Vomiting 2 & 3 (Duke) Flashcards
What are 2 acronyms helpful for generating DDx?
DAMNIT
DINAMITE
What does DAMNIT stand for?
Degenerative, developmental
Autoimmune
Metabolic, mental (behavior)
Neoplastic, nutritional
Infections, inflammatory, idiopathic
Toxic, trauma
What does DINAMITE stand for?
Degenerative, developmental
Infectious, inflammatory
Neoplastic, nutritional
Autoimmune
Metabolic
Idiopathic
Toxic, trauma
Endemic, epidemic, exotic
What are granular casts?
Protein and cell debris released into the urine - can be indicative of renal disease
With renal azotemia, _____ and ____ are high because at least ___% of the nephrons in the kidney are _____.
BUN, Creat, 70, nonfunctional
What do the kidneys look like in acute renal injury?
Normal to enlarged
What is the urine output in acute renal injury?
Oliguric to anuric
What type of azotemia is involved with acute renal injury?
renal
What do the kidneys look like in chronic renal failure?
Small, irregular, firm, fibrotic
What is the urine output in chronic renal failure?
Polyuria (and polydypsia)
What type of azotemia is associated with chronic renal failure?
renal
What additional changes might be associated with chronic renal failure in an animal that is having vomiting and diarrhea?
Anemia, weight loss, hyper PTH, etc.
if the kidney is swollen and pale, there is evidence of _____.
acute renal injury
Why does bradycardia occur in animals with renal failure?
Due to hyperkalemia, hypocalcemia
Identify the lesions.
What is the pathogenesis for ethylene glycol toxicity?
- Ingestion –> rapid absorption in GIT –> unmetabolized EG causes ethanol type effects on brain, 20-50% of total EG gets excreted by the kdineys unchanged.
- Ingestion –> rapid absorption in GIT –> (ADH) –> glycoaldehyde –> (Ox) –> glycolic acid –> renal tubular injury –> ARF
- Ingestion –> rapid absorption in GIT –> (ADH) –> glycoaldehyde –> (Ox) –> glycolic acid –> (Ox) –> glyoxylic acid –> oxalate –> Ca Oxalate crystals form and accumulate in tubules –> crystals plug and damage tubules –> ARF
- Ingestion –> rapid absorption in GIT –> (ADH) –> glycoaldehyde –> (Ox) –> glycolic acid –> (Ox) –> glyoxylic acid –> oxalate –> renal tubular injury –> ARF
How much ethylene glycol can cause disease in a dog? In a cat?
Dog = 15 mls (1 tbsp)
Cat = 5 mls (1 tsp)
What is stage 1 of ethylene glycol toxicity?
(30 min - 12 hours PI)
Ataxia, hypersalivation, vomiting, seizures, PU/PD
What is stage 2 of ethylene glycol toxicity?
(12-24 hours PI)
Clinical signs seem to resolve, but severe internal injury is happening, dehydration, tachycardia, tachypnea
What is stage III of ethylene glycol toxicity?
(12-24 hours PI in cats, 36-72 hours PI in dogs)
Severe acute kidney injury secondary to calcium oalate crystalluria, anorexia, lethargy, coma, vomiting, seizures
What is the prognosis for ethylene glycol toxicity?
Poor to ugly with increasing time from ingestion to treatment
