Clinical Evaluation of Urine Concentrating Ability and Azotemia

Question 1

Normal BUN is:

Answer 1

5 – 20 mg/dl

Question 2

Normal Creatinine is:

Answer 2

0.6 – 1.6 mg/dl

Question 3

Young healthy animals should not have a creatinine over ___

Answer 3

1 mg/dl

Question 4

Does ‘Normal’ BUN and Creatinine imply normal renal function?

Answer 4

No

Question 5

Small changes in the creatinine may indicate bigger changes in the _______ happening

Answer 5

GFR

Question 6

*66% loss of GFR (33% remaining):

Answer 6

decrease in urine concentrating ability

Question 7

(T/F) Any or all three types of azotemia can exist at the same time in the same patient

Answer 7

True, Like in a blocked cat

Question 8

75% loss of GFR (25% remaining):

Answer 8

increase in BUN and Creatinine

Question 9

80% loss of GFR (20% remaining):

Answer 9

increase in Phosphorus

Question 10

Remember that water follows________

Answer 10

sodium

Question 11

‘Normal’ Urine Concentration:

Answer 11

1.001 – 1.080 (diet, water intake)

Question 12

Isosthenuria:
(no water added/no water removed)

Answer 12

1.007 – 1.015 (300 mOsm/kg)

Question 13

Hyposthenuria:
(body is actively getting rid of free water)

Answer 13

<1.007 (< 300 mOsm/kg)

Question 14

Hypersthenuria (Baruria):

Answer 14

> 1.015 (> 300 mOsm/kg)

Question 15

Drugs that influence Urine Concentration:

Answer 15

steroids, diuretics, phenobarbitol, dextrose, mannitol, IV, SQ, IM, or PO fluids

Question 16

Diseases that influence Urine Concentration:

Answer 16

diabetes (M or I), hyperadrenocorticism, hypoadrenocorticism, hyperthyroidism, liver disease, hypercalcemia, renal disease, psychogenic polydipsia, etc.

Question 17

Are you concerned if you see protein in a isosthenuric sample?

Answer 17

Yes

Question 18

Assessment of Hydration
In juveniles animals their hydration tends to be ___________

Answer 18

overestimated

Question 19

Assessment of Hydration
In elderly animals their hydration tends to be _______________

Answer 19

underestimated

Question 20

If the animal (with Azotemia) is adequately hydrated, it is probably not…….?

Answer 20

Pre-renal Azotemia

Question 21

• Severe dehydration, volume depletion
• GI hemorrhage
• Emaciation
• Young animal

Answer 21

↑ BUN relative to Creatinine

Question 22

• Liver disease (can’t convert ammonia into UREA)
• Anorexia or low protein diet
• Acute massive muscle injury
• Well-muscled animal (Greyhounds)

Answer 22

↑ Creatinine relative to BUN