Companion Animal Advanced clinical Management WEEK 4

Week 4 iRATs

Created by
@SmartestJasper8335

Questions and Answers

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True or False: Antimicrobials are generally indicated in the treatment of struvite urolithiasis in dogs but not in cats.

True

Which breed has a genetic predisposition to forming urate uroliths?

dalmatians

According to the readings, what is the cornerstone of urolith prevention strategies for MOST stone types?

Feeding a high moisture diet

Due to possible androgen-dependent formation, castration may be recommended in male dogs diagnosed with which urolith?

<p>cystine</p> Signup and view all the answers

Which urolith has NO potential to be medically dissolved?

<p>ca ox</p> Signup and view all the answers

Which of the following is a consequence of allopurinol administration in a Dalmatian with urate uroliths who is not on a purine restricted diet?

<p>xanthine stone formation</p> Signup and view all the answers

Which of the following has been described as a risk of struvite urolith recurrence? a. Changing to a high-moisture diet b. Feeding an acidifying diet c. Presence of suture material in the bladder d. Recurrent urinary tract infections e. Both b and c f. Both c and d

<p>f. Both c and d</p> Signup and view all the answers

Administration of hydrochlorothiazide (a thiazide diuretic) is recommended in prevention of what urolith type?

<p>calcium oxalate</p> Signup and view all the answers

Knowledge of the composition of which part of the urolith is most important when developing a urolith prevention plan for your patient?

<p>nidus/body</p> Signup and view all the answers

Which drug is used to convert oliguric patients to a non-oliguric status in acute kidney injury patients?

<p>furosemide</p> Signup and view all the answers

True or False: The effectiveness of renal diets in improving outcomes for patients with chronic kidney disease (CKD) is unproven, but likely does no harm.

<p>False</p> Signup and view all the answers

True or False: Despite its cost, the benefit of darbepoetin to address anemia of CKD is that it is generally well-tolerated, has a longer half-life than human erythropoietin, and free of serious adverse effects.

<p>False</p> Signup and view all the answers

According to the ISCAID consensus guidelines, which drug is NOT considered first-tier treatment for sporadic bacterial cystitis?

<p>enrofloxacin</p> Signup and view all the answers

Generally cats presenting with lower urinary tract signs likely have bacterial cystitis and will require a short course of antibacterial drugs.

<p>False</p> Signup and view all the answers

Cats are prone to become inappetent with disinterest in drinking water when they are in pain or general discomfort. Which category of drugs used to manage pain in non-obstructive feline idiopathic cystitis can affect renal function, especially in a poorly hydrated cat?

<p>NSAIDs</p> Signup and view all the answers

Tricyclic antidepressants (TCAs) have adverse effects related to their ability to act as anticholinergics and antihistaminics, leading to the potential for xerostomia, tachycardia, urine retention and sedation. Which drug is a TCA?

<p>amitryptaline</p> Signup and view all the answers

Which drug is considered the drug of choice for canine bacterial prostatitis based on its high lipid solubility, low protein binding, and broad spectrum of activity against many uropathogens?

<p>enrofloxacin</p> Signup and view all the answers

Which drug may cause vulvar enlargement

<p>estriol</p> Signup and view all the answers

Which drug is used to treat renal secondary hyperparathyroidism?

<p>calcitriol</p> Signup and view all the answers

In a patient with chronic kidney disease, at what IRIS stage are SQ fluids recommended?

<p>stage 3</p> Signup and view all the answers

What is the best recommended treatment for dogs with moderate hypertension?

<p>Start enalapril and if not improving add amlodipine.</p> Signup and view all the answers

A 14YO MN DSH is presented on emergency for constipation. He has a history of chronic kidney disease (CKD) and appears to be about 5% dehydrated on exam. You can palpate hard feces in his colon, but the colon does not feel abnormally distended. Knowing this information, what is the best therapy to administer first?

