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Chronic Renal Failure: Equine Urinary Disease - Coggle Diagram
Chronic Renal Failure: Equine Urinary Disease
general info
uncommon
progressive loss of renal fxn leading to permanent loss of fxn
usually irreversible
goal is to slow rate of nephron loss
increased prevalence in older horses but overal prevalence is 0.12%
etiology
75% nephrons dysfxn'l
azotemia
remaining nepherons have..
increased GFR
increased hydrostatic pressure
increased filtration of proteins through golmeruli
compensatory responses
activate renin-angio-aldo system
syndromes
chronic interstitial nephritis
causes
progression from acute tubular necrosis
can be drug-induced
can be developmental abnormality
present with CRF as young adults (<10y)
no history of ARF
urinary obstriction
pyelonephritis
amyloidosis
CS
non-specific
chronic weight loss
lethargy
inappetance
dental tartar accumulaltion
gingivitis +/- GI ulcers
+/-
PU/PD
ventral edema
diagnosis
bloodwork
mild anemia
+/- hypoalbuminemia
azotemia
BUN:Cr >10:1
e- abnormalities
hypercalcemia
hyperphosphatemia
hyperkalemia
hyponatremia
hypochloremia
urinalysis before fluid therapy
isosthenuria USG 1.008 - 1.012
urine culture
increased fractional excretion
urine protein:Cr often >3:1
urine GGT rarely elevated
rectal
small, form Lkidney +/- irregular surface
US
more useful than for ARF
small kidneys
irregular echogenicity
loss of corticomedullary definition
+/- nephrolithiasis
renal biopsy
not commonly performed
complication: hemorrhage
ID underlying pathology
glomerular?
tubular?
interstitial?
management
minimize rate of decline in renal fxn
optimize QoL
IV fluids (short term)
provide...
fresh water
pasture access
palatable low-CA diet
avoid high-protein food
discontinue nephrotoxic drugs
prognosis
long-term is POOR
short-term FAIR
pyelonephritis may respond to abx if caught early
no staging system
poor prognostic indicators
marked clinical uremia
Cr >10 mg/dL
BUN:Cr >10:1
non-respnsive anorexia
later diagnosis
severe proteinuria