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Small Animal Disease Conditons > Urinary Tract Disease > Flashcards

Urinary Tract Disease Flashcards

1
Q

Functions of the Urinary Tract

A

Filters waste from the blood and excretes it as urine.

Maintains extracellular fluid (ECF) balance in the body.

Balances nutrients. I.e. Minerals.

Produces the hormone erythropoietin which stimulates the bone marrow to produce red blood cells.

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2
Q

Nephritis

A

Inflamation of the kidneys

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3
Q

Glomerulonephritis

A

Glomerulonephritis, also known as glomerular nephritis (GN), refers to inflammation of the glomeruli (individual units within the kidneys that filter the blood) – they may become inflamed for various reasons and if prolonged this can lead to CKD

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4
Q

Pyelonephritis

A

A bacterial infection of the kidneys, which are part of the upper urinary tract. Infection is more common in middle-aged or older dogs. Often pyelonephritis starts from bacteria in the bladder that spread upwards to the kidneys.

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5
Q

Interstitial nephritis

A

Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed).

Can be chronic or acute, whihc can be caused by side effects of certain drugs.

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6
Q

Renal insufficiency

A

damaged kidney can still process waste, clinical signs not yet evident.

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7
Q

Renal failure

A

damage increases to point where waste cannot be processed (~75% nephrons damaged), clinical signs become apparent.

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8
Q

What happens in the diseased Kidney?

A

Decreased renal function interfering with the kidneys ability to maintain fluid and electrolyte homeostasis.

Decrease in the ability to concentrate urine early on.

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9
Q

GFR

A

Glomerular Filtration Rate

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10
Q

Azotaemia (Uraemia)

A

Increase of nitrogenous waste products, creatinine and urea (BUN).

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11
Q

What can Azotaemia (Uraemia) be classed as?

A

Pre-Renal – Dehydration, shock.

Renal – Nephrotoxins, glomerulonephritis

Post-Renal – Urinary obstruction, trauma.

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12
Q
  • % of kidney function needs to be lost before urea and creatinine levels raise to significant levels to be detected in bloods
A

70%

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13
Q

AKD

A

Acute kidney disease

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14
Q

ARF

A

Acute renal failure

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15
Q

CKD

A

Chronic kidney disease

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16
Q

CRF

A

Chronic renal failure

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17
Q

Aetiology: Acute Kidney Disease

A

Reduced blood flow to the kidneys.

Cell damage of the kidneys.

Post-renal obstruction.

Acute exacerbation of chronic renal failure.

18
Q

Clinical Signs: Acute Renal Failure

A

Sudden onset:
Anorexia
Lethargy
Depression

Oliguria/Anuria -> Polyuria
Vomiting
Diarrhoea
Polydipsia
Dehydration
Uraemic breath

19
Q

Diagnosis: Acute Renal Failure

A

Blood test: Haematology and biochemistry.

Urinalysis: Specific gravity, dipstick and sediment examination.

Radiography

Ultrasonography

20
Q

Treatment: Acute Renal Failure

A

Treatment of the underlying cause - often not possible to treat the actual disease

Mainly supportive:
Fluid therapy
Diuretics – Frusemide
Antiemetics
Dialysis

21
Q

Aetiology: Chronic Kidney Disease

A

Once kidneys are no longer able to compensate the animal presents with signs of renal failure.

Idiopathic deterioration in geriatric cats – most common.

Acute renal failure i.e. injury or toxin

Pyelonephritis

Glomerulonephritis

Congenital/hereditary disease – polycystic kidney disease

Concurrent condition – Diabetes mellitus, hypertension.

22
Q

Pathophysiology: Chronic Renal Failure

A

The kidney is unable to filter nitrogenous waste from the blood leading to uraemia

Deterioration in renal function causes pH and electrolyte imbalance (potassium and phosphate)

Reduced production of erythropoietin leads to reduced erythrocyte formation in the bone marrow

23
Q

When do signs of renal failure appear?

