The Kidney in Critically ill Small Animals

Katharine F. Lunn, BVMS, MS, PhD, MRCVS
Vet Clin Small Anim 41 (2011) 727–744

This article discusses kidney disease in critically ill small animal patients. Critically ill patients may present to the clinician with kidney disease as the primary complaint, or kidney damage or dysfunction may arise as a complication or consequence of other illness. In the latter scenario, the clinician must carefully monitor parameters that assess renal function and be prepared to intervene to prevent irreversible injury.

Diagnosis of Urolithiasis

Cathy Langston, DVM,DACVIM, Kelly Gisselman, DVM
Douglas Palma, DVM, John McCue, DVM
Compendium
August 2008. 

Diagnostic imaging is usually required to determine the presence of urolithiasis. Double-contrast cystography is more accurate than survey radiography and approximately as accurate as ultrasonography. Knowledge of the mineral composition of calculi helps direct appropriate management of urolithiasis, and signalment can help predict composition with about 70% accuracy. In cats, about half of cystic calculi are struvite and half are calcium oxalate; most nephroliths and ureteroliths are calcium oxalate. In female dogs, struvite uroliths are the predominant type found in the bladder. In male dogs, breed plays a strong role in prediction of bladder urolith type. It is difficult to predict the composition of nephroliths and ureteroliths based on signalment alone in dogs. Urinalysis and imaging findings can help in predicting urolith composition, although chemical analysis is necessary for definitive diagnosis.

Protein-losing Nephropathy in Small Animals (Nefropatia Perdedora de Proteínas en Pequeños Animales)

Meryl P. Littman, VMD

Veterinary Clinics of North America: Small Animal Practice

Volume 41, Issue 1 , Pages 31-62, 
January 2011

Genetic and acquired defects of glomerular permselectivity may lead to proteinuria and protein-losing nephropathy (PLN). Morbidity and mortality from complications of PLN may be severe even before progression to azotemia and renal failure. Leakage of plasma proteins into the glomerular filtrate can damage tubular cells and the function of the entire nephron. Detection, localization, and treatment of proteinuria are important to decrease the clinical signs and complications of PLN and the likelihood of progression to renal failure. Thorough diagnostic work-ups help to identify subsets of glomerular disease and their response to specific treatment protocols.

Chronic Kidney Disease in Small Animals (Enfermedad Renal Cronica en Pequeños Animales)

David J. Polzin, DVM, PhD

Veterinary Clinics of North America: Small Animal Practice

Volume 41, Issue 1 , Pages 15-30, January 201

Chronic kidney disease (CKD) affects multiple body systems and presents with a wide variety of clinical manifestations. Proper application of conservative medical management can profoundly affect the clinical course of CKD. Diagnosis and management is facilitated by staging CKD and applying therapies that are appropriate for the patient's stage of CKD. Therapy and follow-up of CKD are described, with emphasis on stage-based therapy to ameliorate clinical signs and slow progression.

Texto Completo/Full Text (Ingles)

Acute Kidney Injury in Dogs and Cats (Insuficiencia Renal Aguda en Perros y Gatos)

Linda Ross, DVM, MS

Veterinary Clinics of North America: Small Animal Practice

Volume 41, Issue 1 , Pages 1-14, January 2011

The term acute kidney injury (AKI) has replaced the historical term acute renal failure for renal damage occurring over a short period of time (hours to days) because it is thought to better describe the pathophysiologic changes and duration of the different phases of injury. There are many potential causes of AKI in dogs and cats, and the prognosis has been shown to vary with the cause as well as with therapy. This article reviews current concepts of the pathophysiology, causes, clinical presentation, approach to diagnosis, and medical management of AKI in dogs and cats.

Full Text/Texto Completo (Ingles)