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82 Cards in this Set
- Front
- Back
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What type of kidney do mammals have? Fish/amphibians?
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Mammals/birds - metanephros
Fish/amphibians - mesonephros |
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What is unique about the renal pelvis of the ox and pig? The horse?
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Ox/pig - no renal pelvis (medulla drains into calyces)
Horse - renal pelvis contains goblet cells (urine is viscous) |
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What ligamentous support does the bladder have?
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One medial and two lateral (round) ligaments
Round ligaments are remnants of the umbilical arteries, medial ligament is a remnant of the urachus |
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What THREE nerves innervate the bladder?
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Hypogastric - sympathetic
Pelvic - parasympathetic Pudendal - somatic |
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What THREE cellular layers are there in the Bowman's membrane?
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Parietal layer - simple squamous epithelium
Visceral layer - podocytes/basement membrane Mesangial cells - macrophages |
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What is the macula densa?
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Literally 'dense spot'. The region of the nephron that signals to juxtaglomerular cells to produce renin
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Outline the RAAS system
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Renin is produced by the kidneys in response to reduced perfusion
Renin cleaves angiotensinogen from the liver to angiotensin I ACE in the lungs converts angiotensin I to angiotensin II Angiotensin II stimulates aldosterone release from the adrenal cortex |
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What are the FIVE functions of angiotensin II?
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- stimulates vasoconstriction
- stimulates ADH secretion - stimulates Na+ (and therefore water) retention - increases sympathetic tone - stimulates aldosterone release |
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What is the function of aldosterone?
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causes sodium retention
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What is ANP? What does it do?
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Atrial naturitic peptide - secreted in response to cardiac distension
Inhibits aldosterone secretion Inhibits Na+ retention directly Increases GFR |
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How can urinary protein be assessed in concentrated urine?
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UPC (urinary protein:creatinine ratio) - creatinine is excreted at a constant rate. UPC should be less than 45
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What TWO receptor types control ADH secretion? Where are they located?
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Osmoreceptors in the hypothalamus
Baroreceptors in the kidney |
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Compare oscillometric and Doppler methods of measuring blood pressure
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Oscillometric measures systolic, diastolic and mean arterial pressures, but is unreliable in conscious cats and small dogs. Doppler measures systolic pressure only but can be used in any animal
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Outline nervous control of micturition
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Bladder filling phase: hypogastric nerve maintains internal urethral sphincter competency and relaxes detrusor
pudendal nerve maintains external urethral sphincter tone Emptying phase: pelvic nerve stimulates detrusor contraction and inhibits pudendal nerve |
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What happens to phosphorus in the kidneys?
What are the FOUR results of loss of this function in renal disease? |
Actively excreted under the influence of PTH
In renal disease get hyperphospataemia, parathyroid gland hypertrophy, osteodystrophy (rubber jaw) and mineralisation/fibrosis of soft tissue |
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Explain the aetiology of kidney cysts
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Occur due to fibrotic tubule occlusion in the medulla
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What causes renal subcapsular petechiae in pigs?
What is a more likely differential if the cortex is also affected? |
Subcapsular petechiae = Salmonellosis
Subcapsular and cortical petechiae = swine fever |
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What is the effect of NSAID toxicity on the kidney?
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Renal papillary necrosis (medullary ischaemia)
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How can you confirm the presence of amyloid histopathologically?
Grossly, at post mortem? |
Stains pink with congo red then turns green in polarised light
Affected glomeruli are grossly pale, stain brown with iodine then purple if subsequently treated with dilute sulphuric acid |
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What are the TWO types of renal cast?
Name FOUR conditions in which they may be produced |
Hyaline (protein) and granular (cell remnant) casts
Pulpy kidney (C. perfringens) Mycotoxin poisoning Heavy metal poisoning Oak poisoning |
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You find embolic nephritis in a foal. What is your top differential?
In a pig: In a cow? |
Foal: Actinobacillus equuli
Pig: Erysipelothrix rhusiopathiae Cow: Corynebacterium pyogenes |
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What s the most common route of pyelonephritis infection in the sow? What organism is most likely to be responsible?
In the cow? |
Ascending infection for both
Corynebacterium renale/suis |
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What muscular signs are seen with kidney dysfunction. Why?
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Phosphate retention causes muscular tremors and coma
Potassium retention causes cardiac arrest |
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What are the cardiovascular consequences of chronic uraemia? Why?
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Chronic RAAS stimulation results in persistent hypertension and left ventricular hypertrophy
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What is the top differential for bladder wall petechiae in the pig?
In the cow? |
Pig - classical swine fever
Cow - bovine enzootic haematuria |
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What is the usual appearance of a bladder with cystitis?
How does this differ in the dog? |
Most species - diffuse thickening with mucosa thrown into villous projections (polypoid)
Dog - small white nodular clumps of lymphocytes underlay ulcerated epithelial layers (follicular) |
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A cow's bladder contains pea-sized haemorrhagic nodules.
