Renal failure is divided into acute renal failure and chronic renal failure in terms of course and pathology. Compared with chronic renal failure, it is not easy to detect in the early stage. When symptoms occur, renal function has already declined greatly and requires immediate medical attention. The characteristics of acute renal failure It is a sudden stop of kidney function, and most of the symptoms are decreased urine or acute uremia. This is often easier to judge and can be treated in time. But renal failure is ultimately painful for cats, and we should pay attention to it in our daily feeding.

1. Pathogenic mechanism

1. Nephrotoxin is the most common cause of ARF in small animals. Nephrotoxins that can cause ARF include endotoxins, drugs, anesthetics, radiocontrast agents, and endogenous pigments.

2. Renal ischemia is mainly caused by low renal blood perfusion and severe dehydration, prolonged anesthesia, heart failure, hypovolemic shock, thromboembolism (such as disseminated intravascular coagulation, vasculitis and Transfusion reaction) malignant hypertension, heatstroke, excessive vasoconstriction (such as the use of nonsteroidal anti-inflammatory drugs, NSAIDs), excessive vasodilation (such as the administration of angiotensinase inhibitor Aceh or antihypertensive drugs), etc.

3. Infectious sources that can cause ARF include leptospiraspp, Rocky Mountain spotted fever, Ehrlichia canis and any bacteria that can cause pyelonephritis. In short, acute pyelonephritis does not cause renal failure unless ureteral obstruction occurs. Occasionally, ARF may develop secondary to embolism in left-sided purulent endocarditis.

2. Clinical symptoms

　1. Depression, depression, collapse

　2. Anorexia and uremia

　3. Vomiting, diarrhea accompanied by melena

　4. Other organ dysfunction occurs: a. Jaundice b. Congestion and ecchymosis c. Tachypnea, tachycardia d. Low temperature or high fever e. Mucosa is brick red or earthy color

There are three distinct stages of acute renal failure: (1) initial stage, (2) maintenance stage, and (3) recovery stage. Treatments that reduce kidney damage during the initial stages can prevent the progression of already existing acute renal failure. The maintenance phase is characterized by the development of tubular damage and nephron dysfunction. Although treatment measures at this stage are aimed at saving lives, they usually rarely slow down the severity of kidney damage or improve kidney function.

Function, or promote recovery. During the recovery phase, kidney damage is repaired and kidney function improves. If the basement membrane in the renal tubules is intact and active epithelial cells are present, the damage to the renal tubules is reversible. Although new nephrons cannot be generated and irreversible nephron damage cannot be repaired, the remaining nephrons will develop functional hypertrophy., and sufficient to fully compensate for the reduced nephron function. Even if the function of the kidneys has not been fully restored, the functions of the kidneys can still be fully exerted.

3. Diagnosis:

1. There may be a history of potential nephrotoxicity or ischemia, based on clinical symptoms;

2. Acute azotemia and hyperphosphatemia occur;

3. Oliguria/anuria is common in ischemia. ARF caused by Qingda and cisplatin is non-oliguric ARF.

4. Abdominal palpation, pain in kidney area;

5. Renal tissue biopsy can be performed in the following situations: ① The diagnosis cannot be clearly confirmed, ② There is obvious persistent proteinuria, ③ It is suspected that multiple systemic diseases have no obvious effect after traditional treatment: the urine volume lasts for more than 1 to 2 days, and the urine output Too little or lasting for more than 4 to 5 days will lead to severe uremia and hyperkalemia. ④ Carry out histological examination to determine the prognosis. Histological signs of tubular regeneration and intact tubular basement membranes indicate a good prognosis; extensive tubular necrosis and interstitial damage to the basement membrane mineralization indicate a poor prognosis.

4. Treatment:

General treatment methods:

Purpose: To correct the hemodynamic abnormalities of the kidneys and reduce the imbalance of water and salt metabolism, and give the kidneys enough time to recover and compensate. The treatment response is as follows: first, the serum creatinine concentration decreases, indicating an increase in glomerular filtration; secondly, an increase in urine production (if there was originally oliguria or anuria)

Special therapy:

Fluid therapy is the primary treatment for ARF; correcting fluid and electrolyte balance, improving renal hemodynamics and inducing polyuria. Replenish intravenous fluids within the first 4-6 hours; when cardiovascular dysfunction is suspected, infuse slowly! You can use 0.45% NaCl and 2.5% dextran or 0.9% NaCl. If edema occurs, infusion should be slow and diuretics and/or vasodilators may be given. If oliguria persists after fluid therapy, one or more of the following methods can be used. Furosemide, mannitol, low dose dopamine. Furosemide is more effective when infused with mannitol and dopamine than alone. If urination still cannot be promoted within 4 to 6 hours, consider using dialysis therapy. Treat hyperkalemia. If severe hyperkalemia (>6~8mEq/L) (normal value: 3.0-3.5) or hyperkalemia causes cardiovascular disease, the following drugs can be used: 5% NaHCO3, 10% calcium gluconate, to induce polyuria, excretion Potassium. Correct metabolic acidosis. Prevent infection. Antiemetic: famotidine or ranitidine or cimetidine.