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Equine Medicine and Surgery > Lecture 27: Medical diseases of equine renal and urinary systems > Flashcards

Lecture 27: Medical diseases of equine renal and urinary systems Flashcards

(78 cards)

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1
Q

What is function of renal system

A

Excrete nitrogenous waste and control fluid and ion balances

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2
Q

How much water should horse consume/ day

A

60-65ml/kg/day- 23L or 6 gallons ~5% BW

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3
Q

What is the GFR per day in horse

A

2ml/kg/min-1400L/day- 370 gallons

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4
Q

What does the proximal tubule absorb

A

Glucose, amino acids, electrolytes and water

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5
Q

Urine becomes more ___in Loop of henle

A

Concentrated

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6
Q

What part of LOH is permeable to water, but impermeable to solutes

A

Descending limb

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7
Q

What part of LOH is impermeable to water, but permeable to solutes

A

Ascending

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8
Q

Where does furosemide block

A

NaKCC in ascending loop of henle

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9
Q

What does distal tubule secrete

A

Calcium, potassium and acid

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10
Q

What channel does water leave through in collecting duct and what hormone controls it

A

Aquaporins controlled by ADH

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11
Q

What is USG for hyposthenuria

A

<1.008, very dilute

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12
Q

What is USG for isothenuria

A

1.008-1.014

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13
Q

What is the USG for concentrated urine

A

1.025-1.050

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14
Q

Foals urine should be ___

A

Hyposthenuria

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15
Q

Chronic renal failure produces USG of ___

A

1.008-1.025

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16
Q

What is the normal pH of urine

A

7-9

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17
Q

Paradoxical aciduira is seen with ___

A

Hypokalemia, hypochloremic metabolic alkalosis

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18
Q

What urine protein: creatinine ratio is too high

A

> 2:1

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19
Q

Glucose should be ___in urinalysis

A

Negative

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20
Q

What test can you run for myoglobin

A

Ammonium sulfate precipitation

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21
Q

What is bilirubin associated with

A

Intravascular hemolysis, hepatopathy

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22
Q

Pyrua has a WBC > ___

A

10

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23
Q

Hematuria has a RBC > __

A

5

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24
Q

What tests do you run if PU/PD patient signlament is consistent with PPID or EMS

A

ACTH, insulin, glucose

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25
What challenge/test can you run for PU/PD diagnostic, how does it work and what are some possible results
Water deprivation test Normal renal function USG>1.045 Concentrated urine- psychogenic polydipsia Noncentrated: run vasopressin tests
26
What is acute renal failure classified by
abrupt decrease in GFR associated with failure to excrete nitrogenous wastes causing azotemia, electrolyte imbalances, acid base disturbances
27
What are some causes of acute renal failure
1. Decreased renal perfusion- hypovolemia (Pre renal, or ischemic) 2. Acute tubular necrosis (NSAIDS) 3. Interstitial nephritis or glomerulonephritis 4. Post renal- elevated creatinine
28
What condition in foals can cause post-renal ARF, elevated creatinine in peritoneal fluid
Bladder rupture
29
What is anuria
No urine
30
What is oliguira
Decreased urine
31
What are some clinicopathologic findings associated with ARF
Increase BUN, creatinine
32
What % of nephrons have lost function before azotemia is noticing
75%
33
What test is a sensitive early maker or declining GFR
SDMA
34
What electrolyte imbalances are seen with ARF
