Ettinger Urinary 5

Front 1

Familial amyloidosis has been characterized in these 3 cat breeds

Back 1

Abyssinian

Siamese

Oriental

Front 2

What breed of cats have polycystic kidney disease

Back 2

Persian

Front 3

How old are Abyssinian cats with familial amyloidosis when they develope CRF?

Back 3

with in the first 3 years of life

Front 4

Besides amyloid depositis in the kidney's, where else can it be deposited with Abyssinian cats?

Back 4

adrenal

thyroid

pancrease

colon

- generally not clinical to the syndrome

Front 5

In Siamese and oriental shorthair cats, where is amyoid deposted?

Back 5

more commonly liver

The amyloid AA protein is a little different than Abyssinian cats and might explain why it prefers the liver

Front 6

PKD in Persians is a ____ trait (inheritance)

Back 6

autosomal dominant

Front 7

Where do cysts form in PKD?

What happens over time?

Back 7

proximal and distal tubules

renal cortex and medulla

increase in number and size

Front 8

How early can PKD be detected in cats?

Back 8

6-8 weeks of age U/S

but absence of custs does not preclude their developement at a later age

Front 9

Do cats with PKD have hypertension

Back 9

no

Front 10

What familial renal disease do samyed dogs get?

Back 10

heridatary nephritis

abnormal collagen linking of the basement membrane

Front 11

What familial disease do soft coated wheaten terriers get?

Back 11

PLE

PLN

or both

immune complex glomerulonephritis

Front 12

TX of cystinuria

SX

Medical

RX

Back 12

- mechanical removal

- dietary dissolution of calculi (dissolve in alkaline urine)

- D-penicillamine (make more soluable in urine) - more GI upset

2-mercaptopropinoylglycine (2-MPG)

Front 13

Dogs with DCM have defective biosynthesis of this non-essential AA which generally occurs in dogs that also have cystinuria

Back 13

carniturua (carnitine deficiency)

Front 14

What animals get hyperuricosuria?

Back 14

Dalmations and primary hepatic disease

Front 15

How do dogs with primary hepatic disease develope hyperuricosuria

Back 15

Reduced conversion of uric acid to allantoin and ammonium to urea.

Most common with PSS

Front 16

How does Allpurinol work?

What should be avoided?

Back 16

reduce the serum and urine uric acid concentrations

administered to dogs consuming a purine restricted diet to avoid formation of xanthine calculi

Front 17

How long until urate uroliths are dissolved

Back 17

3.5 months

Front 18

What animals will allopurinol not work for?

Back 18

hepatic defects

possibly will resolve with PSS correction

Front 19

How is primary renal glucosuria diagnosed?

Back 19

serial blood glucose measurements or fructosamine R/O hyperglycemia.

Front 20

This is an inherited proximal tubular defcet that results in glucosuria, amonoaciduria, proteinuria, phosphaturia, and phyophosphatemia.

Back 20

Fanconi syndrome in humans

Front 21

What breed of dog has inherited fanconi syndrome

Back 21

basenji

Front 22

What diseases/drugs can cause acquired Fanconi Syndrome?

Back 22

gentamicin

ethylene glycol

primary hypoparathyroidism

Front 23

What abnormalities does Fanconi Syndrome Cause?

Back 23

glucosuria

aminoaciduria (cystine)

proteinuria

abnormal absoroption of HCO3, Na, K, and urate

Front 24

What is the sex prediliction for Fanconi syndrome?

Back 24

females 3:1

Front 25

Diagnostic testing for Fanconi Syndrome show initially and late disease:

Back 25

glucosuria

euglycemia

isostenuria

as the disease progresses

hyperchloremic metabolic acidosis and renal failure

Front 26

TX for Fanconi Syndrome:

What breeding enthusiasts want

Urinary alkalization option

Goals of HCO3 levels and K levels

Back 26

Supportive

- Administration of sodium bicarbonate - exacerbates bicarbonaturia.

- Urinary alkalization with potassium citrate is helpful.

- Goal is to keep HCO3 above 12 and potassium 4-6 mEq/L

- TX: Renal failure

Front 27

Prognosis for Fanconi Syndrome

Back 27

Depends on the degree of azotemia at diagnosis

short term - guraded to good

long term - poor

Front 28

How do the renal tubules regulate acid base hemostasis (2)?

Back 28

1. absorption of 90% of HCO3- in the proximal tubule

2. excretion of H and ammonium in the distal renal tubule

Front 29

What is type II RTA?

Back 29

inability of the proximal tubule to prevent loss of HCO3-

Front 30

What is type I RTA?

Back 30

inability of the distal tubule to excrete H

Front 31

What is renal tubular acidosis

Back 31

rare tubular disorders that lead to hyperchloremic metabolic acidosis

Front 32

What occurs at the cellular level(transporter) that causes proximal RTA.

Back 32

defect in the basolateral membrane Na/HCO3- cotransporter with leakage of HC)3- into the tubular lumen resulting in priximal RTA

Front 33

Why is proximal RTA self limiting?

Back 33

metabolic acidosis is self-limiting because the distal tubule's ability to excrete acid. If oral sodium bicarbonate is added, the HCO3- presented to the distal tubule overwhelms the distal buffering system and results in bicarbonateuria.

Front 34

How is proximal RTA diagnosed?

Back 34

acidic urine pH

hyperchloremic metabolic acidosis

identification of other tubular defects (euglycemia, glucosuria, aminoaciduria)

Front 35

TX for proximal RTA

Back 35

potassium citrate

Front 36

What can the kidneys not do with type 1 RTA in response to systemic acidosis?

Back 36

in response to systemic metabolic acidosis, unable to acidify the urine.

Front 37

This type of RTA is associated with hypoaldosteronism

Back 37

Type IV distal RTA

Front 38

What occurs at the molecular level of Type IV RTA

Back 38

loss of aldosterone stimulated H/ATPase pump and loss of distal Na absorption

Front 39

How is type I RTA diagnosed

Back 39

hyperchloremic metabolic acisosis with alkaline urine

failure to acidify the urine in response to an ammonium chloride challenge

Front 40

TX for type I RTA

Back 40

administration of a alkali source

potassium and sodium citrate

Front 41

Under what two situations is ADH released

Back 41

hyperosmolality

hypovolemia

Front 42

Where dose ADH act in the nephron and what does it do?

Back 42

collecting tubules and collecting ducts

makes them become more permable to free water resulting in more concentrated urine

Front 43

What are some causes of acquired NDI?

Back 43

E.coli - endotoxin - receptor interference

RX - glucocorticoids/chemotherapy

low K high Ca

tubular injury

medullary washout

Front 44

What is congential NDI

Back 44

rare

deficiency of ADH receptors

Front 45

Why dose dietary sodium restriction help with NDI?

Back 45

reduces the amount of solute presented to the kidney that must be excreted therefore, decreasing water loss.