Renal Disease in Dogs and Cats: Comparative and Clinical Aspects

Study of chronic renal disease in canine and geriatric felines
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A case -control study evaluating risk factors for CKD in cats found a dry food diet was potentially protective Piyarungsri although this finding has not been replicated in the few other published epidemiology studies from different parts of the world. Recent studies have suggested high inclusion rates of inorganic forms of phosphate in diets may lead to kidney damage in cats Dobenecker et al. Further work is required to determine the mechanisms and the forms of phosphorus which give rise to these observations.

Drugs Several therapeutic or diagnostic agents have been associated with the development of CKD in dogs and cats, for example NSAID, aminoglycosides, sulfonamides, polymyxins, amphotericin, vaccines or other chemotherapeutics Polzin et al. Acute kidney injury Any glomerular or tubular-interstitial acute injury from primary or secondary diseases Tables could initiate the development of CKD in dogs and cats Cowgill et al.

In people, prior acute kidney injury is associated with an increased risk of CKD and end stage renal disease Chawla and Kimmel , Coca et al and the same may apply to dogs and cats. Identifying, monitoring and managing at RISK patients A comprehensive history and good medical records are essential for identifying patients at risk of CKD. Serum markers of renal function will be within the laboratory reference range and considering the dog and cat at risk is based purely on the history.

Evidence of renal abnormality, such as abnormal renal imaging, persistent renal proteinuria or persistently reduced urinary concentrating ability after excluding other medical conditions confirm a diagnosis of kidney disease, even in the absence of any increase in sCr or serum SDMA. If indicated, the disease may be further characterized by obtaining a renal biopsy in order confirm a diagnosis of CKD.

Thus, blood biochemistry, urinalysis, blood pressure, body weight, and body condition score should be monitored, initially every 3 months to ascertain potential disease progression. For example, avoiding nephrotoxic drugs, prompt treatment of dehydration and careful management of anesthesia to avoid hypotension.

Table 1. Familial nephropathies in dogs and cats. Effects of the long-term feeding of diets enriched with inorganic phosphorus on the adult feline kidney and phosphorus metabolism.

Br J Nutr ; Case-control study of risk factors associated with feline and canine chronic kidney disease. Changes in systolic blood pressure over time in healthy cats and cats with chronic kidney disease. J Vet Intern Med ; Observation about phosphorus and protein supply in cats and dogs prior to the diagnosis of chronic kidney disease. Vet Pathol ; Acute kidney injury and chronic kidney disease: an integrated clinical syndrome.

Kidney Int ; Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Cohen SM. Crystalluria and Chronic Kidney Disease.

Identifying, monitoring and managing at RISK patients

Toxicol Pathol ; Vet Rec ; Renal phosphorus excretion in adult healthy cats after the intake of high phosphorus diets with either calcium monophosphate or sodium monophosphate. Effect of a high phosphorus diet on indicators of renal health in cats. J Feline Med Surg b; Risk factors associated with the development of chronic kidney disease in cats evaluated at primary care veterinary hospitals. J Am Vet Med Assoc ; A retrospective evaluation of contrast-induced kidney injury in dogs Evaluation of predictors of the development of azotemia in Cats.

Jepson RE. Am Fam Physician ; Frequency of bacteriuria in dogs with chronic kidney disease: A retrospective study of cases. Littman MP. Genetic basis for urinary tract diseases. Chronic kidney disease in dogs in UK veterinary practices: Prevalence, risk factors, and survival. Polzin D. Chronic Kidney disease. Piyarungsri K, Pusoonthornthum R. Risk and protective factors for cats with naturally occurring chronic kidney disease.

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JFMS ; Feline CKD: Pathophysiology and risk factors--what do we know? J Feline Med Surg ; 15 Suppl 1: Weekly pet tips - sent straight to your inbox. Subscribe to our free e-newsletter. Please enter a valid address.

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Kidney failure is that common. And that deadly. After all, cats with kidney disease often live for years beyond their initial diagnosis.

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Snakebite: First Aid. Surgical Treatment for Feline Hyperthyroidism. On palpation over the spine, scapulae, skull or wings of the ilium, muscle mass is moderately wasted. The IRIS has proposed that dogs and cats with CKD should be sub-staged on the basis of risk of hypertensive injury as determined by serial blood pressure measurements Table b. Pain Reliever Facts for Dogs and Cats.

To be sure, most do not. These are usually the first symptom owners of chronic renal disease cats notice: Large volumes of urine clotting the clumping kitty litter. And lots of water downed in record time. When kidneys decline, they can no longer efficiently excrete lots of toxins. That can lead to a major rise in some very nauseating chemicals in the blood. Fortunately, this nausea can be assuaged by a growing arsenal of veterinary drugs designed for this purpose. Subcutaneous fluid administration is the most common route of fluid input in the long term, though intravenous fluid administration is typically preferred at the outset and may be necessary intermittently throughout the course of the disease.

The kidneys make a hormone erythropoietin that triggers red blood cell production. This means that when the kidneys suffer, the blood suffers too. Moreover, the excess of fluids these patients sometimes receive means their blood is always more dilute than it would otherwise be, effectively lowering the number of red blood cells making the rounds. Anemia low red blood cells in the circulation is common to chronic renal failure cases and can be managed with nutritional supplementation of iron to a small degree and with synthetic or natural hormone supplementation darbopoetin or erythropoitin, respectively to a larger degree.

But these drugs have side effects, so cats must be managed carefully when they receive them. Phosphorus is not your friend during kidney failure. Consequently, calcium levels rise to match the phosphorus load—and the calcium has to come from somewhere, right? The calcium-rich bones are subsequently leached of their stores, weakening them severely in some cases.

Cats with renal disease tend to be geriatric.

Identifying, monitoring and managing at RISK patients

Renal Disease In Dogs And Cats: COMPARATIVE AND CLINICAL ASPECTS [A., ED. MICHELL] on *FREE* shipping on qualifying offers. Book by. By A.R. Michell The aim of this book is to encourage veterinarians, at whatever stage of their career or training, to take a deeper, more perceptive.

Which, of course, makes them weak. Drugs to stimulate appetite can be had. Some are actually moderately effective even when nausea-damping drugs have made no headway. Keeping tabs on weight is crucial for kidney failure kitties.

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But most cats never have this issue addressed usually through drugs, like amlodipine. For some, drugs can make a very real difference. By far the most controversial aspect of chronic renal disease therapy, nutritional treatment is nonetheless the most popular approach to mid- to long-term management of feline kidney patients. Low in sodium and protein, these diets are engineered to reduce blood pressure and limit the buildup of toxins. After all, our carnivorous cats are built to relish their protein-rich meats.

Luckily, plenty of research has gone into these diets and lots of manufacturers are coming up with increasingly appetizing approaches. By the way, cooking for chronic renal failure kitties is often a fruitful endeavor.

Chronic Kidney Disease, Part 1: Overview