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12 Cards in this Set
- Front
- Back
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What does the diagnosis of CKD depend on? |
The diagnosis of chronic kidney disease relies on the identification of loss of kidney function with dilute urine, +/- proteinuria, +/- azotaemia over 3 months. |
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Clinical signs of CKD? |
PU/PD- As renal tubules loose their concentrating ability. Hyporexia/anorexia due to increased levels of urea making them feel sick. Vomitting Weight loss. Hindlimb weakness- hypokalaemia Constipation. Behavourial changes. |
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Thinks you might notice in an animal with chronic kidney disease ? |
Poor condition. Halitosis. Ulcers of the mouth. Lump kidneys. Blindness- dilated unresponsive pupils. Unretracted claws. Plantigrade stance. |
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What investigation would you undergo with a cat you have suspicions of CKD? |
Urinalysis. Culture urine as increased risk of UTI. UPC to assess proteinuria. Blood pressure. Biochem to confirm azotaemia. |
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How do we address CKD in terms of dietary management ? |
Dietary manangement- renal diets that increase fat but restrict protein and phosphate. Fatty acids supplemented and alkanisation if they have metabolic acidosis. Antioxidants. Restrict sodium. Address the issue of potassium. |
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At what stage of chronic kidney disease do we advise dietary management? |
IRIS II onwards. |
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Why should we control phosphates when we have chronic kidney disease? |
They contribute to ongoing renal disease and damage. Also leads to the development of secondary renal hyperparathyroidism. |
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How can we manage phosphates in an animal with CKD's diet? |
Give a phosphate restricted diet, check 4 weeks later for changed. If still to high use a phosphate binder. |
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How do phosphate binders work and name some? |
They bind phosphate in the GIT tract and reduce absorption. Options include: Aluminium salts, calcium salts etc. |
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Why must we control the proteinuria in CKD? How do we do this? |
It leads to further renal tubular damage. ACE inhibitors. |
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What do renal ACE inhibitors do? |
Dilate the efferent arteriole reducing glomerular hypertension. Reduction of angiotensin II decreasing systemic hypertension. Reduction of aldosterone and reduce renal fibrosis. Increase appetite and feeling of wellbeing. May cause an increase in azotaemia as a result of reduction in GFR. |
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What do we use in cats to address the hypertension? |
Calcium channel blocker. |