Hyponatremia, hypochloremia, hypocalcemia, hyperphosphatemia, metabolic acidosis
35
What is tx for ARF
1. Fluids- saline or balanced electrolyte solution 2. Furosemide
36
If hypernatremic in ARF what can you give
Dextrose
37
What is the most important prognostic indicator for ARF
Duration of ARF and if continue oliguria
38
What is prognosis for creatinine <5 and >10
Less than 5- good >10 grave
39
What are some characteristics of CRF
Loss of ability to concentrate urine, retain metabolic waste, alterations in electrolytes, acid-base
40
What are some causes of CRF
1. Congenital anomalies 2. Acquired: glomerulonehrphitis or interstitial nephritis caused by immune complex deposition 3. Glomerular tubular injury: NSAIDs, hypoperfusion
41
What are some signs of CRF
Ill-thrift, weight loss, ventral edema, PU/PD, poor athletic performance, excess dental tartar, uremic breath
42
What is the USG of CRF
Isothenuria 1.008-1.012
43
What are the classic electrolyte disturbances associated with CRF
Hyponatremia, hypochloremia, hyperkalemia, hypercalcemia, hypophosphatemia
44
How can you manage CRF
1. Short term IV fluids 2. Avoid alfalfa 3. Encourage appetite 4. Vitamin E and C 5. Omega 3 fatty acids
45
T or F: diuretics are useful in CRF
False
46
What is the expected lifespan in CRF for creatinine <5, 5-10 and >10
<5: >18 months 5-10 <18 months >10 days to weeks
47
Case example: 20yr Morgan gelding presented with urine dribbling for weeks to months, 8/9 BSC what are some differentials
Neurological disease, urolithiasis/cystitis, congenital, trauma, tail injections, neoplasia
48
What does the pudenal nerve innervate
Striated muscle of urethra
49
What does hypogastric nerve supply
Sympathetic nerve supply
50
What does pelvic nerve supply
Parasympathetic nerve supply
51
Contraction of bladder is controlled by __nerve supply
Parasympathetic
52
What are some signs of lower motor neuron bladder
Loss of detrusor function, dribbling, large easily expressible bladder, loss of anal and tail tone
53
What are some signs of upper motor neuron bladder
Initially increased urethral resistance, turgid bladder (colic)
54
What are 2 causes of sabulous urolithiasis
1. Secondary to neurogenic bladder 2. Primary sabulous accumulation secondary failure to empty
55
What is prognosis for sabulous urolithiasis
Grave
56
Patients with sabulous urolithiasis usually prevent with ___
Incontinence/dribbling
57
What is tx for sabulous urolithiasis
Removal with 0.25% acetic acid, bethanecol, phenoxybenzamine
58
What does bethanecol do to tx incontinence
Improve destrusor function
59
What does phenoxybenzamine do to tx incontinence
Decrease urethral tone
60
What is the top differential diagnosis for Hematuria
Urolithiasis/cystourolithaisis- usually associated with exercise
61
What are some clinical signs of urolithiasis/ cystourolithiasis
Hematuria with exercise, normal renal function with chemistry and urinalysis
62
What urinary stones are yellow-green speculated, easily fragmented
Calcium carbonate
63
What urinary stones are gray white smooth, resistant to fragmentation
Calcium carbonate phosphate
64
Renal idiopathic Hematuria is common in what breed
Arabians
65
What are some signs of renal idiopathic Hematuria
Clots of blood in urine, endoscopic exam reveals clots of blood in 1 or both ureters
66
What is the most common urinary tract neoplasms
Urethral and external genitalia tumors
67
What is the tx for renal neoplasms
Remove kidney
68
What is the most common complaint for bladder neoplasms
Hematuria
69
What is the most common bladder neoplasm in horses
Squamous cell carcinoma
70
Pyelonephritis and ureteritis are associated with upper or lower urinary tract infections
Upper urinary tract
71
Which is a life threatening urinary tract infection: upper or lower
Upper
72
Is cystitis and urethritis associated with upper or lower urinary tract infections
Lower
73
What breed is genetically predisposed to renal tubular necrosis
Fresians
74
What is the inciting cause of renal tubular necrosis
Drugs- SMZ, antibiotics
75
What clinical pathologies are associated with renal tubular acidosis
Decreased bicarbonate, hyperchloremia, metabolic acidosis
76
What is the distal type I renal tubular acidosis
Can’t secrete H+
77
What is the proximal type II renal tubular acidosis
Can’t reabsorb bicarbonate
78
What is tx for renal tubular acidosis
Bicarbonate IV, potassium supplementation, sodium bicarbonate PO (baking soda)

Equine Medicine and Surgery (27 decks)

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