Azotemia is an excess of urea, creatinine, or other non-protein nitrogenous substances in blood, plasma, or serum.
Uremia is the polysystemic toxic syndrome that results from marked loss in kidney functions. Uremia occurs simultaneously in animals with increased quantities of urine constituents in blood (azotemia), but azotemia may occur in the absence of uremia as suggested by best vet doctor in Gurugram.
Causes of azotemia: Azotemia can be caused by:
(1) increased production of non-protein nitrogenous substances.
(2) decreased glomerular filtration Rate
(3) reabsorption of urine that has escaped from the urinary tract into the bloodstream. High production of non-protein nitrogenous waste substances may result from high intake of protein (diet or gastrointestinal bleeding) or accelerated catabolism of endogenous proteins. Glomerular filtration rate may decline because of reduced renal perfusion (prerenal azotemia), acute or chronic kidney disease (renal azotemia), or urinary obstruction (post-renal azotemia). Reabsorption of urine into the systemic circulation may also result from leakage of urine from the excretory pathways (also a form of post-renal azotemia).
SYSTEMS AFFECTED: Uremia affects virtually every body system.
1. Cardiovascular—arterial hypertension, left ventricular hypertrophy, heart murmur, cardiomegaly, cardiac rhythm disturbances.
2. Endocrine/Metabolic—renal secondary hyperparathyroidism, inadequate production of 1,25-dihydroxycholecalciferol (calcitriol) and erythropoietin, hypergastrinemia, weight loss.
3. Gastrointestinal—anorexia, nausea, vomiting, diarrhea, uremic stomatitis, xerostomia, uremic breath, constipation.
4. Hemic/Lymph/Immune—anemia and immunodeficiency.
5. Neuromuscular— dullness, drowsiness, lethargy, fatigue, irritability, tremors, gait imbalance, flaccid muscle weakness, myoclonus, behavioral changes, dementia, isolated cranial nerve deficits, seizures, stupor, coma, impaired thermoregulation (hypothermia).
6. Ophthalmic—scleral and conjunctival injection, retinopathy, acute-onset blindness.
7. Respiratory—dyspnea may occur.
8. Skin/Exocrine—Pallor, bruising, increased shedding, unkempt appearance, loss of normal sheen to coat.
How to diagnose the condition:
- Nonregenerative anemia (normocytic, normochromic)—often present with chronic renal failure as tested by many veterinary Doctor in Gurugram.
- Hemoconcentration—often present with prerenal azotemia; can also be seen with acute renal failure and post-renal azotemia.
- Concurrent hyperkalemia may be consistent with post-renal azotemia, primary renal azotemia due to oliguric renal failure, or prerenal azotemia associated with hypoadrenocorticism.
- Increased serum albumin and globulin concentration suggest prerenal azotemia or a prerenal component.
OTHER LABORATORY TESTS
- Abdominal radiographs— Helps in diagnosis of the condition.
- Ultrasonography—may detect changes in echogenicity of the renal parenchyma and size and shape of kidneys that support a diagnosis of primary renal azotemia.
- Excretory urography, pyelography, or cystourethrography—may help establish the diagnosis of post-renal azotemia due to urinary obstruction or rupture of the excretory pathway.
Primary renal azotemia and associated uremia:
(1) specific therapy directed at halting or reversing the primary disease process affecting the kidneys
(2) symptomatic, supportive, and palliative therapies that ameliorate clinical signs of uremia; minimize the clinical impact of deficits and excesses in fluid, electrolyte, acid-base balances; minimize the effects of inadequate renal biosynthesis of hormones and other substances, and maintain adequate nutrition.
Post-renal azotemia—eliminate urinary obstruction or repair rents in the excretory pathway; supplemental fluid administration is often required to prevent dehydration that may develop during the solute diuresis that follows correction of post-renal azotemia as suggested by many dog care clinic in Gurugram.
Fluid therapy—indicated for most azotemic patients; preferred fluids include 0.9% saline or lactated Ringer’s solution. Determine fluid volume to administer on the basis of severity of dehydration or volume depletion. If no clinical dehydration is evident, cautiously assume that the patient is less than 5% dehydrated and administer a corresponding volume of fluid. Generally, provide 25% of calculated fluid deficit in the first hour as suggested by Pet clinic in sector 5 in Gurgaon.