Renal failure

Re: Renal failure

Christopher Saul — Tue, 05 Nov 2013 12:58:05 GMT

Not much I can add to what's already been said but would add the caveat of monitoring the 'ins' and 'outs' - if a patient is in anuric or oliguric renal failure then it will be quite easy to cause fluid overload and consequent pulmonary oedema.

Re: Renal failure

Andrew Kent — Tue, 05 Nov 2013 11:38:05 GMT

I think you need to be a bit careful using an ACEi in an animal who is significantly azotaemic as can lead to a significant reduction in GFR in some patients. I would try to stabilise the azotaemia first if possible, and as others have said IVFT unlikely to massively increase BP. Andy

Re: Renal failure

Martin Atkinson — Tue, 05 Nov 2013 10:53:06 GMT

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Re: Renal failure

Kate Richardson — Tue, 05 Nov 2013 10:03:38 GMT

Just keep the iv fluid rate to 1-2 x maintenance and monitor BP regularly and adjust rate accordingly. But unlikely to massively increase BP and as Michael said, make sure an anti-hypertensive on board. High BP doesn't necessarily equate to good perfusion. I am not sure I agree that alive and blind is acceptable, but it depends on how the animal copes. I think acute loss of vision is very distressing for an animal, so if I couldn't restore vision I would be concerned. Fine balancing act and it needs the owner to be realistic about the possible outcomes.

Re: Renal failure

Michael Woodhouse — Tue, 05 Nov 2013 01:20:51 GMT

Blind and alive or maintain eyesight and die from renal failure?

You need to give fluids. Can you measure BP? Could always give fluids and ACE inhibitor (dog) or calcium channel blocker (cat).

IV fluids rapidly redistributed so as long as you don't go crazy unlikely to have a great effect on BP.