Dog & Cat Library, Vet Notes

Notes Oct 13 UGA CE – Renal Injury

LinkedIn0
Google+0

Selena Lane

Isosthenuria is 1.007 – 1.015

When you see azotemia just know that 66% of nephrons are dysfunctional. Not necessarily irreparably.

UNTIL there’s that much damage, lab tests for kidney are undetectable. NOTE: I wonder  if old dogs should eat K/D or a kidney sparing diet “any way” say, from ten on? Ajax?

AKI stands for Acute Kidney Injury

Low blood pressure (hypotension) during anesthesia can injure kidneys. Damage them ischemically.

NSAIDS can injure the kidneys.

Case:

  • ADR with GI signs, melena. Appetite off. 5% dehydrated. “Seems” sudden. 
  • Labs:   Elevated white cell count. Slight left shift. <= High WBC in renal failure: Think Lepto at least for a minute.
  • Labs: BUN 129, CREAT 8.0 K+ high.
  • Labs UA blood, USPG 1.012 (iso)

Renal imaging Ultrasound is a top shelf but useful diagnostic

Lepto tests can be false-positive in immunized dogs. So RISING TITERS are the “thing”

PRACTICE NOTE:  All renal cases:  Lepto snap –> If ambiguous – chase it down because people are at risk.

Lepto tests available: MAT/PCR/Snap

Management: They measure urine output. Normal is 1-2ml/kg/hour. They catheterize or weigh pads. Not sure what they can do with that information other than say “The dog is oliguric, anuric, polyuric. NOTE: If he’s not letting off his fluids due to oliguric renal disease, he might get “fluid overload”

  • (tears from the nose)
  • (They can even get edema, even in the face!)
  • Difficult to reverse at that point.
  • Weigh the pet to see suspicious short term gains – she said that several times.
  • Furosemide increases renal flows, perfusion. But can result in dehydration.

If a pet is dehydrated with a USPG of 1.007 – 1.015 the kidneys are impaired.

I get this feeling that clinicians just want to know, know, know everything about a case. It’s nice to know everything that’s going on and micromanage the disease process but so much of this is irrelevant to survival and a lot of it provides useless information except: To know.

Practicality note: Synthetic colloid fluid support is neither helpful nor detrimental to AKI patients. But in people can set up sepsis.

She likes Mannitol – up to the possibility that it might result in untoward fluid retention. (Injection only?) Increases flow, flushes tubules, reduces tubular swelling.

Dopamine, Fenoldopam. My takeaway is that it’s not as good as Furosemide.

Lepto AKI? Consider Diltiazem. They recover faster.

Then the owner goes crazy and wants the pet alive no matter the impact on the pet:   Peritoneal dialysis, Hemodialysis, constant transfusion.

Lepto kidneys have a decent prognosis. 60% of dog AKI’s die. And of the survivors, 60% end up managed long term for CKD

Cats do a little better.

 

 

 

Enter your email address for a free PDF of this article including its images.

Enter your Email Address

My Favorite Amazon Recommendations

Items and content will not show in "Reader View" check your browser.

This is The LCD Screen Scope
We Did The Tutorial With. I did a twenty page tutorial (Here's the tutorial) with video, audio, images and even little parasite movies to show you how to use a microscope. 

This Filter is Good For BIG Dirty Tanks
I've been wrestling with water quality with the turtles. The sponges work GREAT, but in THOSE turtle systems where they eat MICE the poops are bulky. This filter can handle it. In "Tortu's" tank, it's got an 800 gph pump and it rocks. 

PraziPro for Flukes
They nailed it. Figured out the solubility and worked out the dosing. It works. 

PraziPro

Buy Some Good Koi?
No, this isn't really for the 'high end' collector y'all. But for someone who isn't near a decent garden center, here are "good-to-quite-good" Koi you will like at a very good price. I know these guys personally.

Buy Koi Online

Best Food, Ever
It's made for (and I discovered it for) my Blood Parrots but the small size, intense color enhancers and excellent formulation make it superb young-Koi food. Oh, and it's AMAZING on color-cichlids like Flowerhorn and Blood Parrots. 

Pro Air 60 Aerator is a VERY high output air pump pushing my whole fish room (17+ drops), and I have one at home driving everything there, and I have one as a back up. 

Formalin Malachite (Not dilute)
There are formalin malachite preparations at 10%, 22% and 37%. There's economy in the concentrates. Hard to get Prime shipping because air transport is curtailed. This is a good value on 32 ounces. 

Topical For Koi and Pond Fish Ulcers
I like 7% tincture of iodine because it stains but it's hard to hurt anything with it. Used with a WOVEN gauze, this works well to clean and disinfect a wound. Only use ONCE. Do not 'repeatedly' scrub wounds. 

Confectioner's Glaze 
Is the way to bind a medication to fish food. Gone are the days of paste food and oil. The write up is done, it's RIGHT HERE.

Koi Health & Disease
Hopefully this link takes you to the newest edition by PRIME to get it to your house the fastest. 

I have over ten of these Titanium Heaters in my fish room and at home. They're a paradigm shift in aquarium heating. They're titanium and 400W for under $30! Whaaaaaaaaat?

CyroPro by Hikari is safe and easy for Anchor Worms and Fish Lice.

Whatever heaters you use, back yourself up with a temperature controller, it'll turn on, and off your heaters. If your heater seizes "on" at least the thermostat will stop a tragedy. 

LifeGuard by Tetra is a tablet version of a tame 'chloramine-t' or 'halamid' compound that's easy to get and good on bacterial infections, in baths. 

Antimicrobial
If you're making medicated feed for a larger group of fish, this will come in handy. Dosing is available in the site. 

For me, filtration-of-choice
For aquariums, even small Koi holding facilities or small ponds. These sponge filters are cheap, easy to clean, and they clear hazes very well when used with some Accuclear or similar.

Rubber sided, round, nettable tanks
Make great hospital or quarantine facilities. They SHOULD cost about $200-300 depending on size, but this, lower quality unit (while panned in some reviews) may be good. Don't overfill and make sure it's propped up.

1200 Watt heater, on a thermostat held securely above the waterline, works GREAT as a large tank heater. That's all I'll say because there's risk of electrocution and all that. But then, even in a bucket you could get killed. Sound like fun?
I have several of these ALLIED PRECISION stainless ones that are a couple years old. Working still. 

Potassium Permanganate 
500 grams could be a lifetime supply but it's 50% more than the 100g cost wise, for 500% more amount. Dosing is in the site and the book.

What Does Ajax Eat?
I looked for something well formulated, with meat as the first ingredient. Something UNDER $2/lb and something they could deliver for free. And this was it. He looks and feels great on it.