Polyuria/Polydipsia

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what is another name for hyperadrenocorticism?

Cushing's disease

what are symptoms of cushings disease?

bilateral alopecia, pendulous abdomen, Pu/Pd

what does hypercalcemia indicate?

cancer or cushings

how does pyometra lead to PuPd?

causes the tubules to be unresponsive to ADH

what are diuretics?

chemicals that enhance urinary output

what is thoracic caval constriction?

constriction of the vena cava in thorax

how does renal disease cause PuPd?

decreases renal concentration mechanisms

how do you perform the water deprivation test?

deprive the animal of water for 12 hours and measure urine SG every 3-4 hours; terminate if urine is concentrated, weight loss of 7% or more occurs, or increase in plasma protein or osmolality

what is thirst?

desire to drink

what should be included in treatment for kidney failure?

dextrose

what are some disorders that cause Pu/Pd?

diabetes insipidus, diabetes mellitus, hyperadrenoncorticism, hypercalcemia, hyperthyroidism, liver failure, medullary washout, pyometra, renal disease, iatrogenic diseases

what are renin and angiotensin?

dipsinogenic molecules that stimulate thirst

what are the 4 steps of diagnostic plan for PuPd?

document that issues of PuPd exit, data base collection, perform urine concentration tests, perform special diagnostic tests

if presenting PuPd what may be seen on an ultrasound?

enlarged pelvic area

what is polydipsia?

excessive thirst

what is polyuria?

excessive urination

what controls the ADH control center?

extracellular fluid osmolality

what SG would indicate a kidney issue?

greater than 1.035

what causes primary polydipsia?

hypothalamic irritation, compulsive water drinking or pseudopsychogenic polydipsia, increased plasma renin, hypercalcemia, thoracic caval constriction

where is the thirst center located?

hypothalamus

when should a ADH response test be performed?

if the animal fails to concentrate their urine during the water deprivation test

when should you not perform a water deprivation test?

if the animal is azotemic, dehydrated or hypercalcemic

what does iatrogenic mean?

illness or disease caused by humans or drug induced

what is the function of antidiuretic hormone?

increase water reabsorption to concentrate urine

what is the ADH osmoreceptor control system?

increased extracellular osmolality leads to ADH release causing increased collecting tubule permeability for increased water resorption

what would you use diuretics to treat?

inflammation

how does hypercalcemia cause PuPd?

inhibits ADH and mineralizes kidneys causing chronic renal failure

how does alcohol cause PuPd?

inhibits ADH release

what is diabetes mellitus?

insulin deficiency

what causes primary thirst?

intracellular dehydration and low blood volume and pressure detected by left atrial receptors

how does hyperadrenocorticism cause Pu/Pd?

it causes an increased production of glucocorticoids which inhibit ADH recognition at collecting duct

how does diabetes mellitus cause Pu/Pd?

it causes hyperglycemia leading to glucosuria

what is the common name for furosemide?

lasix

what is medullary washout?

loss of countercurrent multiplier system

does the urine of polyuric animals have a high or low specific gravity?

low

what diuretic would be choice for cerebral edema?

mannitol

what are common diuretics?

mannitol, dextrose, furosemide, alcohol

what causes thoracic caval constriction?

mass putting pressure on vena cava

what is the neurogenic cause of diabetes insipidus?

neural injury to pituitary gland causes a deficiency of ADH

what diseases cause ADH deficiency?

neurogenic diabetes insipidus, iatrogenic causes

what are the two causes of diabetes insipidus?

neurogenic or nephrogenic

are animals with SG >1.035 poly uric?

no

is secondary thirst well understood?

no

how do you perform a ADH response test?

obtain urine SG withhold water and food, give SQ injection of vasopressin tannate, take urine SG at 30 min

does polyuria or polydipsia cause the other?

polydipsia is usually a result of primary polyuria

what is pseudopsychogenic polydipsia?

primary polydipsia caused by stress, anxiety, boredom leading to compensatory polyuria

what is pathologic thirst?

primary polydipsia that causes compensatory polyuria

what is pyometra?

pus in the uterus

what does dipsinogenic mean?

quality of compounds that stimulate thirst by direct action on the thirst center

what are common dipsinogenic compounds?

renin and angiotensin

what are pituicytes?

specialized neurons that produce ADH

what does isosthenuric mean?

specific gravity of glomerular filtrate is equal to plasma meaning urine is more concentrated than glomerular filtrate

what is secondary thirst?

the animal anticipates its water needs prior to deficiencies so it drinks a lot in preparation

what does a positive vasopressin response test indicate?

the animal has a ADH deficiency or unresponsiveness

what does a failure to obtain concentrated urine from a water deprivation test indicate?

the animal has an ADH deficiency, ADH unresponsiveness, primary renal disease or medullary washout

what does a failure to respond to the vasopressin response test indicate?

the animal has primary renal disease, diabetes insipidus or medullary washout

what is the water deprivation test used for?

to rule out primary polydipsia

what is the nephrogenic cause of diabetes insipidus?

tubule enzyme deficiency causing an unresponsiveness to ADH

what is another name for antidiuretic hormone?

vasopressin

what are some urine concentration tests?

water deprivation test and ADH response test

what is the countercurrent system?

water is reabsorbed along concentration gradients found in the loop of henle in renal medulla causing decreased osmolality

what should be included in a physical exam of a dog with suspected PuPd?

weight, hydration status, PCV, plasma proteins, urine SG

what is medullary wash out?

worn out kidneys

what is the SG of plasma?

1.008-1.012

what is a normal SG in response to the vasopressin response test?

1.015

what is a dog's normal SG?

1.020-1.025

what is a cat's normal SG?

1.025-1.030

how much fluid can a 25# dog's glomeruli process each day?

68 liters

how much of a blood volume decrease stimulates thirst?

8-10% decrease

how much urine would a 25# dog produce in a day?

<500ml

how do glucocorticoids cause PuPd?

ADH inhibition

what are some renal concentrating mechanisms?

ADH osmoreceptor control system and countercurrent system

what is the abbreviation for polyuria and polydipsia?

Pu/Pd

what is diabetes insipidus?

a disorder caused by inadequate amounts of ADH which causes excessive water loss

where is the antidiuretic hormone control center?

adjacent to the thirst center in the hypothalamus

what are some iatrogenic causes of PuPd?

alcohol, glucocorticoids, diuretics


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