Azotemia lossis creatinine thiab urea nce, tuaj yeem tshwm sim hauv miv vim muaj ntau yam xwm txheej. Azotemia, nyob ntawm nws keeb kwm, tuaj yeem muab faib ua prerenal azotemia (thaum lub raum perfusion txo qis), raum azotemia (vim lub raum puas) lossis tom qab lub raum azotemia (kev hloov pauv hauv kev tshem tawm cov zis ntawm lub cev). Qhov ua rau tuaj yeem muaj ntau haiv neeg, los ntawm lub cev qhuav dej lossis hloov pauv ntawm cov dej ntws, kev haus luam yeeb, hloov pauv electrolyte, tshuaj nephrotoxic lossis lub raum pathology, mus rau kev cuam tshuam ntawm cov zis lossis uroabdomen.
Azotemia hauv miv yog dab tsi?
Azotemia txhais tau tias yog qhov nce hauv cov khoom tsis muaj protein ntau nitrogenous pov tseg hauv cov ntshav, nrog urea thiab creatinine yog qhov ntsuas ntau tshaj plaws. Yog li hais tias miv muaj azotemia yog hais tias tus miv ua kom urea thiab creatinine ncelos yog ib qho ntawm ob.
Urea yog dab tsi?
Urea is a me molecule thiab cov khoom kawg ntawm cov protein metabolism tsim nyob rau hauv daim siab nyob rau hauv lub voj voog urea. Cov tshuaj no yog lim los ntawm glomerulus ntawm lub raum thiab reabsorbed rau hauv lub raum tubule thiab sau ducts ntawm lub raum.
creatinine yog dab tsi?
Creatinine yog ib qho tshuaj uas tsim los ntawmCreatinine yog cov khoom pov tseg tsim nyob rau hauv cov leeg nqaij metabolism thiab yog tsim los ntawm tus nqi tas mus li, nyob ntawm seb cov leeg nqaij. Thaum kawg nws kuj tau lim nyob rau hauv lub glomerulus ntawm lub raum tab sis nws tsis reabsorbed tom qab ntawd, yog secreted nyob rau hauv cov zis.
Types of azotemia in miv
Muaj peb hom azotemia hauv miv. Txawm li cas los xij, hauv txhua qhov peb muaj txo qis hauv lub raum glomerular pom nrog rau qhov nce hauv creatinine thiab urea.
Feline prerenal azotemia
Prerenal azotemia tshwm sim vim qhov txo qis hauv lub raum perfusion vim yog hloov pauv hauv cov ntshav , xws li hypovolemia, lub plawv tsis txaus, cim vasodilation, los yog lub cev qhuav dej. Hauv cov xwm txheej no, los ntawm kev txo lub raum perfusion, glomerular filtration rate txo qis, uas ua rau Urea yog reabsorbed ntau npaum li cas, tshwm sim sai dua nyob rau hauv kev tsom xam vim qhov qeeb qeeb hauv cov tubules thiab ducts. Creatinine yog ib qho uas yuav ua rau qeeb tshaj plaws, vim nws tsis reabsorbed.
Nyob rau hauv cov xwm txheej no, cov miv yuav tsum ua tib zoo mloog cov zis, nws qhov ceev yog sib npaug los yog ntau dua 1.035. Raws li cov nephrons nyob twj ywm, tsis muaj kev puas tsuaj lossis hloov pauv hauv lawv txoj haujlwm, thaum perfusion rov qab los, lub raum ua haujlwm rov zoo li qub.
Feline renal azotemia
ZIBHAUV LUB Renal Azotemia, raws li nws lub npe qhia, muajKev txo qis hauv lub raum ua haujlwm ntawm 66-75 % ua rau cov ntshav urea nce ntxiv, tom qab creatinine, nrog cov zis tsis txaus (1.008-1.012).
Txawm li cas los xij, qhov ceev ntawm 1.013 thiab 1.034 qhia tias ib feem ntawm cov zis muaj peev xwm tsis zoo, tab sis nws tsis txaus los them rau qhov poob. Tsis tas li ntawd, cov miv uas muaj kab mob raum ntev khaws lub peev xwm los mloog cov zis ntev dua li cov dev, thiab qhov ceev ntau dua 1 tuaj yeem xav tau.020, tab sis yuav nyob twj ywm tsis txaus los tiv thaiv azotemia.
Postrenal azotemia
Nyob rau hauv lub raum tom qab azotemia, lub raum kev ua haujlwm thiab glomerular filtration tus nqi yog kiag li ib txwm thiab muaj txiaj ntsig, txawm li cas los xij cov khoom siv tawm tsis tawm hauv lub cev los ntawm cov zis rau thaiv cov dej ntws tawm
Dab tsi ua rau azotemia hauv miv?
Kev nce hauv creatinine thiab urea tuaj yeem tshwm sim hauv ntau lub sijhawm, yog li nws tseem yuav nyob ntawm seb hom azotemia raug kho.
