Term
| Acute renal failure is usually secondary to ___________________ or _____________/_____________. |
|
Definition
Nephrotoxins
Hypoperfusion/ischemia |
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Term
| T/F: the kidney can usually handle a single overdose of aminoglycosides. |
|
Definition
True.
Acute renal failure is usually the result of repeated AG administration. |
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Term
| Which aminoglycosides cause the most nephrotoxicity? |
|
Definition
|
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Term
| What is a pigment nephropathy? |
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Definition
| Pigment nephropothy occurs with rhabdomyolysis or hemolysis. Exposure to toxins can cause severe intravascular hemolysis, and hemoglobin can overwhelm the renal tubules and cause oxidative damage. |
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Term
| With a pigment nephropathy, what chemistry values should be monitored? |
|
Definition
|
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Term
| If a horse presents for Red Maple toxicity, what can be done in an attempt to prevent severe hemolysis? |
|
Definition
Diuresis
Avoidance of nephrotoxic drugs |
|
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Term
| T/F: the use of NSAIDS at the correct dose and frequency will help to avoid renal injury. |
|
Definition
|
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Term
| NSAIDs cause what kind of lesions in the kidney? |
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Definition
|
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Term
| Why do NSAIDs cause medullary crest necrosis of the kidney? |
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Definition
| The medullary nephrons of the kidney receive only a small 1% of the total CO. NSAIDs inhibit PG synthesis and eliminate the normal mechanism that the medullary region of the kidney uses to provide adequate blood flow. |
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|
Term
| What finding might be seen on UA of a horse with NSAID toxicity? |
|
Definition
|
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Term
| ________________, _____________, _____________, and _______________ are all heavy metals that can cause acute renal failure in horses. |
|
Definition
|
|
Term
| List the various causes of acute renal failure in horses: |
|
Definition
Aminoglycosides toxicity
Pigment Nephropathy
NSAID toxicity
Vitamin D toxicity
Heavy Metals
Acorn Poisoning
Tetracyclines
Polymyxin B
Blister Beetle Toxicity
Hypoperfusion/ischemia |
|
|
Term
| Immature leaves and green acorns contain ___________ that can cause diarrhea, edema, and renal failure in horses. |
|
Definition
|
|
Term
| What are the classifications of acute renal failure (with respect to urine output)? |
|
Definition
|
|
Term
| What clinicopathologic findings will show up with acute renal failure? |
|
Definition
Hematuria
Isosthenuria
Proteinuria
Azotemia
Hyponatremia
Hypochloremia
Hypocalcemia
Hyperkalemia
Metabolic Acidosis |
|
|
Term
| What is the treatment for acute renal failure? |
|
Definition
Fluid therapy to replace volume deficits, correct electrolyte derangements, acid-base abnormalities
0.9% NaCl
Diuretics: furosemide, mannitol, dopamine
Treatment of primary disease |
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|
Term
| Renal neoplasia is rare in horses, but when it occurs, what type of tumor usually predominates? |
|
Definition
|
|
Term
| What are some clinical signs of renal neoplasia? |
|
Definition
Hematuria
Weight loss
Pollakiuria
Stranguria |
|
|
Term
| What are the two broad categories of chronic renal failure? |
|
Definition
Glomerulonephritis (Primary Glomerular Disease)
Chronic Interstitial Nephritis (Primary Tubulointerstitial Disease) |
|
|
Term
| Describe the mechanism of developing glomerulonephritis: |
|
Definition
| Increased cellularity of glomerulus due to inflammatory cell influx-->deposition of immune complexes causes activation of complement and vasculitis (streptococcal antigens, glomerular proteins) |
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|
Term
| Chronic interstitial nephritis usually develops as a sequel to ________________________. |
|
Definition
|
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Term
| What are the clinical signs associated with chronic renal failure? |
|
Definition
Weight loss
PU/PD
Ventral edema
Stunted growth (if young horse with congeintal defect)
Dental tartar
Oral ulcers |
|
|
Term
| What clinicopathologic abnormalities will occur with chronic renal failure? |
|
Definition
Hematuria
Proteinuria
Isosthenuria
Azotemia
Hypercalcemia
Hypophosphatemia
Hyponatremia
Hypochloremia
Hyperkalemia
Anemia (+/- hypoalbuminemia) |
|
|
Term
| What are the treatment strategies for chronic renal failure? |
|
Definition
Supportive care: adequate water/electrolytes
Decreased calcium intake--grass hays
Nutritional management: increased fat in diet
Avoidance of aminoglycosides and NSAIDs |
|
|
Term
| What are some risk factors for a horse developing a urinary tract infection? |
|
Definition
Urolithiasis
Bladder paralysis
Urethral damage
Neoplasia |
|
|
Term
| Females/Males have a higher risk of developing urinary tract infections. |
|
Definition
| Females--due to a shorter urethra |
|
|
Term
| What types of organisms can be involved in urinary tract infections in horses? |
|
Definition
E. coli
Staphylococcus
Pseudomonas
Proteus |
|
|
Term
| Upper urinary tract infections usually involve _________________ (inflammation of kidney and renal pelvis). |
|
Definition
|
|
Term
| What types of clinical signs will be noted with a lower urinary tract infection? |
|
Definition
Dysuria
Stranguria
Pollakiuria
Urinary Incontinence |
|
|
Term
| What antimicrobials can be used for treatment of urinary tract infections? |
|
Definition
TMP-sulfa
Penicillin
Aminoglycosides
Cephalosporins |
|
|
Term
| Type I uroliths are _________ in color, easily/do not easily fragment, are made up of ________________, and make up ____% of uroliths in horses. Type II uroliths are _______________ in color and are easily/ not easily fragmented. |
|
Definition
Yellow-green
Easily fragmented
Calcium carbonate
90%
Gray-white
Not easily fragmented |
|
|
Term
| What are the clinical signs of a urolith? |
|
Definition
Dysuria, pollakiuria, stranguria
Incontinence
Mild colic
Severe pain (if obstructive)
Hematuria
Recurrent UTI |
|
|
Term
| What is the treatment for uroliths in females? |
|
Definition
Urethral retrieval
Manual crushing if large stone
Laser lithotripsy |
|
|
Term
| What is the treatment for uroliths in males? |
|
Definition
Laparocystotomy
Perineal urethrotomy
Laser lithotripsy |
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