Eval Renal FXN
What percentage of glomeruli are affected before azotemia occurs?
65-70%
1. What can cause Albumin to increase?
2. What can cause it to decrease?
1. Dehydration
2. Liver disease (↓ prod.), Kidney disease, GI loss
CRITICAL THINKING: You are running a urinalysis on a patient and you place a sample on the test strip. You notice the square listed "blood" is showing positive. What all could cause this square to be positive? How do you confirm what is causing this to be positive?
Blood, Hemoglobin, Myoglobin
Confirm RBC: Microscopic exam
Confirm Hemoglobin: red serum
Confirm Myoglobin: Clear serum
A patient's urine is considered isothenuric if the USG is:
This means the urine and _________ have the same concentration.
1.008-1.012
Plasma
What is the renal threshold for glucose in most species and cattle?
Most: 180mg/dL
Cattle: 100mg/dL
Blood Urea Nitrogen (BUN) is:
1. Made from:
2.Produced in:
1. ammonia - toxin during normal protein metabolism
2. Liver - placed in bloodstream to be secreted by kidney during glomerular function
What values do you expect to change regarding a patient that has renal disease? (Chem profile)
* ↑ Phosphorus
* ↑ BUN
* ↑ Creatinine
* ↓ Albumin
* ↓ Potassium (K) - Cats with urethral block
What are physical properties that are evaluated with urine? (3)
*Color
* Turbidity
*USG
What is the normal pH of urine?
6.5-7.2
What is the best way to detect azotemia before BUN and Creat increase on chem profile?
Protein in urine
2. What causes a low BUN?
1. Kidney Disease - ↓ GFR, GI bleeds
2. Liver disease - portosystemic shunt, Diuresis (↓ Aldosterone - Addison's)
CRITICAL THINKING: You are working in an ICU and you have a patient that was diagnosed with renal disease. Your vet places the patient on IVF. The next day you run more BW on this patient and see that the renal values have decreased from yesterday. How can this happen? What is it called?
Pre-renal Azotemia:
Pre-renal is cause by dehydration or shock, so the kidneys are working, but due to decreased blood perfusion to the kidneys this decreases GFR.
REMEMBER: With pre-renal the kidneys are still able to concentrate urine.
What can cause a color change in urine?
Diet, disease, drugs, RBCs, or heme pigments
Ketonuria indicates:
* Excessive fat metabolism
* Deficiency in carbohydrate metabolism
What has a better quantitation of protein loss than test strip?
Protein/Creatinine ratio
1. What causes creatinine to increase?
2. What causes it to decrease?
1. Kidney disease (↓GFR), rhabdomyolysis
2. Starvation, Diuresis
CRITICAL THINKING: Otter, a 4 y/o MC DSH, comes to your clinic due to a possible urinary blockage. Your vet wants to run BW before sedating patient. What do you expect this bloodwork to show before and after blockage is corrected?
Otter will have increased renal values and possibly increased Potassium.
After urinary blockage is corrected, renal values should return to normal. Renal failure may occur is Otter was left blocked too long.
Normal urine should be clear. If you collect a fresh urine sample that is cloudy, what could be the cause?
*Pus
*Blood
*Mucus
*Bateria
*Casts
*Crystals
If there is bilirubin present in urine, this indicates:
liver damage
FROM CHART ON PAGE 140: You determine that there is blood present in urine (clear supernatant). What does this indicate? What other values should be evaluated?
Indicates: Possible UTI, bleeding mass, bleeding problems
Other values: urine sediment, PCV, TP, platelets
What are the total proteins found in blood?
* Globulins
* Albumin
What type of azotemia can not be corrected with IVF and the kidneys are not able to concentrate urine?
Renal azotemia
What is the normal USG for dogs and cats?
Cats: 1.035
Glucose is filtered by the:
glomerulus
FROM CHART ON PG 140: You determine that there is hemoglobin present in urine. What does this indicate? What other values should be evaluated?
Indicates: RBC destruction
Other Values: PCV, TP, Blood film