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Hello. My name is Dr. Jessica Quimby and I'm
an Associate Professor at the Ohio State University.
I'm a specialist in small animal internal medicine and have previously
performed PhDs studying feline chronic kidney disease.
The topic of today's talk will be feline chronic kidney disease,
pathophysiology, diagnosis, and then staging of disease.
The next portion of this talk will focus on
the diagnosis of chronic kidney disease in the feline patient.
An overview of this section of the talk will include looking
at what factors are important for us on history,
physical exam, laboratory work,
and imaging in order to determine this particular patient has chronic kidney disease,
and then again, we'll also took a closer look at
the IRIS substaging system and what this means.
When presented with the feline patient who has elevated kidney values and is azotemic,
it's important to remember that this does not
necessarily mean that it is chronic kidney disease,
and we have a number of steps therapeutically that we
need to go through in order to determine that this is the case.
We may have various components of azotemia,
including pre-renal azotemia, which would include dehydration,
or we may actually have renal azotemia where an insult to the kidney has occurred,
or because something like a urethralis,
or a urethral obstruction are so common in the cat,
we do need to make sure that there's not a post-renal component to the azotemia
that potentially requires surgical correction or some other intervention.
In order to actually say that the cat has chronic kidney disease,
we also need to think about the concept that they could have
acute kidney injury versus chronic kidney disease.
It's important to determine from a combination of history,
physical exam, and lab work,
as well as imaging that this patient actually does have
chronic disease and that there are not
other interventions that are necessary for the patient.
Only then we will start instituting therapies that we consider to be appropriate for
chronic disease and basically would
stop the diagnostic hunt for additional interventions that we could do,
so this is quite important.
When we first have this azotemic patient,
we do need to make sure that we're adequately working up the azotemia,
and determining is this chronic disease or is there
another component of disease that we need to be identifying and treating.