A

Reserve capacity of kidneys means signs of renal failure only appear when 2/3-3/4 of functioning tissue is lost

24
Q

Clinical Signs: Chronic Kidney Disease

A

Polyuria Polydipsia Depression

Oral ulcers Halitosis Seizures

Anaemia Anuric Vomiting

Inappetence/Anorexia Dehydration

Weight loss

25
Q

Diagnosis: Chronic Kidney Disease

A

History
Clinical signs
Physical examination
Urinalysis – Specific gravity/dipstick.
Blood test
Blood pressure
Radiography
Ultrasound
Determine cause and extent of azotaemia

26
Q

CKD Diagnosis: Blood Tests

A

Elevation in urea and creatinine in plasma.

Check electrolytes.

SDMA testing.

27
Q

SDMA blood testing

A

Symmetrical Dimethylarginine (SDMA)

28
Q

CKD- Diagnosis: Urinalysis

A

Urine specific gravity. Less than 1.035 is suggestive.

Identifies loss of concentrating ability.

Declining USG raises suspicions.

Urine protein levels

Presence of blood and infection should be ruled out.

29
Q

CKD - Kidney Staging:

A

International renal interest society. (IRIS)

Stages 1 to 4.

Staging allows us to generate an appropriate treatment/monitoring plan for the patient.

Based on:

Creatinine - Needs to be repeated twice on different occasions.
Proteinuria
Blood pressure

30
Q

CKD - Treatment

A

Fluid therapy.
Diet.
Drugs. i.e Antibiotics
Restriction of phosphate. i.e phosphate binders, potassium supplementation.
Managing hypertension. i.e. amlofipine
Anaemia. i.e. Nandralone, erythropoietin.
Monitor urine infections.
Manage anorexia and vomiting.

31
Q

Aetioloy: Lower Urinary Tract Disease

A

Infection
Calculi/crystals
Neoplasia
Trauma
Iatrogenic
Neurogenic
Concurrent disease. i.e. Diabetes Mellitus
Idiopathic – Most common.

32
Q

Iatrogenic

A

a potential complication of surgical procedures performed in or around the retroperitoneal abdominal space or pelvis.

33
Q

Neurogenic

A

abnormal function of either the bladder, bladder neck, and/or its sphincters related to a neurologic disorder

34
Q

Lower Urinary Tract Disease Clinical Signs:

A

Cystitis – pollakuria, dysuria, haematuria
Pain
Blockage – oliguria, anuria
Incontinence
Varying frequency/volume of urine
Abnormal micturition – weak and interrupted
Licking external genitalia
Depression
Vomiting
Anorexia
Dehydration

35
Q

Urolithiasis – FLUTD

A

Affecting the lower urinary tract of the cat.

Can be multi-factor in origin.

36
Q

FLUTD - meaning

A

Feline lower urinary tract disease.

37
Q

Aetiology: FLUTD

A

Idiopathic cystitis.
Urolithiasis (stones)
Crystals (Urethral plug)
Infection – very rare.
Multicat household – Stress can trigger.
Underactive, overweight, neutered cats.

38
Q

Pathophysiology: FLUTD

A

rritation/inflammation of the bladder wall/urethra.

May get recurrent bouts of cystitis.

Uroliths or urethral plugs may cause urinary obstruction – complete obstruction is an emergency!!

Trauma/iatrogenic damage may result in bladder wall dysfunction or rupture of the urinary tract.

Inability to void urine leads to azotaemia and signs associated with Acute Renal Failure (ARF)

39
Q

FLUTD Diagnosis:

A

History
Clinical signs
Observation of micturition
Neurological examination
Urinalysis – Visual, dipstick, microscopy, culture, specific gravity
Radiography
Ultrasound
Bloods – Haematology and biochemistry.

40
Q

FLUTD treatment-

A

Treat the cause.

Clear blockages:
Catheterisation
Sterile saline
Cystocentesis

Increase water intake.
Resolve any toileting problems. I.e. Litter trays.
Antibiotics, anti-inflammatories, analgesia
Diet modification
Phermones

Small Animal Disease Conditons (17 decks)

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