Lapis ISSN 2398-2969

Kidney: disease

Synonym(s): Renal disease

Contributor(s): Anna Meredith, John Chitty

Introduction

  • Renal disease common.
  • Diagnosis complicated as serum biochemistry changes less useful owing to insensitivity of urea/creatinine (latter especially) as a diagnostic indicator in herbivores.
  • Serum biochemical changes only seen after 50-70% renal function lost.
  • Differential diagnosis of azotemia (other than renal-related):
    • Time-related changes; peak levels late afternoon/early evening.
    • Breed-related- higher in Polish.
    • Does > bucks in New Zealand Whites.
    • Dehydration/water deprivation.
    • Shock.
    • Stress.
    • Cardiac disease.
    • High protein diet.
    • Gastrointestinal hemorrhage, or diarrhea.
    • Generalized catabolic state.
    • Post-renal urinary tract obstruction or rupture.
  • Creatinine levels more specific for renal failure, but less sensitive. Older samples (>24 h) may have artificially lowered creatinine level.
  • Calcium and phosphate levels may be lowered or raised dependent on calcium/phosphate content of diet, ie renal disease reduces ability of body to compensate for dietary levels.
  • Non-regenerative anemia seen in renal failure as in other species, but may also be present due to other causes of chronic pain/disease.

Presentation

  • Thin/weight loss   Weight loss  .
  • Polyuria/polydipsia.
  • Variable appetite: usually reduced, with corresponding reduction in fecal output.
  • Sometimes urine scalding/staining   Moist dermatitis  .
  • Occasional dysuria.

Differential diagnosis

  • Acute:
    • Pre-existing renal or systemic disease.
    • Shock/hypotension/hypovolemia/reduced cardiac output.
    • Hypo-/hyperthermia.
    • Sepsis.
    • Fatty kidney/hepatic lipidosis   Liver: hepatic lipidosis  .
    • Urinary tract infection   Cystitis  .
    • Trauma.
    • Nephrotoxin:
      • Aminoglycosides.
      • Edetate.
      • NSAIDs.
      • Chemotherapy agents.
      • Amphotericin B.
      • Lead.
      • Ethylene glycol.
      • Oxalates (plant-based).
      • Zinc.
      • Vitamin D.
    • Urinary obstruction   Urinary tract obstruction  .
    • Hypercalcemia   Hypercalcemia  .
  • Chronic:
    • Congenital disease, eg kidney agenesis.
    • Age-related fibrosis.
    • Chronic pyelonephritis   Kidney: nephritis  .
    •  E. cuniculiinfection   Encephalitozoonosis  .
    • Hypercalcemia   Hypercalcemia  /hypervitaminosis D.
    • Obesity   Obesity  .
    • Amyloidosis secondary to chronic inflammatory disease.
    • Neoplasia.

Diagnosis

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Treatment

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Prognosis

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Reusch B, Murray J K, Papasouliotis K et al (2009) Urinary protein:creatinine ratio in rabbits in relation to their serological status to Encephalitozoon cuniculi. Vet Rec 164 (10), 293-295 PubMed.
  • Harcourt-Brown F (2007) Radiographic signs of renal disease in rabbits. Vet Rec 160 (23), 787-794 PubMed.
  • van den Buuse M & Malpas S C (1997) 24-hour recordings of blood pressure, heart rate, and behavioural activity in rabbits by radiotelemetry: effects of feeding and hypertension. Physiology & Behaviour 62 (1), 83-89 PubMed.

Other sources of information

  • Klaphake E & Paul-Murphy J (2012) Disorders of the Reproductive and Urinary Systems. In: Ferrets Rabbits and Rodents: Clinical Medicine and Surgery. 3rd edn. Eds: Quesenberry & Carpenter. Elsevier.
  • Oglesbee B L (2011) Blackwells Five-Minute Veterinary Consult: Small Mammal. 2nd edn. Wiley-Blackwell.
  • Fisher P G (2006) Exotic Mammal Renal Disease: Causes and Clinical Presentation. Vet Clin North Am Exotic Anim Pract. pp 33-68.
  • Fisher P G (2006) Exotic Mammal Renal Disease: Diagnosis and Treatment. Vet Clin North Am Exotic Anim Pract. pp 69-96.
  • Jenkins J R (2006) Clinical Pathology. In: BSAVA Manual of Rabbit Medicine and Surgery. 2nd edn. BSAVA.
  • Reusch B (2006) Urogenital System and Disorders. In: BSAVA Manual of rabbit Medicine and Surgery. 2nd edn. BSAVA.
  • Saunders R A & Rees Davies R (2005) Notes on Rabbit Internal Medicine. Blackwell.
  • Girling S (2003) Preliminary Study into the possible use of Benazepril on the Management of Renal Disease in Rabbits. In: Proc British Veterinary Zoological Society. pp 44.
  • Harcourt-Brown F (2002) Textbook of Rabbit Medicine. Butterworth-Heinemann.


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