Symptoms and treatment of canine uremia.
Uremia is usually caused by kidney failure in dogs, which makes the metabolites and other toxic substances in the dog unable to be excreted well, resulting in a toxic syndrome caused by the accumulation of toxins. Therefore, if dogs have uremia, their kidneys must have serious lesions.
1. After the absorption of intestinal toxic substances, such as phenol, tyramine phenylethylene diamine, etc., is absorbed into the blood from the intestinal tract, due to renal failure and the reduction of liver detoxification function, the toxic substances accumulate in the blood and cause poisoning.
2. Due to kidney failure, urea enters the intestinal cavity, is decomposed into ammonia and ammonium salts by intestinal bacteria, and then absorbed into the blood, causing symptoms of nervous system poisoning.
3. The accumulation of toxic products from the decomposition of certain proteins, such as guanidine compounds, can inhibit the activity of certain enzymes (lactate dehydrogenase, ATPase, etc.) in the body, thereby causing convulsions in dogs, and can also induce gastroenteritis and pericarditis in dogs , bleeding and decreased immune function.
4. Acidosis occurs due to the obstruction of excretion of acidic metabolites, causing changes in breathing, cardiovascular activity and coma.
The main symptoms
1. Due to the damage of various tissues and organs in dogs, its clinical symptoms are also more diverse. Sick dog is extremely depressed, unconscious, sensory disturbance, lethargy: loss of appetite or abolition, vomiting, gastrointestinal inflammation, mucosal ulcer, diarrhea , bloody stool, intestinal paralysis: increased blood pressure, cardiac insufficiency, pulmonary edema, congestion, breathing Shallow and frequent.
2. Due to the metabolic disorder, the dog may show dehydration, hyponatremia, calcium and hyperkalemia, phosphorus and magnesium hyperemia, significantly increased non-protein nitrogen content in blood, acidosis, and hyperlipidemia. Impaired glucose tolerance, vitamin deficiency. Hyperphosphatemia further leads to abnormal calcium metabolism, vitamin D deficiency, and osteochondrosis and osteodystrophy in dogs, and can also be secondary to hyperparathyroidism. Since dogs are immunocompromised, they are prone to secondary infections.
3. The kidneys have the function of concentrating and diluting urine. In prerenal renal failure, renal concentrating and diluting functions are reduced: in postrenal renal failure, urine specific gravity varies. When critically ill, oliguria or anuria may occur.
Blood urea nitrogen was higher than 40 mg/100 ml, creatinine was higher than 4 mg/100 ml, and blood sodium, calcium, and carbonate were decreased. Elevated serum potassium and phosphorus.
1. General treatment. Sodium bicarbonate was given according to the degree of acidosis, and calcium-free infusions were selected to adjust hyperkalemia. Amino acids, high energy, vitamin preparations, etc. are supplemented in large quantities to improve hyperazotemia. For dogs with prerenal uremia, administer furosemide 2-4 mg/kg body weight every 8-12 hours. Or diuric acid 1-2 mg/kg body weight, administered in 2 doses. When neurological symptoms occur. To chlorpromazine 10 ~ 20 mg / kg body weight or phenobarbital 2 ~ 5 mg / kg body weight, orally 3 times a day.
2, peritoneal dialysis. Peritoneal dialysis can be performed when blood urea nitrogen is 100 mg/100 mL, serum creatinine is 10 mg/100 mL, and serum potassium is 6 mmol/L. Dialysate is a calcium-free liquid. Intermittent peritoneal perfusion The method is relatively simple. For dogs with severe water retention, hypertonic glucose perfusate can be used. If the symptoms are relieved and then relapse after repeated perfusion, it indicates that the kidneys have completely lost their function. poor prognosis.
3. When the pulmonary edema is severe, use a combination of glucose and sodium lactate with high osmotic pressure. Since the perfusate does not contain potassium chloride, for patients with hypokalemia, 4 ml of potassium chloride should be added per liter of perfusate.