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Acute Renal Failure: Equine Urinary Disease - Coggle Diagram
Acute Renal Failure: Equine Urinary Disease
predisposing factors
decreased renal perfusion
hypovolemia
dehydration
concurrent NSAID use
high dose and/or prolonged use nephrotoxic drugs
CS
early
nonspecific depression and anorexia
decreasedwater consumption
progressive dehydration
oliguria/anuria
colic
diarrhea
endotoxemia
hemorrhagic shock
pigmenturia
diagnosis
bloodwork
azotemia
mild e- abnormalities
hypo-
natremia
chloremia
kalemia
poluric RF)
calcemia
hyper-
kalemia (oliguric RF)
phosphatemia
urinalysis
before fluid therapy
isosthenuria (USG 1.008-1.012)
inappropriate concentration
USG <1.020
signs of dehydration
sedimentenzymuria
RBCs
casts
can perform fractional clearances if you feel like it
rectal palpation
enlarged kidney?
perianal pain?
renal pain?
US
+/- renal enlargment
perienal edema
prominent corticomedullary junction
+/- renal biopsy
not commonly performed
complications
pain
hemorrhage
indication
ARF of uncertain origin
not responding to tx
treatment
correct fluid deficits
LRS or normal saline
Deficit (L) = % dehydration x BW (kg)
coorect e- imbalances
monitor
hydration, acid/base balance
e- and minerals
BUN/Cr
urination
perform serial urinalysis
discontinue nephrotoxic drugs
oliguric ARF specific concerns
caution w/ fluid therapy
risk of fluid overload
furosemide to induce urination and increase GFR
CRI > bolus
monitor BW
polyuric ARF
fluid therapy until patient Cr, appetite, attitude improve
causes
pigment nephropathy
myoglobunuria secondary to rhabdo
hemoglobinuria secondary to intravascular hemolysis
uncommon nephrotoxins
vitamin D3
oversupplementation
Cestrum diurnum
ingestion
mercury
cantharidin toxicity
acute tubular necrosis
aminoglycoside
monitoring of hydration and perfusion
urinalysis
blood
casts
urine GGT
produced in tubular epithelial cells
may be used to monitor toxic effects
BUN/Cr
gentamycin>amykacin
measure drug through levels if using
duration of exposure is the risky part
affects proximal tubular epithelial cells
NSAIDs
predisposing factors
dehydation
hypovolemia
poor renal perfusion
high doses
sustained treatment
medullary crest necrosis
prognosis
usually resolves with therapy
dependent on underlying problem
poor prg factors
72hrs ARF
serum Cr >10mg/dL
azotemia worsens/fails to improve after 48h therapy