What is the likely aetiology? How does the disease progress? What is the prognosis? |
Enzootic bovine haematuria/bracken fern poisoning
Progress to wart-like neoplastic growths 10% metastasise |
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BUN is a reliable way to rule in/out renal disease, except in... [TWO things]
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Ruminants (ruminal excretion of urea)
Birds (increase urate production) |
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What is the difference between uraemia and azotaemia?
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Uraemia is the presence of clinical signs, azotaemia is a biochemical abnormality
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What TWO conditions cause a falsely elevated USG reading?
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Proteinuria
Glucosuria |
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What is the function of aldosterone?
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Reabsorbs Na+ in the proximal tubule (and therefore Cl- and water)
Excretes K+ in the collecting duct |
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How can potassium be used to differentiate between acute and chronic renal failure?
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Hyperkalaemia in acute renal failure (decreased excretion)
Hypokalaemia in chronic renal failure (glomerular loss) |
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Does renal failure affect blood pH? Explain how/why
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Causes metabolic acidosis by failing to conserve bicarbonate
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What TWO biochemical abnormailties are unique to equine renal failure?
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Hypercalcaemia and hypophospataemia
Mechanism unknown |
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Give TWO causes of a low urine pH
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Protein diet
Old sample |
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Give TWO causes of a high urine pH
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Herbivore
Cystitis |
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What is the most likely cause of ammonium biurate crystals in the urine?
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Portosystemic shunt
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What contrast agent is appropriate for urography?
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Ionic or non-ionic iodine
Barium is inappropriate as it is not water-soluble |
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How can blood clots, calculi and air bubbles be differentiated radiographically?
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Calculi have a smooth outline and move to the most dependent part of the bladder
Blood clots have a rough outline and move to the most dependent part of the bladder Air bubbles move to the least dependent part of the bladder |
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How do you ultrasonographically determine a thicker bladder wall in a full bladder?
An empty bladder? |
Full bladder walls should be under 2mm
Empty bladder walls should be under 5mm |
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How is leptospirosis diagnosed in unvaccinated animals?
In vaccinated animals? How is it treated? |
Unvaccinated - positive antibodies
Vaccinated - paired titre showing antibody increase Treatment - penicillin and doxycycline |
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How is chronic kidney disease staged?
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I - non-azotaemic, normal or near-normal GFR
II - mildly azotaemic (may be PU/PD or no clinical signs) III - moderately azotaemic (PU/PD, may be extrarenal signs i.e. V+D+) IV - severely azotaemic (systemic illness, poor prognosis) |
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What are the SEVEN mainstays of chronic kidney disease treatment?
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Restrict dietary phosphate
Supplement potassium Supplement iron ACE inhibitors CSL Encourage to drink Manage UTIs |
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What is the difference between a urolith and a crystal?
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Uroliths are macroscopic
Crystals are microscopic |
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How are crystals formed? What prevents them becoming uroliths in the normal bladder?
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Metastable ion concentration allows crystal formation
Bonding with other ions prevents crystal nucleation and stone formation |
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What is the most common type of urolith in the dog?
In the cat? |
Dog - struvite
Cat - calcium oxalate |
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What stones can be medically dissolved?
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All except calcium oxalate
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What is the target of dietary management of cystine?
Urate? Struvite? |
Cystine and urate - alkalynising diet
Struvite - acidifying diet |
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Which uroliths are radiolucent?
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Cystine and urate
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What is the common principle of dietary control of all uroliths?
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Reduction of dietary protein
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What sort of urolith do dalmatians get?
What other demographic is prone to developing this type of stone? How is it managed? |
Ammonium urate (dalmatians have a uricase insufficiency)
Also occurs in dogs with liver disease Feed fewer purines and supplement allopurinol to competitively inhibit xanthine oxidase |
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Name FIVE possible risk factors for FLUTD
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Signalment (young, neutered, obese, oriental breed)
Calicivirus/herpesvirus infection Neurogenic inflammation Deficient GAG layer overlying bladder Sympathetic overactivity |
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Suggest FOUR treatments for FLUTD
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Switch to canned food
Encourage increased water intake Add synthetic GAGs to diet (unproven) Amitriptyline |
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What are the FOUR properties of amitriptyline that make it a suitable treatment for FLUTD?
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Anti-cholinergic
Antihistamine Anti-inflammatory Analgesic |
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What is the rationale for adding omega-3 fatty acids to a renal diet? Give FOUR functions
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Appetite stimulant
Preserve renal function Reduce inflammation Lower systemic and glomerular arterial pressure |
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Give FIVE mainstays of dietary management of renal disease
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Omega-3 fatty acids
Protein restriction Phosphate restriction Potassium supplementation Fermentable fibre (nitrogen trap in gut) |
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What is the difference between omega-3 and omega-6 fatty acids?
