Uremia
Uremia is defined as the constellation of clinical signs, impaired metabolic processes, and alteration of organ function that occurs as a result of failure to excrete waste products from the body via the kidneys and urine.
Uremia may be the result of either acute or chronic renal failure, retention of urine in the body because of urinary tract leakage (e.g., bladder rupture), or both. In humans more than 100 retained toxins, including urea, guanidine, phenolic compounds, and phosphorus, are associated with the uremic process, and it can be assumed that similar magnitudes of toxins are present in uremic large animals.33 The predominant clinical signs of uremia seen in large animals are depression and anorexia, along with progressive weight loss, polyuria, polydipsia, melena, and diarrhea. Oral erosions or ulcers, gingivitis, diffuse stomatitis, dental tartar, and halitosis may be evident on examination of the oral cavity. Gastroscopy may reveal gastric ulceration. Coagulopathy and platelet dysfunction make uremic patients prone to gastrointestinal hemorrhage and impaired clotting. Pulmonary edema and uremic encephalopathy may develop in severe cases. Uremia and renal failure are discussed in further detail in Chapter 34.
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