Ua rau feline prerenal azotemia
Prerenal azotemia tshwm sim thaum tsis muaj lub raum puas los yog lub raum outflow obstruction thiab tsim raws li ib tug tshwm sim ntawm txo perfusion ntawm lub raum vim yog ib qho hloov pauv hauv cov ntshav, xws li:
- Hypovolemia.
- Hlub plawv tsis txaus.
- Vaj tswv tseem ceeb.
- Dehydration.
Ua rau lub raum azotemia hauv miv
Renal azotemia tshwm sim thaum muaj kev puas tsuaj rau lub raum lawv tus kheej. Yog li, azotemia hauv cov xwm txheej no yog tsim los ntawm:
- : mob raum mob heev: tshwm sim sai thiab khaus nrog txo glomerular filtration rate. Qee zaum nws tuaj yeem thim rov qab. Feem ntau ua rau miv yog nephrotoxins (tshuaj, ethylene glycol, hnyav hlau, lilies, thiab iodinated contrast agents), hypercalcemia, hypophosphatemia, mob ua rau lub raum tsis zoo (hypovolemia, thrombosis, infarction, polycythemia, los yog hyperviscosity), los yog lub raum. kab mob parenchymal (pyelonephritis, glomerulonephritis, urinary tract obstruction).
- Kab mob raum: Kev txo qis hauv glomerular filtration rate thiab lub raum ua haujlwm, uas muab sijhawm los qhib cov txheej txheem them nyiaj. Nws yog ib qho tsis pom qhov tshwm sim thawj zaug hauv miv, thiab nws tuaj yeem tshwm sim los ntawm qee qhov ua rau mob raum mob xws li kab mob urinary tract, non-steroidal anti-inflammatory tshuaj los yog hypovolemia. Nws kuj tuaj yeem tshwm sim los ntawm ntshav siab.
Causes of postrenal azotemia in miv
Postrenal azotemia tshwm sim thaum cov zis ntws los ntawm extrarenal ua rau. Ua li no, cov laj thawj tuaj yeem yog:
- Obstruction of the urethra.
- Obstruction, rupture los yog ligation nyob rau hauv lub ureters.
- Bladder leak or zais zis rupture.
Lwm yam ua rau azotemia hauv miv
Ntawm qhov tod tes, high urea hauv miv tsis muaj creatinine nce ntxiv tuaj yeem tshwm sim tom qab noj cov zaub mov muaj protein ntau thaum muaj cov hnyuv. los ntshav. Nce urea thiab ib txwm creatinine kuj tuaj yeem tshwm sim hauv miv thaum cov protein catabolism nce ntxiv rau pyrexia lossis corticosteroid siv.
Txawm li cas los xij, creatinine siab hauv miv tej zaum tsuas yog vim tus miv muaj cov leeg nqaij ntau, vim cov leeg nqaij ntau dua. muaj, qhov siab dua qhov qub creatinine concentration.
Symptoms of azotemia in miv
Nyob ntawm hom azotemia hauv miv, cov tsos mob yuav yog:
Feline prerenal azotemia cov tsos mob
Cov tsos mob nyob rau hauv cov ntaub ntawv no yog cov uas muaj feem xyuam rau cov perfusion qis vim yog hloov ntawm cov ntshav ntws. Hauv cov xwm txheej no, tus feline tuaj yeem tshwm sim:
ZAUGANCE.
Cov tsos mob ntawm lub raum azotemia hauv miv
Renal azotemia los ntawm mob raum mob tuaj yeem ua rau cov tsos mob xws li:
- Oliguria (tso zis ntim).
- Anuria (tsis tso zis).
- Khob rov qab vim mob raum.
- Tachypnea.
- Tub kub nce.
- Txoj kev nyuaj siab.
- ntuav thiab/los yog raws plab.
- Nyob zoo los yog lub raum loj.
INRHYTHMIAS.
Renal azotemia vim mob raum mob tuaj yeem tsim cov tsos mob xws li:
- Pab qhov ncauj.
- Halitosis.
- Dehydration.
- Cov tsos mob ntawm plab hnyuv.
- Polyuria-polydipsia.
- Kidney txo qhov loj.
- Pab tsis qab los noj mov.
- Vim.
- Vim qhov muag tsis pom kev.
Symptoms of post-renal azotemia
Cov tso zis tso zis vim muaj kev cuam tshuam ntawm cov zis los ntawm pob zeb los yog mucous plugs nyob rau hauv FLUTD (feline qis urinary tract kab mob), kev puas tsuaj rau lub ureters los yog zais zis rupture tuaj yeem tsim cov tsos mob xws li:
- Dysuria (mob tso zis).
- Strangury (mob tso zis, drip).
- Frequency (tso zis me me ntau zaus hauv ib hnub).
- Hematuria (tso zis ntshav).
- Urogenital area lick.
- tso zis tawm sab nraum lub thawv khib nyiab.
- Hyperkalemia (nce poov tshuaj).
