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66 Cards in this Set
- Front
- Back
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Name the 3 major components of the primary renal panel
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BUN, Creatinine, Urinalysis
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Non-renal + influences on BUN
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Enteric hemorrhage
High Protein Diet Terminal starvation Severe burns Renal dysfunction |
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Non-renal - influence on BUN
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Anorexia
Low protein diets Decreased liver f(x) Polydipsia |
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Adequate Urine concentration- RF
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The minimum urine sprecific gravity that is consistently attained in healthy animals when faced w/a need for water conservation.
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Mechanisms for Prerenal azotemia
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1. Decreased blood flow to the kidneys
2. Increased production of nitrogenous wastes |
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Mechanisms for 2nd Renal azotemia
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1 ADH deficiency : Diabetes Insipidus
2 ADH (tubules refractory) -Cushing's -Hypokalemia -Pyometra (toxins) -Pyelonephritis (toxins) -Hypercalcemia (aquaporins) |
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secondary renal panel
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Electrolytes, Acid-base, cholesterol
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Hypercholesterolemia
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Nephrotic syndrome
Hepatobiliary disease, cholestasis Pancreatitis Diabetes mellitus Cushing's disease Hypothyroidism |
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Complete UA
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Physical, Chemical, Sediment
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Turbidity
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cells, protein, mucus, other sediment (crystals,lipids)
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SSA
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albumin & globulins detection when there is an alkaline urine (pH > 7), confirms presence of non-albumin proteins
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Agarose gel
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Electrophoresis test
Confirms albuminuria, and identifies monoclonal vs. polyclonal globulin patterns |
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Mechanisms for Proteinuria- RF
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1. Hemorrhage!!!
2. Inflammation 3. Pre-renal - Physiologic: transient increased glomerular permeability - Overflow: myoglobin, Hb, lt. chains 4. Primary Renal Disease |
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Ketones
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Acetone
Acetoacetate: detected B-Hydroxybutyrate: primary biologically produced |
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Ketonuria precedes ketonemia
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Doesn't necessarily reflect degree of ketoacidosis
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Glucosuria
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1. Exceeds renal threshold
2. Decrease renal threshold Dogs; 180 Cats: 280 Cows: 100 |
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What does exposure to light do to bilirubin?
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Degrades it and can form a false negative
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Which form is bilirubin excreted?
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conjugated, it is not protein-bound
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Should cats have bilirubin in normal urine?
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No, but dogs can due to their low threshold and the ability to degrade Hb into bilirubin in the tubules.
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Does serum bilirubin increase faster than bilirubinuria?
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No, bilirubinuria will appear first.
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Primary interpretation of bilirubinuria - RF
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Cholestasis, NOT hemolysis
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Occult blood - RF
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Hemorrhage (RBCs), most common
Hemolysis (Hb): serum is discolored Myoglobin: serum is clear |
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Examination of urine sediment
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1. Cells
2.Micro-organisms (bacteria,yeast, macroconidia, fungi) 3.Casts 4. Crystals |
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Casts
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formed in distal tubules, usually Tamm-Horsfall mucoprotein
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Hyaline casts
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clear, round edges
possible proteinuria |
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Granular casts
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tubular degeneration
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Waxy Cast
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clear, sharp, edges, clefts
tubular degeneration |
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RBC Cast
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renal hemorrhage (glom. &/or tubular)
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WBC Cast
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renal inflammation
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Broad cast
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BIg, dilated tubules; severe renal disease
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Amorphous phosphates
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common in dogs (normal)
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triple phosphate (Struvite)
Looks like coffin lid |
can be normal in dogs (cats), or associated w/calculi
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Calcium oxalate, dihydrate form
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can be normal; also in ethylene glycol toxicity
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Calcium oxalate, monohydrate form
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more specific for ethylene glycol toxicity
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Bilirubin crystal
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evaluate the liver panel for cholestasis
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Ammonium urate
Thornapple; Mase |
Can be normal for Dalmatians
Disorders of ammonia metabolism (shunts, liver mass) |
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uric acid
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common in Dalmatians
associated w/altered purine metabolism, gout in man |
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Cholesterol crystal
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may be normal in dogs & cats
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Sulfa-type drugs
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bizarre colored crystals
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How do you identify body depletion of K+? RF
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Hypokalemia w/acidemic
Be careful before giving any insuli, which drives K+ into the cells more |
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Alkalemia with Hypocalcemia dz
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may have hypocalcemia but disguised b/c of the increased binding of Ca++ to albumin
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Hypercalcemia above 13
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Humoral Hypercalcemia of Malignancy
Primary Hyperparathyroidism Vitamin D toxicity Addison's Disease |
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Hypercalcemia mild elevation
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Renal Failure
Various bony lesions (H.O.D, Blasto) |
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Hypocalcemia mild signs
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Hypoproteinemia (Major)
Renal Failure Acute Pancreatitis HypoMg++ (Grass Tetany) Mercury toxicity |
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Hypocalcemia severe signs
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Milk Fever, ecclampsia
Ethylene glycol toxicity Hypothyroidism Blister Beetle toxicity |
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Do horses have hyper- or hypo- calcemia with renal failure?
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Hyper
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Do dogs have hyper-/hypocalcemia with renal failure?
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hypo or normal, only 5-10% become hypercalcemic
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Phosphorous < 1.0 mg/dL
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Hemolysis due to P needed for membrane structure
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Hyperphosphatemia
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Renal
Young animals Hypoparathyroidism Vitamin D toxicity Osteolytic bone lesions |
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Hypophosphatemia
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HHM
Hyperparathyroidism Anorexia, inadequate diet Diabetes Mellitus Insulin therapy Bovie post-parturient hemoglobinuria |
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Hypernatremia
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Dehydration:
Insensible H20 Loss GI loss Renal Failure Diabetes insipidus |
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Hyponatremia
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Loss: GI and renal
3rd space disease Ascites/edema GI obstruction/sequestration |
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Na+ w/renal failure in Bovine
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Renal Azotemia w/hyponatremia
Greater renal loss GI sequestration of sodium 2 to ileus |
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Dog: Na<120 and renal azotemia
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2 renal azotemia
Addison's disease + dehydration 3rd space disease + dehydration GI sodium loss + dehydration |
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Population parameters
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Age
Species* Sex Breed |
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Environmenta
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Diet
Fasted Pregnant BCS Medications Excitement Altitude |
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Define heatlhy?
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Physical exam, client information
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Two main selection criteria for Stds.
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health and speciesAss
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Assumption for ref. ranges
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1. Ref. pop. is representative of the patient pop. for important criteria
2. Unused selection criteria cause only small variations in results. 3. Disease causes large changes in test results. |
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Secondary Renal profile
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Electrolytes, Cholesterol, Acid-base
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Creatine phosphate
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energy source for muscle
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creatinine
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degradation product creatine
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Secretional Metabolic acidosis
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GI/pancreatic secretions
Urinary loss (RTA?) |
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Paradoxical Aciduria
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Need for Na resorption (dehydration/hypoNa+)
decreased Cl- : HCO3 will go decreased K: H+ will go |
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Hypokalemic polymyopathy
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older cats + renal disease/failure
polyuria and anorexia cervical ventroflexion |
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Hyperkalemic Periodi paralysis of QH
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Genetic, periodic paralysis
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