What are the risk factors associated with FIC?
IF a patient is fluid overload, will you see edema form before or after there is organ damage?
A dog or cat w/ AKI may have an elevated anion gap which is indicated by an anion gap levels > ?
Abnormal function of the glomerulus often presents with what clinical finding?
Which two breeds are congenitally pre-disposed to GN?
terriers & french bulldogs
When reading a urine dipstick, which measures are not accurate?
What factors affect the urine dipstick results the most?
SG, nitrites, urobilinogen, leukocytes
moisture, alkaline urine, discolored urine
What environmental considerations are important for tx of FIC?
food & water
social interactions: people & other cats
What are the benefits of fluids to a patient with CKI?
What are the considerations for UTI tx w/ abx?
What biochem changes might be observed with AKI?
An owner reports a dog is drinking more. How can you tell it is polyuria?
A dog present with the following signs. DDX?
What factors can affect UPC and not affect UPC?
What is the SG values for isosthenuric/hypo/hypersthenuric urine?
What are the management principles for AKI?
What tx could be used for FIC that may be beneficial but no strong evidence supports their use?
feliway to reduce STRESS & aggressive social interactions
Tricyclics (Amitriptyline)- antidepressants w/ anti-inflammatory effects** (avoid rebound inflammation when quickly remove)
GAG (human evidence altered in UT- helps HIC)
steroids/NSAIDS/analgesics- good for pain
muscle-relaxants, anti-spasmodic, paralytics
If a cat presents with FIC, what would be the best method of approach?
Wait for 2-7d as most cases spontaneously resolve (80-90%)
only 39-55% have a recurrence
What drug is a parasympathomimetic that can be used to stimulate detrusor cx?
When is the drug CI?
CI if there is a urethral obstruction
What happens when 2/3 fxn mass kidney loss? 75%?
lose fluid control
decreased excretion of BUN/CRE
What clinical actions should be taken w/ regards to UPC levels based on IRIS?
What two things does IRIS include in subtype staging that are associated w/ progression of CKI?
Describe the neurological control of the storage (filling) phase.
The hypogastric (lumbar; sympathetic) stimulates b-R to cause relaxation of the bladder & a-R to stimulate the internal sphincter to cx and hold it closed
pudendal n. - voluntary control
Why does uremic gastritis develop in AKI? Tx?
A young male DSH presents for dysuria, pollakiuria, and periuria for the first time. What would be the best first step DX? What if this was a recurrent problem/complicated case?
UA w/ sediment
If complicated: Chem/CBC, U/S, +/- contrast urethrocystography/urethrocytoscopy (females)/biopsy
Which signs are/are not typically associated w/ FLUTD?
NOT associated is PU/PD
What is the neuro pathway of voluntary sensory and motor voiding of the bladder?
sensory: distension is sensed by the pelvic n. & pain/over-distension- hypogastric n.
motor: pons- spinal cord-sacral- pelvic n. (parasympathetic)- activate via Ach detrusor muscle
A cat is DX via exclusion w/ FIC. When would if be appropriate to not treat the cat?
NO tx: benign neglect if:
episodic (w/ short duration)
What results would you expect if you spun down urine and blood looking to differ betw/ blood/Hgb/Myogb?
Is clavamox a good abx to tx E.coli UTI?
use amikacin which is also effective against staph
Infectious causes of AKI are more common in dogs or cats? What about urinary obstructions?
When performing a excretory urogram, what does it help with diagnosing UTI?
Proposed pathophysiology for FIC?
In what state does SG need to be evaluated to make a determination of pre-renal?
Describe the P-binder available for CKI?
To classify as pre-renal in a dehydrated state the SG for dog & cat must be >/equal to ??
What is the tx for USMI?
What are the three options for tx a mixed infection for UTI?
What are the stages of AKI?
Name most common urinary bacteria?
How is fluid load defined?
>10% increase in BW from baseline
A cat is dx w/ FIC. You tell the owner that there is a cure and the cat will be fine. T/F
there is no cure
focus on decrease frequency & severity of signs & reduce the risk of obstruction
What does the staging system for AKI- RIFLE stand for?
End Stage Renal DZ
What is the most common cause of FLUTD?
Feline Idiopathic cystitis (FIC)
>50% all FLUTD
~64-69% of non-obstructive FLUTDs
(rare for cat to have a UTI- not as common as you would think)
For AKI, what is the normal urine output (mg/kg/hr), oliguric, anuric?
What is the difference in diagnostic intervention for proteinuria alone or +/- other conditions from IRIS?
What structures does an excretory urogram evaluate?
What structures does cystoscopy evaluate?
What are the parts of nephrotic syndrome?
proteinuria, hypoAL, hyperchol, edema +/- azotemia
What uremic complications do we want to avoid by starting dialysis early?
What considerations are important for cats w/ FIC?
canned food - want the cat to increase its water consumption anyway possible
prescription diet may help to improve symptoms (struvite prevention important for obstructive cases)
What are the key things to keep in mind regarding IRIS staging of CKI?
What are the target levels of pH/HCO3 for animal w/ CKI? How would you tx MA?
How would you dx an ectopic ureter?
What might the bloodwork show CBC/Chem for a dog w/ UTI?
How would a cat present w/ FIC?
non-specific signs of LUTD
few systemic signs (unless obstructed- aka spasm or urethral plugs)
How do you tx a physical urinary obstruction?
In non-azoemic dogs/cats, what levels of CRE would you monitor, investigate, and intervene?
In azotemic dogs/cats, what levels of CRE would you monitor, investigate, and intervene?
increase frequency & small volume
How to the C.S. differ for LUTD vs. UUTD?
What is the cause suggested for USMI?
How would you tx an ectopic ureter that is intramural? Extramural?
DDX if a animal is having stranguria, pollakiuria, and hematuria?
What measure reqs. are used to IRIS staging of CKI?
What two animals a pre-disposed to amyloidosis?
Abyssinians & Sharp pei
How would you tx detrusor spasticity?
tx the underlying cause
enhance relaxation (use anti-cholinergic drugs)
How can you dx between urethral spasm & obstruction?
place a urinary catheter
How do you differ AKI from CKI?
AKI vs. CKI
>50% CKI cases are caused by what?
Storage disorder are/are not associated with stranguria e/c in the two cases of ...
ARE NOT unless:
if destrusor instability- may have frequent small urinations but not stranguria
other factors of storage disorders can put a patient at risk for UTI- perform urine culture
What is the tx for urethrospam?
What are the potential different inciting causes of renal AKI?
What is the basic tx for detrusor atony?
address underlying cause (neurogenic vs. non-neuro obstruction)
keep the bladder small & re-establish tight jxns
stimulate detrusor cx (parasympathomimetic)
How would you control hypertension in a dog vs cat w/ CKI?
What UA results would you expect w/ AKI?
What changes in CRE and urine production indicate AKI?