Diagnosis of azotemia in miv
txhawm rau kuaj azotemia, ntshav yuav tsum tau kostxhawm rau txiav txim siab qhov concentration ntawm urea hauv cov ntshav los yog ntshav ntshav. Tom qab ntawd nws yuav tsum tau saib seb qhov azotemia no puas yog lub raum ua ntej, lub raum lossis tom qab lub raum.
Diagnosis of prerenal azotemia
Dehydration in miv tuaj yeem txiav txim tau los ntawm kev ua cov kev ntsuam xyuas hauv qab no:
- Nkauj kho siab.
- Kuaj xyuas qhov qhuav ntawm cov mucous.
- Khib lub qhov muag poob.
- Ntshav ua hauj lwm los kuaj qhov nce hauv hematocrit thiab tag nrho cov protein.
A A A A A
Diagnosis ntawm lub raum azotemia
Glomerular filtration rate txo qis hauv cov kab mob hauv lub raum thiab creatinine concentration tau raug suav hais tias yog qhov qhia tsis ncaj ntawm tus nqi glomerular pom. Txawm li cas los xij, SDMA qhia meej dua tus nqi no thiab kuaj mob raum ua ntej tshaj li creatinine, vim tias SDMA nce ntxiv thaum tsawg kawg 25% lub raum ua haujlwm tau tshwm sim thiab creatinine tsis nce mus txog thaum qhov kev poob no tsawg kawg yog 75%. Tsis tas li ntawd, nws yuav tsum tau txiav txim siab tias creatinine nyob ntawm cov leeg nqaij ntawm tus miv, thiab tej zaum yuav muab cov txiaj ntsig tsis tseeb hauv cov leeg nqaij lossis nyias nyias xws li hyperthyroids, uas tsis tshwm sim nrog qhov ntsuas no..
Kom kuaj tau theem ntawm cov kab mob raum, yuav tsum tau ua ntau yam kev ntsuas thiab ntsuas, xws li SDMA, creatinine, UPC (protein / creatinine piv hauv cov zis) thiab systolic ntshav siab.
Yuav tsum tau ua keeb kwm zoo kom paub seb nws puas tau ntsib nrog cov tshuaj nephrotoxic lossis tshuaj, yog tias muaj kab mob urinary, kub siab los yog lub raum tsis ua haujlwm thiab txiav txim siab txog qhov muaj phosphorus thiab calcium kom nrhiav tau tus kab mob raum.
NOJ NTXHAM UA NTEJ YUAV UA NTEJ YUAV UA HAUJ LWM NWS.
Diagnosis of post-renal azotemia
Kom kuaj pom urethral lossis ureteral obstruction lossis zais zis rupture, yuav tsum tau ua cov kev ntsuam xyuas hauv qab no:
- Blood biochemistry los kuaj azotemia, hyperkalemia, hyperphosphatemia thiab metabolic acidosis.
- Cov tswv yim ua kom pom cov kua dej hauv lub plab (uroabdomen) thiab qee zaum txawm tias muaj kev cuam tshuam yuav pom. Kev tshuaj xyuas cov kua tom qab nws rho tawm kom paub tias nws yog zis.
- Urinalysis for crystals, mucous plugs, or blood.
Tshuaj mob azotemia hauv miv
Nyob rau hauv lub ntsej muag ntawm prerenal azotemia, dab tsi yuav tsum tau ua tam sim ntawd yog hloov cov kua thiab perfusion rau feline, los ntawm kev kho dej thiab qee zaum ntshav ntshav.
Nyob rau hauv lub raum azotemia, yog tsim nyog electrolyte cuam tshuam. Nws yog ib qho tseem ceeb los kho cov kab mob sib kis yog tias lawv muaj (mob ntshav qab zib, hyperthyroidism, kab mob plawv, qog). Kev kho mob tshwj xeeb rau lub raum muaj xws li:
- Thiab lub cev qhuav dej nrog kev kho dej.
- Kho siab ntshav siab nrog amlodipine.
- Kho cov proteinuria nrog ACE inhibitors, xws li benazepril.
- Yog tias muaj hyperphosphatemia, pib nrog rau lub raum noj thiab tom qab ib hlis, yog tias cov phosphate tseem siab, muab phosphate binder.
- Npau suav tshuaj xws li mirtazapine.
- Antiemetics xws li maropitant lossis metoclopramide.
- Yog tias muaj mob plab, omeprazole lossis ranitidine.
- Yog zaub mov tsis kam, pub tube.
- Kev noj haus: txo cov protein, phosphorus, sodium thiab nce cov poov tshuaj, rog thiab cov vitamins B.
- Yog tias muaj ntshav liab nrog hematocrit tsawg dua 20%, erythropoietin.
- Tshuaj tua kab mob, yog muaj kab mob urinary.
Nyob rau hauv lub raum azotemia tom qab lub raum azotemia, feline yuav tsum tau unblocked, puas kho, urinary pob zeb tshem tawm nrog kev noj haus (struvite) los yog phais (calcium oxalate), thiab nyob rau hauv cov ntaub ntawv ntawm lub zais zis rupture, phais los kho cov kev puas tsuaj..