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Omega-3 slow progression of renal failure
Omega-6 accelerate progression of renal failure Omega-3 contains a-linolenic acid -> good prostaglandins (: Omega-6 contains linoleic acid -> bad prostaglandins ): |
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A cat presents with a flaccid, overdistended bladder. It is easy to express and urine leaks out.
What is the diagnosis? What signalment is most likely to be affected? |
Lower motor neurone functional urethral obstruction due to cauda equina syndrome (compression of nerves in lower spinal cord)
Common in manx cats |
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A cat presents with a firm, tense bladder that is difficult to express. What is the diagnosis?
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Upper motor neurone functional urethral obstruction
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What is reflex dynergia?
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Asynchrony between detrusor contraction and urethral relaxation
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What radiographic finding would make you suspect urethral sphincter mechanism incontinence?
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Intrapelvic bladder neck (supportive, not diagnostic)
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How can urethral sphincter mechanism incontinence be managed medically?
Surgically? |
Medical: testosterone analogues
Surgical: Colposuspension, Vas deferens pexy/prostatopexy |
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What are the TWO types of ureteral ectopia?
Which is more likely in the dog? In the cat? How is it managed? |
Dogs: intramural (tunnelling) ureteral ectopia
Cats: extramural ureteral ectopia Ureteronephrectomy indicated if unilateral or damaging hyroureter/hydronephrosis |
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What is congenital absence of a vagina?
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Genitourinary dysplasia, enlarged urethra may have a uterine remnant attached dorsally
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What is the outcome of excessive bladder distension?
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Bladder atony - distension disrupts tight junctions in the wall leading to urinary retention with overflow
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How is hypersomatotrophism diagnosed [THREE methods]?
What is the most likely cause in cats? In dogs? |
Diagnosis is serum IGF-1 estimation, serum progesterone (dogs) or CT/MRI (cats)
In cats most likely pituitary tumour, in dogs most likely mammary tumour |
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How should hypersomatotrophism be treated in dogs?
In cats [THREE things]? |
Dogs - remove progesterone influence
Cats - dopamine agonists, somatostatin analogues or local irradiation |
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What causes hyposomatotrophism?
What disease often occurs at the same time by the same mechanism? |
Congenital anterior pituitary malformation
Hypothyroidism |
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How is hyposomatotrophism diagnosed?
How is it managed? |
Dx serum IGF estimation or radiographic evidence of persistent epiphyseal plates
No tx required; sufferers normal life expectancy |
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What are the two types of diabetes insipidus?
How are they differentiated? |
Central and nephrogenic.
Confirm diagnosis by water deprivation test Differentiate by adding exogenous vasopressin |
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What cell type secretes parathyroid hormone?
What is its half-life? What is its function? |
Chief cells secrete PTH. Some neoplastic cells secrete PTHrP
Half-life is 3-5mins Increases renal calcitriol production and phosphate excretion, decreases renal calcium excretion |
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How is vitamin D3 metabolised?
What is its function? |
D3 (CHOLECALCIFEROL) is obtained from the diet or manufactured in the SKIN from 7-DEHYDROCHOLESTEROL.
The LIVER converts it to 25-HYDROXYCHOLECALCIFEROL, then the KIDNEY may transform it into inactive 24,25- DEHYDROXYCHOLECALCIFEROL or active 1,25-dehydr (CALCITRIOL) Increases calcium absorption from bone, GIT and kidneys |
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How does calcium circulate in the blood?
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35% complexed to albumin
10% complexed to ions 55% free (active) calcium |
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How is primary hyperparathyroidism diagnosed?
What is the cause? |
Always caused by unilateral parathyroid adenoma. Not palpable but demonstrable ultrasonographically
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Why should urinary protein:creatinine ratio be used?
What is a normal value? |
UPC quantifies proteinuria by correcting for urine concentration.
Normal is over 0.4 in cats and over 0.5 in dogs |
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What is Fanconi syndrome?
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Failure of renal tubular protein reabsorption
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What are THREE maladaptive consequences of protein-losing nephropathy?
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Thromboembolism
Hypertension Hepatic rupture due to amyloidosis |
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What are the FOUR cardinal signs of nephrotic syndrome?
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Severe proteinuria
Hypoalbuminaemia Hypercholesterolaemia Oedema/fluid accumulation in body cavities |
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What is the predilection site for uroliths in male cattle?
In male small ruminants? |
Cattle - sigmoid flexure
Small ruminants - veriform (urethral) process |
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What FIVE properties of diet contribute to urolith formation in ruminants?
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High concentrate
Low roughage High phosphate High magnesium Low calcium |
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What causes enzootic haematuria?
What species are infected? |
Bladder wall haemangiosarcoma or transitional cell carcinoma following chronic exposure to bracken fern
Cattle and sheep |
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When does bladder rupture occur in foals?
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Either during parturition or secondary to infection before 6 months of age
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