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Exam 2
PU/PD
30
Veterinary Medicine
Professional
04/01/2017

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Cards

Term
What is Polyuria? What is the clinical cut-off?
Definition
-excessive urination
->50 ml/kg/day-
Term
What is polydypsia? What is the clinical cut-off?
Definition
-excesive water consumption
->100 mls/kg/day
Term
Which test is the most helpful in eliminating PU/PD as a differential?
Definition
-USG
Term
What do we do if owner observations do not match with rine concentration?
Definition
-have the client measure water consumption at home
Term
What controls water intake & thirst?
Definition
-hypothalamus, pituitary gland, and kidney
Term
Thirst is primarily stimulated by what?
Definition
-inc in plasma osmolality
-others: arterial hypotension, fever, pain, drugs
Term
What is ADH?
Definition
-antidiuretic hormone
Term
Where is ADH stored? What does it stimulate?
Definition
-pituitary
-stimulate thirst
Term
Water permeability is dependent on what?
Definition
-ADH
Term
Permeability of the nephron to urea is fairly low except in the inner medulla. How is this affected by the presence of ADH?
Definition
-enhanced
-during times of water conservation, ADH is inc => inc [urea] in medulla
Term
What two things are necessary for additional concentration of urine to occur?
Definition
-ADH
-salty medulla
Term
What are the general physiologic causes of PU/PD?
Definition
-brain can't make or release ADH
-kidney can't respond to ADH
-excreted fluid overwhelms absorption system (medullary washout)
Term
What are the 3 most common causes of PU/PD in dogs?
Definition
-CKD
-DM
-Cushing's (hyperadrenocorticism)
Term
What are the 3 most common causes of PU/PD in cats?
Definition
-CKD
-DM
-hyperthyroidism
Term
When would we perform urine culture in a PU/PD case?
Definition
-every case
Term
Why would we perform ACTH stim testing in a PU/PD dog?
Definition
-Addison's (hypoadrenocorticism)
Term
Which imaging techniques do we perform on a PU/PD patient?
Definition
-thoracic rads & abdominal U/S
Term
What does iohexol clearance test do?
Definition
-measures GFR
Term
What does DDAVP (desmopressin) trial do?
Definition
-it is a synthetic analog of ADH
-positive response = central DI
Term
What constitutes a positive response to a DDAVP trial?
Definition
-dec water consumption & in cUSG
Term
Why do we test for Addison's before a DDAVP trial?
Definition
-hypoadrenocorticism dogs will also have a positive response to this
Term
Why would we not perform a modified water deprivation test?
Definition
-azotemic
-dehydrated
-hypercalcemic
-significant systemic dz is present
Term
Why would we stop a modified water deprivation test mid-test?
Definition
-USG > 1.030 in dogs OR > 1.035 in cats
-clinical dehydration, azotemia, or illness
-serum osmolality > 320 mOsm/kg
-loss of 5% BW
Term
If urine concentrates during a modified water deprivation test, what is the diagnosis?
Definition
-psychogenic polydypsia
Term
If patient has inadequate conc w/ modified water deprivation test, give ADH & measure USG every 30 min. If urine concentrations >1.018 what is the diagnosis? If not, what is the diagnosis?
Definition
-CDI
=NDI
Term
What is central DI?
Definition
-los or lack of pdn of vasopressin
Term
What is nephrogenic DI?
Definition
-lack of response of kidney to vasopressin
Term
What are some causes of central DI?
Definition
-pituitary tumor in older animals
-head trauma
-pituitary sx
-idiopathic
Term
What causes nephrogenic DI?
Definition
-primary/familial
-or secondary to a ton of renal & metabolic disordrs
Term
What is primary polydispia?
Definition
-typically a behaviro problem in young labs
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