• Childhood Kidney Diseases
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• 제21권1호
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• pp.21-25
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• 2017

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

• 한국임상수의학회지
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• 제27권5호
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• pp.614-617
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• 2010

3년령, 암컷 점박이 하이에나가 분만의 증상을 나타내나 분만이 이루어지지 않아 이를 교정하기 위해 충북대학교 동물의료센터에 의뢰되었다. 분만 징후가 관찰된 후 5일이 경과되었고, 스스로 분만이 불가능하였기 때문에 제왕절개를 계획하였다. 수술 전 혈액화학검사 결과 심각한 질소혈증이 관찰되었으며, 수술 중 골반입구를 폐쇄하고 있는 태아의 두부가 요도를 압박하여 배뇨가 불가능하였음을 확인하였다. 또한 확장된 자궁내의 태아는 견관절굴절위를 나타내고 있었으며, 태아의 두부가 골반입구로 진입할 수 없을 정도의 크기를 나타내고 있었다. 태아의 상태는 폐사 후 부패가 진행된 상태였으며, 과다 체중(모체의 약 5%)을 나타냈다. 이 증례는 점박이 하이에나에서 과대태아 및 견관절굴절위로 인한 난산이 신후성 질소혈증을 일으킨 최초의 보고이다.

• Journal of Veterinary Science
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• 제24권5호
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• pp.62.1-62.7
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• 2023

This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in Hanwoo. Hyponatremia, hypochloremia, azotemia, and hyperglycemia were observed in both urethral obstruction and urinary bladder rupture. However, cattle with urethral obstruction showed hyperkalemia and mild hyperglycemia, whereas cattle with bladder rupture showed marked hyperglycemia and normal potassium levels. In ultrasonography, the urethral obstruction showed a dilated bladder with a thick bladder wall. In contrast to previous literature, in this study, severe electrolyte changes such as severe hyponatremia, hypochloremia, and hyperkalemia occurred in a case of complete urethral obstruction.

• 한국임상수의학회지
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• 제33권1호
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• pp.34-38
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• 2016

1년동안 ACVIM C단계의 심부전 및 IRIS 4단계의 신부전으로 관리 중이던 13세의 중성화 잡종견과 급성으로 발병한 신부전으로 인한 요독증과 이에 속발한 형태의 폐부종이 동반된12세의 중성화 암컷 잡종 고양이가 본원에 내원하였다. 본 환자들에 체외초미세여과법을 이용한 투석요법을 적용하여 폐부종, 요독증 및 이에 동반된 전해질 및 산염기 불균형 등이 개선되었다. 본 증례는 초미세여과법을 이용한 투석요법이 이뇨제 저항성 및 심한 전해질 불균형이 있는 심장신장증후군 환자와 이뇨제를 이용한 폐부종 치료 도중 급성으로 신장기능 이상이 발생한 환자 등에서 생명을 구하는 치료옵션으로 고려될 수 있음을 보여준다.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.140-145
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• 2017

Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

• 한국임상수의학회지
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• 제21권1호
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• pp.66-71
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• 2004

2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

• 한국임상수의학회지
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• 제31권6호
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• pp.535-538
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• 2014

8년령의 수컷 비글견이 이틀 동안 식욕 부진, 구토, 기력 저하를 주증으로 내원하였다. 혈액학적 검사에서 경등도의 질소혈증과 심각한 저알부민혈증, 뇨 검사에서 심각한 단백뇨가 관찰되었다. 복부 초음파 검사에서 양쪽 신장의 크기가 증가하고 미만성 고에코의 피질이 두드러지게 관찰되었다. 신장 생검과 조직 검사 결과 신장 아밀로이드증으로 확진되었다. 3 개월 동안 환자는 적극적인 내과적 관리를 받았고, 보호자는 환자의 삶의 질에 만족하였다. 이후 심각한 질소혈증과 콩팥증후군이 발생하여 안락사가 실시되었다.

• 한국임상수의학회지
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• 제32권5호
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• pp.440-444
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• 2015

본 케이스는 요독증이 해소되지 않는 말기 만성 신부전 환자에서의 지속적 신대체요법에 관한 보고이다. 본 원에 내원하여 만성신부전으로 진단 내려진 6마리의 환자에서 수액요법과 같은 일반적인 대증요법에 개선이 없었다. 따라서 혈액투석방법을 진행하였다. 평균 57-72%의 요소감소율을 보인 4마리의 환자와 37.3%의 요소감소율을 보인 1마리의 환자견에서 좋은 개선을 보였다. 하지만 6마리의 환자견에서의 93회 혈액투석 동안 체외흐름 폐색, 항응고제 사용에 의한 과도한 출혈등과 같은 부작용이 12회 발생하였다. 따라서 요독증이 개선되지 않는 만성 신부전 환자에서의 지속적 신대체요법은 유용하다 할 수 있으며 혈액투석동안 면밀한 부작용 관찰이 중요하다 여겨진다.

• 한국임상수의학회지
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• 제39권3호
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• pp.144-148
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• 2022

A one-year-old spayed female Korean Shorthair cat presented to Kangwon National University Veterinary Hospital with vomiting, weight loss, lethargy, loss of appetite, and polyuria that lasted for more than two weeks. The body condition score, blood pressure, heart rate, and body temperature were abnormally low, and the physical examination findings were consistent with moderate dehydration. Hematological and biochemical tests demonstrated mild azotemia and a low Na:K ratio. Additional abdominal ultrasound imaging revealed reduced size of both adrenal glands. The adrenocorticotropic hormone (ACTH) stimulation test showed decreased post-ACTH cortisol and aldosterone levels and increased endogenous ACTH levels, confirming a diagnosis of primary hypoadrenocorticism. The cat was treated with subcutaneous injections of desoxycorticosterone pivalate (DOCP) and oral prednisolone supplementation, and subsequent electrolyte analysis showed a normal Na:K ratio. Clinical symptoms were also improved in response to treatment. Hypoadrenocorticism in cats is a very rare disease, but it should not be excluded as a potential diagnosis in favor of kidney diseases or other conditions, especially when the Na:K ratio is low. In addition, the prognosis for the disease and the response to DOCP treatment should be further evaluated in cats.

• 한국임상수의학회지
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• 제17권1호
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• pp.247-251
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• 2000

A male German Shepherd dog, $2{\frac{1}{2}}$years of age, was admitted with sudden anemia, weakness, hyperpyrexia, anorexia and lethargy. The patient showed hypoplastic anemia, thrombocytopenia, absolute and relative lymphocytosis, absolute and relative granulocytopenia, hypoalbuminemia, slight hepatic disorder, slight azotemia, hematuria and proteinuria by the screening examination. The bone marrow aspiration smear showed high cellularity, severs infiltration of lymphoblasts and prolymphocytes, and mitotic figures of lymphoid cells. The liver aspiration smear demonstrated infiltration of lymphoblasts. Acute lymphoblastic leukemia was diagnosed as none of the superficial lymph nodes showed enlargement and marked functional disorder of important organs other than the liver was not found. The patient was treated with vincristine, cyclophophamide, predniosolone for chemotherapy and blood transfusion and either ampicillin or cefoperazone for supportive treatment. But the patient did not show marked remission and died 9 days after the start of the chemptherapy. The necropsy was not permitted.