Urinary

Question 1

What are the features of acute renal failure?

Answer 1

Good body condition
Enlarged kidneys
Severe clinical signs related to bloodwork
Normal to increase PCV
Normal to increase K
More severe metabolic acidosis

Question 2

What are the features of chronic renal failure?

Answer 2

Poor body condition
Small kidneys
Mild clinical signs related to bloodwork (BUT higher BUN and creatinine)
Nonregenerative anemia
Normal to decrease K
Less severe metabolic acidosis
Long standing PU/PD

Question 3

Renal aplasia/agenesis

Answer 3

Absence of one or both kidneys

Question 4

Renal hypoplasia

Answer 4

Kidneys smaller than normal (contralateral one may be hyperplastic)

Question 5

Horseshoe kidney

Answer 5

Kidneys fused at pole (normally function fine)

Question 6

What is PKD? What breed does it mainly affect?

Answer 6

Polycystic kidney disease

Persian cats (also Himalayans, British Shorthairs)

Question 7

How is PKD inherited in this breed?

Answer 7

Autosomal dominant defect in PKD1 gene

Question 8

When do animals typically exhibit evidence of renal dysfunction and renal failure in PKD?

Answer 8

Renal dysfuntion: 3-10 years of age

Renal failure: > 7 years of age

Question 9

What are the lesions of PKD?

Answer 9

Lots of cysts on the kidney

Sometimes get hepatic cysts

Question 10

From what part of the nephron do cysts develop in PKD?

Answer 10

Can arise from ANY segment of nephron

Question 11

What shape are renal infarcts and why are they this shape?

Answer 11

Wedge shaped

Because the kidney blood supply shapes wedges

Question 12

Administration of which drugs is associated with papillary necrosis?

Answer 12

NSAIDS

Question 13

What is the pathogenesis of papillary necrosis?

Answer 13

NSAIDS prohibit PGE2 –> PGE2 isn’t there to vasodilate the arterioles in juxtamedullary nephrons (by pelvis) –> infarct and ischemia occurs

Question 14

What do hydronephrosis and hydroureter occur secondary to?

Answer 14

Obstruction

Question 15

What structures can be altered in GN?

Answer 15

Basement membrane
Mesangial cells
Mesangial matrix
Immune complex deposition

Question 16

What is the pathogenesis of immune complex GN?

Answer 16

Circulating immune complexes deposited in glomerular basement membrane OR antibodies formed against glomerular basement membrane –> complement fixation and leukocyte infiltration –> production of inflammatory mediators –> filtration barrier compromised –> protein loss

Question 17

What are conditions commonly associated with immune complex GN?

Answer 17

Chronic inflammatory stimuli:

Viral diseases
Chronic bacterial infection
Parasitic and protozoal disease
Autoimmune disease
Neoplasms

Question 18

Are underlying conditions often identified at the time the animal is symptomatic for renal disease in immune complex GN?

Answer 18

NO

The initial inciting cause is often not determined

Question 19

What is the urinalysis finding that is most suggestive of glomerular disease? What is the most sensitive way to measure it?

Answer 19

Proteinuria (WITH absence of hemorrhage or inflammation)

Urine protein to urine creatinine ratio

Question 20

What type of amyloid is most commonly present in glomerular amyloidosis?

Answer 20

Serum amyloid A (SAA), an acute phase protein associated with chronic inflammation

Question 21

Which animals have systemic reactive amyloidosis?

Answer 21

Most commonly in Shar Pei’s and Abyssian cats, but has been described in multiple breeds

Question 22

What histochemical stain would you use to confirm material in the glomeruli is amyloid?

Answer 22

Congo red

Question 23

What effect does amyloid deposition have on glomeruli and what does this lead to?

Answer 23

Decreases function of filtration barrier

Leads to progressive renal insufficiency and proteinuria

Question 24

What happens to tubules with significant glomerular disease?

Answer 24

They get damaged

Vacuolization and necrosis

Question 25

Where in the kidney do bacteria most commonly lodge in septicemic processes?

Answer 25

Glomerular and peritubular capillaries (so mostly in the cortex)

Question 26

Which bacteria most commonly cause embolic glomerulitis in horses? In pigs? In cattle?

Answer 26

Horses: Actinobacillus equuli Pigs: Erysipelothrix rhusiopathiae Cattle: Trueperella pyogenes

Question 27

What causes ischemic tubular necrosis?

Answer 27

Hypotension (shock)

Question 28

Which part of the nephron is most significantly affected in ischemic tubular necrosis?

Answer 28

Primarily proximal tubules (have the highest energy)

Question 29

Can basement membranes be preserved in ischemic tubular necrosis, and why is this important?

Answer 29

Yes if it's not severe, so the tubules can regenerate

Question 30

Which part of the nephron is most significantly affected by nephrotoxic acute tubular necrosis?

Answer 30

Proximal tubules

Question 31

Can basement membranes be preserved in nephrotoxic acute tubular necrosis, and why is this important?

Answer 31

Yes, so the tubules can regenerate Better chance of preservation than ischemic tubular necrosis

Question 32

What is pyelonephritis? How do these infections typically reach the kidney?

Answer 32

Inflammation of renal pelvis and parenchyma Results from ascending infections from lower urinary tract infection

Question 33

What are the histologic lesions in pyelonephritis, and which portions of the kidney are most severely affected?

Answer 33

Neutrophils Renal tubules

Question 34

What is the kidney worm in swine, and where is the worm located?

Answer 34

Stephanurus dentatus Located in renal pelvis

Question 35

Which species are affected by Dioctophyma renale?

Answer 35

Piscivorous mammals (mink, dogs, cats)

Question 36

Where are the Dioctophyma renale worms located?

Answer 36

Renal pelvis

Question 37

What are the lesions associated with Dioctophyma renal?

Answer 37

Progressive destruction of renal parenchyma

Question 38

What is the most common primary renal tumor in pigs? Dogs? Cattle? Horses?

Answer 38

Pigs: Nephroblastoma Dogs: adenocarcinoma Cattle: adenocarcinoma Horses: adenocarcinoma

Question 39

What is an ectopic ureter?

Answer 39

Ureters empty where they're not supposed to: bladder neck, urethra, vagina, vas deferens, seminal vescicles

Question 40

What is a patent urachus? In which species is it most common?

Answer 40

Failure of closure of the urachral lumen, resulting in dribbling urine Most common in foals

Question 41

What are predisposing factors for urolithiasis?

Answer 41

``` Urine pH (precipitation) Water intake Hereditary factors (dalmatians) Dietary factors UTIs ``` Males more likely to obstruct

Question 42

What are predisposing factors for cystitis?

Answer 42

``` Female Loss of normal voiding mechanisms Loss of acidic urine pH (carnivores) Glucosuria Proteinuria Mucosal trauma ```

Question 43

What is the cause of enzootic hematuria?

Answer 43

Chronic ingestion of bracken fern

Question 44

What lesions are seen in enzootic hematuria?

Answer 44

Mature cattle with persistent hematuria with hemorrhage and/or neoplasms in lower urinary tract

Question 45

Where do transitional cell carcinomas most commonly occur?

Answer 45

Bladder neck and trigone

Question 46

What are common presenting clinical signs for TCCs?

Answer 46

Straining to urinate Hematuria UTI