Name: Sylvia Chee Xiao Wei

Admin no. : 0703753D

Class: TK01

Discuss the clinical diagnosis of acute renal failure in a veterinary clinic with standard in-house instrumentation.

History is an important factor in diagnosis. In acute renal failure, signs like decreased volume of urine, difficulty in urinating, anorexic, vomiting and might change in the daily intake of water and urine output. Upon palpation of abdominal area, pain might be felt by animal and for acute renal failure, kidneys are large and swollen.

Usually, a routine urinalysis is done to check for abnormalities. Several factors are tested and examined.

1. Urine specific gravity (USG) to determine the concentration of urine.

2. pH to gauge if there is any problems such as crystal or stones formation.

3. Glucose to check for diabetes.

4. Cells to see whether cells which are not suppose to be present are present. Different types of cell present represent different types of disease.

5. Presence of crystals.

6. Presence of casts.

7. Presence of bacteria.

*Number 1 – 3 requires dipstick; Number 4 – 7 requires the use of microscope.

If any of above abnormalities is observed, further test should be done to confirm diagnosis. Several tests are conducted to assess function of kidneys.

1. Blood urea nitrogen (BUN) which is caused by high protein catabolism or serious impaired kidney function. There are three types of azotemia.

· Pre-renal azotemia- underperfusion of kidneys

· Renal azotemia- can be due to several reasons Eg. Acute tubular necrosis

· Post-renal azotemia- due to obstruction in urinary tract.

2. Test for creatinine, a substance found in blood which can determine the cause of azotemia. Creatinine is excreted by the kidneys thus increase level of creatinine in blood proves malfunction of kidney excreting it. Usually, the ratio of level of BUN, USG and level of creatinine is compared to further assure the function of kidneys. Test has to be repeat 1 to 2 days later to determine whether results is normal to patient or it’s a sign for acute renal problem.

3. Examination of urine sedimentation.

· Sulfa crystals should be observed carefully as it may be present in pet food acute renal failure. Lignin test can be done to confirm the presence of sulfa crystals.

· Other crystals found can derive from different causes.

4. Proteinuria refers to presence of proteins in the urine. This infers that the kidney is unable to retain protein and thus protein leaks out into the urine. Convention dipsticks are used to test for presence of protein in the urine.

There are limitations for in-house instruments. Thus if the above tests shows high risk og renal problems. Further professional laboratory test should be done to accurately diagnose renal failure.