35. Chronic kidney diseases in dogs and cats. Nephrosis syndrome

Question 1

When is kidney disease considered chronic

Answer 1

after 3months

Question 2

Predisposed to CKD

Answer 2

Cat > dogs

Question 3

Pathophys of CKD

Answer 3

Chronic decrease in number of functioning nephrons —> decreased GFR

Question 4

How does CKD usually start in DOG

Answer 4

glomerulopathy

Question 5

How does CKD usually start in CAT

Answer 5

tubulointerstitial nephritis

Question 6

what are glomulopathies

Answer 6

Hypercoagulability
Hyperlipidaemia
Proteinuria

Question 7

How does the loss of functional nephrons lead to CKD

Answer 7

The remaining nephrons undergo hyperfiltration —-> glomerulosclerosis —> decreased GFR —> proliferation of fibroblasts and inflammatory cells

Question 8

Clinical signs of CKD

Answer 8

PU/PD
Thrombosis
Inappetence
Poor Coat
Weight loss
Anaemia
Dehydration
CNS Signs
Respiratory signs
GI signs
Immunosuppression
Inactivity
Hypertension consequences

Question 9

Stage 1 of CKD

Answer 9

No azotaemia
Normal Creatinine

Question 10

Stage 2 of CKD

Answer 10

Mild azotaemia
Normal/ mildly elevated creatinine

Question 11

Stage 3 of CKD

Answer 11

Moderate azotaemia

Question 12

Stage 4 of CKD

Answer 12

Severe Azotaemia

Question 13

Basis of management of CKD

Answer 13

Eliminate cause
Treat symptoms
Prolong quality of life
Lifelong management
Application of drugs
Palatibility of diets

Question 14

How to prolong survival in case of CKD

Answer 14

renal diet
decrease phosphorus
Improve appetite
Maintain BCSs
Decrease proteinuria
EPO treatment
Correct BP (amlodipine)

Question 15

Renal Diet

Answer 15

Decreased; protein but increase quality, phosphorus
Increase omega 3, K, Vit B

Question 16

If the control of water in the body is not functioning then the result is

Answer 16

PU/PD

Question 17

If the control of electrolytes is not functioning then the result is

Answer 17

Hypo/er kalaemia, Na, Cl

Question 18

If the control of pH is not functioning then the result is

Answer 18

metabolic acidosis

Question 19

If the control of Ca, P, Mg is not functioning then the result is

Answer 19

Hyper phosphataemia, Ca, Mg

Question 20

If the excretion of endogenous waste is not functioning then the result is

Answer 20

azotaemia
uraemia

Question 21

If the erythropoeitin production is not functioning then the result is

Answer 21

anaemia

Question 22

If the elimination of drugs is not functioning then the result is

Answer 22

decreased drug metabolism

Question 23

If the blood pressure control is not functioning then the result is

Answer 23

hypertension

Question 24

Glomerular diseases

Answer 24

glomerulopathy is aka proteinuria
the glomerular wall retains negative proteins (albumin)
Smaller proteins (+ve) pass through the glomerular wall

Question 25

Causes of glomerulopathies

Answer 25

immune complex GN in situ immune complex formation non immune complex NG Amyloidosis Hydronephrosis

Question 26

Immune complex gn

Answer 26

glomerular deposition of immune complexes due to extrarenal disease - leishmania - anaplasma - ehlichia - lymes - neoplasia - inflammation

Question 27

In situ immune complex formation

Answer 27

usually against glomerular basement membrane

Question 28

Non immune complex GN

Answer 28

congenital hypotension; gcc; toxins glomerulosclerosis

Question 29

Amyloidosis

Answer 29

Extracellular deposition of amyloid in the kidneys and other organs.

Question 30

Clinical signs of Amyloidosis

Answer 30

signs of lower uti fever painful kidneys depression anaemia CKD signs

Question 31

Types of Amyloidosis

Answer 31

Aquired - underlying inflammatory/ neoplastic disease Congenital - sharpei, abyssinian cats

Question 32

Diagnosis of Amyloidosis

Answer 32

Lab D - leukocytosis, bacteria in urine Imaging - dialted pelvis Bacteria in renal pelvis Bacteria in inflammatory lesions in renal biopsy

Question 33

Treatment of Amyloidosis

Answer 33

Long term AB Eliminate predisposing factors Nephrectomy

Question 34

Hydronephrosis

Answer 34

dilation of renal pelvis due to outflow obstruction

Question 35

Clinical signs of Hydronephrosis

Answer 35

Pain renal enlargement Signs of CRF

Question 36

Diagnosis of Hydronephrosis

Answer 36

US Excretory urography

Question 37

Treatment of Hydronephrosis

Answer 37

Surgery Relieve obstruction Nephrectomy

Question 38

cause of Nephrotic syndrome

Answer 38

Severe glomerulopathy --> severe proteinuria ---> severe hypoalbuminaemia --> nephrosis syndrome

Question 39

4 criteria of Nephrotic syndrome

Answer 39

Proteinuria Hypoalbuminaemia Hyperlipidaemia Extracellular fluid accumulation

Question 40

Lab D of Nephrotic syndrome

Answer 40

Persistent, severe proteinura Normal urine sediment Normal kidney parameters Hypoalbuminaemia Hypercholesteraemia UPC ration

Question 41

Diagnosis of Nephrotic syndrome

Answer 41

Renal biopsy Urine electrophoresis

Question 42

Treatment of Nephrotic syndrome

Answer 42

Decrease proteinuria immunosuppression amyloid prevention

Question 43

Standard treatment of proteinuria

Answer 43

Renal diet Omega 3 Inhibition of RAS (enalapril, telmisartan) Antihypertensive treatment (amlodipin) Antiplatelet treatment anticoagulant treatment (aspirin)