Acquired renal dysfunction: heartworm disease, ehrlichiosis, and severe pyoderma may all cause damage to which part of the nephron?
Glomerulus
(glomerulonephritis)
They all lead to immune complex deposition.
What is meant by the term “intramural” in reference to ectopic ureters?
The ureter tunnels within the bladder wall and inserts in an excessively caudal location
Which urinary stones are radiopaque, and which are not?
- Most radiopaque: calcium phosphate, calcium oxalate, struvite
- Least radiopaque: cystine and urate
Memory aid for cystine and urate as least radiopaque: I can’t C U.
Which renal syndrome causes primary urinary loss of glucose, amino acids, and phosphate, with concurrent renal tubular acidosis?
Fanconi syndrome
Which nerve provides somatic innervation to the external urethral sphincter?
Pudendal nerve
Where does the majority of sodium reabsorption take place in the nephron?
The proximal convoluted tubule
Renal conjugation of bilirubin with urinary excretion is seen in which domestic species?
Canine
This phenomenon explains why mild bilirubinemia in the dog is not usually clinically relevant.
Name the two endogenous compounds most commonly associated with pigment nephropathy.
- Myoglobin
- Hemoglobin
When blood concentration of either is high, it can cause renal proximal tubule damage.
Calcium oxalate monohydrate crystals and calcium oxalate dihydrate crystals in dogs: which one is more suggestive of ethylene glycol toxicosis?
- Monohydrate (“picket fence” shape): ethylene glycol
- Dihydrate (“envelope”, “Maltese cross” shape): nutritional or artifact of refrigeration or, less commonly, ethylene glycol
Glomerulonephritis can cause severe proteinuria leading to a hypercoagulable state due to the loss of which protein?
Antithrombin III
Heat precipitation or electrophoresis of urine is used for detecting which characteristic substance in cases of multiple myeloma?
Bence Jones proteins
Approximately which proportion of nephrons must be nonfunctional before abnormal concentrating ability of the kidneys is evident?
Lose ability to concentrate when 2/3 of nephrons are nonfunctional
(versus 3/4 for azotemia)
A patient’s azotemia responds rapidly and completely to fluid replacement therapy alone. Is the azotemia more likely of renal or prerenal origin?
Prerenal
A suckling neonatal animal has a urine specific gravity of 1.009. Is this indicative of renal dysfunction?
No, suckling neonatal animals normally produce a very dilute urine with a specific gravity < 1.010
Approximately what proportion of nephrons must be nonfunctional before the bloodwork shows azotemia?
About 3/4
(vs. 2/3 for concentrating ability)
This means animals can have renal disease with no azotemia, but USG may reveal inability to concentrate.
Name the three types of azotemia.
- Pre-renal
- Renal
- Post-renal
Decreased production of which substance causes non-regenerative anemia in animals with chronic kidney disease?
Erythropoietin
It is synthesized by pericytes (peritubular capillary cells) of the kidney.
A creatinine level that is twice as high in abdominal fluid compared to creatinine level in the serum is usually a sequela of which condition?
Ruptured urinary bladder
What is the purpose of the sulfosalicylic acid test component of a urinalysis?
It detects and helps quantify proteinuria
Sulfosalicylic acid testing helps to differentiate between bona fide proteinuria and a false-positive dipstick protein reading from alkaline urine (common in equids).
The resorptive capacity of the proximal renal tubule is exceeded when the blood glucose concentration exceeds which value (renal threshold) in the horse or dog?
~180 mg/dL
(10 mmol/l)
Note, it is much higher in cats (~280 mg/dL) and much lower in cattle (~140 mg/dL).
Name three nonrenal lesions associated with uremia that reflect the systemic effects of chronic kidney disease and accumulation of uremic toxins.
- Ulcerative and hemorrhagic gastritis and/or colitis
- Ulcerative and necrotic stomatitis
- Soft-tissue mineralization
- Pneumonitis/pulmonary edema
- Pericarditis
- Fibrous osteodystrophy
- Atrial and aortic thrombosis
- Hypoplastic anemia
- Parathyroid hyperplasia
- Platelet dysfunction
What is the diagnostic test of choice for evaluating the magnitude of proteinuria?
Urine protein to urine creatinine ratio
(UP:UC or UPC ratio)
The normal urine pH in carnivores is:
- A. Acidic
- B. Alkaline
- C. Neutral
A. Acidic
Reported ranges are 7.0–7.5 in dogs and 6.3–6.6 in cats, vs. herbivores are alkaline.
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