ischaemia
(activation of RAAS, sympathetic drive, further vascular damage)
what is the first line therapy in dogs to treat hypertension;
reduce angiotensin, blood volume
ACE inhibitors
what is the first choice therapy in cats to treat hypertension;
calcium channel blocker, causes arteriolar dilation, including afferent arteriole
Amlodipine besylate
name 3 reasons for urinary tract infections with chronic kidney disease
- dilute urine
- polyuria
- immunodeficiency
name 4 reasons for hypokalaemia with chronic kidney disease
- polyuria
- anorexia
- fluid therapy
- RAAS activation
name 3 supportive treatments to manage nausea/uraemic gastritis
(assoc. with CKD)
- maropitant
- H2 blockers
- sucralfate
name 4 ways to maintain appetite in an animal with CKD
- warm food
- offer palatable food
- vit B12 injections
- Mirtazapine
name the IRIS stage of kidney disease
creatinine: <125 (dog), <140 (cat);
SDMA: <18 (dog), <18 (cat);
no clinical signs;
imaging/biopsy/exam findings;
proteinuria of renal origin
stage 1
name the IRIS stage of kidney disease
creatinine: 125-250 (dog), 140-250 (cat);
SDMA: 18-35 (dog), 18-25 (cat);
clinical signs usually mild if present
stage 2
name the IRIS stage of kidney disease
creatinine: 251-440 (dog), 251-440 (cat);
SDMA: 36-54 (dog), 26-38 (cat);
clinical signs usually present;
less signs more consistent with early of this stage and more signs consistent with late of this stage
stage 3
name the IRIS stage of kidney disease
creatinine: >440 (dog), >440 (cat);
SDMA: >54 (dog), >38 (cat);
severe clinical signs and risk of uraemic crisis
stage 4