<p>fluids</p> Signup and view all the answers

In cases of sporadic bacterial cystitis in dogs, what medication should you consider starting to ameliorate clinical signs while waiting for the culture results?

<p>meloxicam</p> Signup and view all the answers

True or false: Both overweight cats and underweight cats are at increased risk of developing a urinary tract infection (UTI) and feeding cats to maintain ideal body condition may help reduce the risk of a UTI.

<p>True</p> Signup and view all the answers

Key nutritional modifications in therapeutic diets for dogs with CKD include __________ protein, __________ phosphorous, and __________ potassium.

<p>modified, reduced, added</p> Signup and view all the answers

Which of the following would you recommend for a dog with IRIS Stage 4 CKD that has developed proteinuria?

<p>Prescribe telmisartan</p> Signup and view all the answers

Which of the following are goals for nutritional management for cats with CKD?

<p>To maintain adequate nutrition and mitigate clinical consequence of CKD.</p> Signup and view all the answers

True or false: When performing a urine culture in a patient with pyelonephritis it is important to use urine breakpoints.

<p>False</p> Signup and view all the answers

What is the main treatment for patients with acute kidney injury (AKI)?our patient?

<p>IV fluids</p> Signup and view all the answers

Study Notes

Urolithiasis

  • Antimicrobials are generally indicated in the treatment of struvite urolithiasis in dogs but not in cats.
  • Dalmatian breed has a genetic predisposition to forming urate uroliths.
  • Castration may be recommended in male dogs diagnosed with silicate uroliths due to possible androgen-dependent formation.
  • Calcium oxalate uroliths have no potential to be medically dissolved.

Urolith Prevention Strategies

  • The cornerstone of urolith prevention strategies for most stone types is diet modification.
  • Changing to a high-moisture diet, feeding an acidifying diet, and presence of suture material in the bladder are consequences of allopurinol administration in a Dalmatian with urate uroliths who is not on a purine restricted diet.

Urinary Tract Infections

  • Dalmatians with urate uroliths who are not on a purine restricted diet are at risk of developing xanthinuria.
  • Recurrent urinary tract infections are a risk of struvite urolith recurrence.

Pharmacology

  • Hydrochlorothiazide is recommended in prevention of calcium oxalate uroliths.
  • Furosemide is used to convert oliguric patients to a non-oliguric status in acute kidney injury patients.
  • Darbepoetin is used to address anemia of chronic kidney disease (CKD) and is generally well-tolerated, has a longer half-life than human erythropoietin, and is free of serious adverse effects.

Chronic Kidney Disease

  • Renal diets are effective in improving outcomes for patients with chronic kidney disease (CKD) and are likely to do no harm.
  • SQ fluids are recommended at IRIS stage 3 in patients with chronic kidney disease.
  • The best recommended treatment for dogs with moderate hypertension is amlodipine.

Other

  • Amitriptyline is a tricyclic antidepressant (TCA) used to manage pain in non-obstructive feline idiopathic cystitis.
  • Enalapril is considered the drug of choice for canine bacterial prostatitis.
  • Phosphate binders are used to treat renal secondary hyperparathyroidism.
  • In cases of sporadic bacterial cystitis in dogs, cephalexin should be considered to ameliorate clinical signs while waiting for the culture results.
  • Both overweight cats and underweight cats are at increased risk of developing a urinary tract infection (UTI) and feeding cats to maintain ideal body condition may help reduce the risk of a UTI.
  • Key nutritional modifications in therapeutic diets for dogs with CKD include reduced protein, reduced phosphorous, and reduced potassium.
  • For a dog with IRIS Stage 4 CKD that has developed proteinuria, angiotensin-converting enzyme (ACE) inhibitors are recommended.
  • Goals for nutritional management for cats with CKD include minimizing wasting, maintaining muscle mass, and reducing the risk of secondary hyperparathyroidism.
  • When performing a urine culture in a patient with pyelonephritis, it is important to use urine breakpoints.
  • The main treatment for patients with acute kidney injury (AKI) is supportive care.

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