Acutely PUPD Greyhound

Re: Acutely PUPD Greyhound

sophia guymer — Mon, 11 Jul 2011 18:30:52 GMT

Hi Claire,

Only just read this thread, quite interested to find out what happened in theatre?

Sophia

Re: Acutely PUPD Greyhound

Claire Edgington — Fri, 03 Jun 2011 15:40:03 GMT

Just a wee update. He is in theatre although not quite sure why (a nurse phoned in) and is getting a blood transfusion.... I'll let you know when I hear more.

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 21:53:44 GMT

Thanks claire - keep us posted

Re: Acutely PUPD Greyhound

Claire Edgington — Thu, 02 Jun 2011 21:16:46 GMT

Thanks everyone for your suggestions. On re-ex his mm was tacky, he was anorexic, still v pupd. Temp was down to 101.8. The owners were v worried so decided to refer. I felt very limited at this practice so agree that referral was best. We'll wait to see what they find. I would have loved to have been able to scan him! Thanks again.

Re: Acutely PUPD Greyhound

Stephen Ashman — Thu, 02 Jun 2011 19:55:56 GMT

[quote user="Richard Fox"]Hepatic failure - unlikely with the low liver enzyme results[/quote]

Bile acids are high and glucose is low though, so I'd consider a liver problem. Could have bleeding causing platelet consumption if clotting factors poor?

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 18:39:44 GMT

Any update Claire?

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 18:04:05 GMT

Hi Simon

No it does not rule out renal disease - It suggests as you say that GF is working OK as the glomeruli are able to filter fluid out of the plasma but it does suggest tubular dysfunction. This can obviously be primary tubular disease or secondary tubular dysfunction due to systemic disease. But as others say it is not specific for primary renal tubular/intersitial disease.

Vet stream explains it better than I could:

Definition: urine Specific Gravity <1.008; Urine Osmolality <300 mOsm/kg.

Hyposthenuria implies urine with an osmolality less than that of plasma and indicates decreased reabsorption of water by the kidneys and a normal renal ability to dilute urine.

Urine concentration is determined by the action of antidiuretic hormone (ADH) upon the principal cells of the cortical and medullary collecting ducts, and is dependent upon the presence of a hyperosmotic medullary interstitium.

Re: Acutely PUPD Greyhound

Simon Neuhoff — Thu, 02 Jun 2011 16:53:43 GMT

Richard correct me if I'm wrong but I though a urine sg of below 1.008 indicated renal function was ok? Because the kidneys are actively diluting the filtrate?

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 14:47:54 GMT

Ooops - read the op and re-read the op

Re: Acutely PUPD Greyhound

Kate Richardson — Thu, 02 Jun 2011 14:46:04 GMT

[quote user="Richard Fox"]Pyometra - no other evidence to support it?[/quote]

Slightly unusual in a male dog

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 14:39:29 GMT

Most common causes of hyposthenuria <1.008

Pyometra - no other evidence to support it?
Pyelonephritis - unlikely with a normal urine examination
Hyperadrenocorticism - unlikely
Hypoadrenocorticism - poss but depends on K+ Na+ etc
Diabetes insipidus (central or nephrogenic) - def poss
Renal tubular injury/early renal failure - unlikely d.t normal urea creat but I would repeat
Hepatic failure - unlikely with the low liver enzyme results
Primary polydipsia - poss
Hyperthyroidism - unlikely in a dog esp with acute onset
Hypercalcemia (of malignancy, hyperparathyroidism, renal failure, hypoadrenocorticism, hypervitaminosis D, granulomatous disease, physiological in young animals) - not indicated
Fanconi's syndrome/primary renal glycosuria - unlikely given breed
Renal medullary washout - def poss but hx dependant

Re: Acutely PUPD Greyhound

Bob Russell — Thu, 02 Jun 2011 14:33:32 GMT

How old? Vaccinated? Lepto/Infectious canine hepatitis (never seen it!)?

Treat symptomatically - maybe step up the Betamox to Synulox.

Re: Acutely PUPD Greyhound

Kate Richardson — Thu, 02 Jun 2011 14:32:27 GMT

[quote user="Richard Fox"]Ahh ok - but the 1.005 is true? If so I'd be concerned about renal disease[/quote]

Or a urinary tract infection?

Re: Acutely PUPD Greyhound

Kate Richardson — Thu, 02 Jun 2011 14:31:06 GMT

Isn't that PCV fairly normal in greyhounds? Although doesn't mean not dehydrated.

Re: Acutely PUPD Greyhound

Kate Richardson — Thu, 02 Jun 2011 14:28:56 GMT

Is he neutered? If not check his prostate. Likely lethargic due to the pyrexia, but also possibly dehydrated. What were urea/creat/TP/PCV? Glucose is also low which warrants rechecking. As Richard said, check with the lab re the platelets as clumping is common- did they check a blood smear or was it just run on a machine? If no blood smear checked they want telling off! Potassium is high normal, so keep Addisons at the back (or front) of your mind although Na is well normal. If you have the rest of the haematology results post them as well, sometimes gives you clues- eg lack of a stress leukogram in addisons for example. Certainly pancreatitis or a cholangiohepatitis strong possibilities. Any posibility of a foreign body? Any abdominal pain? Unless the dog is improved, and depending on owners wishes, I'd be getting the dog on fluids, opioids if painful and continued antibiosis if still pyrexic, probably some nsaid once hydration improved.

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 14:26:52 GMT

Ahh ok - but the 1.005 is true? If so I'd be concerned about renal disease, get it in on fluids - see what its PCV is doing now with regards to dehydration?

Edit: "Urea, creat, ALT, GGT, ALB, GLOB were all within normal limits" - maybe worth repeating to see if they have changed?

Re: Acutely PUPD Greyhound

Claire Edgington — Thu, 02 Jun 2011 14:26:09 GMT

Urea, creat, ALT, GGT, ALB, GLOB were all within normal limits.

Re: Acutely PUPD Greyhound

Claire Edgington — Thu, 02 Jun 2011 14:24:49 GMT

Full Haem results - RCC 7.53, Hb 19.8, HCT 0.62, MCV 82.3 (68-81), MCH 26.3 (20-26), MCHC 31.9 (32-36), WCC 4.7, Neut 3.67, Lymph 0.71, Mono 0.33, Eosin 0, no abnormal cells, no platelet clumping.

I have no microscope either so can't have a look myself.

With regards to the urine sample, I meant that protein, blood etc was negative!

Re: Acutely PUPD Greyhound

Richard Fox — Thu, 02 Jun 2011 14:15:22 GMT

Check for platelet clumping? "Urine sample was unremarkable with an s/g of 1.005" - SG of 1.005 is not unremarkable - very dilute? Also why is it pyrexic - have you got any haem results? Any increases in Urea/Creatinine? If not what about diabetes insipidous?