Nephrology – 0900-1230, Hall 7

Diagnosis and management of chronic kidney disease in dogs and cats – case based

Dennis J. Chew

This masterclass will briefly review the pathophysiology of chronic kidney disease (CKD) in dogs and cats, with emphasis on features that can be potentially altered to the clinician’s advantage with treatment.  The International Renal Interest Society (IRIS) system for staging CKD based on serum creatinine, urinary protein, and systemic blood pressure will be used throughout the case presentations. Staging of CKD can allow earlier detection of kidney disease and potentially offers guidance for treatment by stage.  Phosphorus restriction will be featured as the pivotal dietary change to increase lifespan and preserve kidney functions; a ‘targeted’ level of serum phosphorus will be emphasized as an overarching goal of phosphorus restriction, rather than aiming to achieve a level that falls within the reference range for serum phosphorus.  The salutary effects of omega-3 dietary oils will also be advanced. The use of intestinal phosphate binders will be featured as a means to further lessen total body phosphate burden during CKD.  Optimal use of the salts of aluminium, calcium (carbonate and acetate) and lanthanum as intestinal phosphate binders will be detailed during the case discussions.  Control of renal secondary hyperparathyroidism using diet, intestinal phosphate binders and activated vitamin D compounds (calcitriol) will be advocated as essential for the optimal management of CKD.  The use of ACE-inhibition will be addressed as to their beneficial effects on reduction in renal proteinuria, systemic hypertension, and intraglomerular hypertension.  Hypoproliferative anaemia is common in advanced CKD – its management with recombinant erythropoietin or darbepoetin will be introduced.   Emerging or controversial treatments for CKD (probiotics, adsorbents, renal transplantation) will be briefly considered.  Cases will be used to guide our discussion for the confirmation of the diagnosis and staging of CKD, to provide a prognosis and to help the clinician decide when specific treatment options should be implemented. A scheme for following the CKD patient will be developed. This class is aimed at the primary care veterinary surgeon that wants to provide optimal care for their CKD patients and assumes some familiarity in the interpretation of urinalysis, serum biochemistry (creatinine, BUN, phosphorus) and urinary tract imaging.

Haematology – 1400-1730, Hall 7

Blood smears

Roger Powell

This session will start with a brief presentation introducing cell features, as well as examples of analyser pitfalls to highlight why blood smear examination is always required.  After this, case examples will be used for direct microscopic examination for you to assess the blood smear and make a diagnosis.  The masterclass will be informal, with discussion and questions encouraged.  Cases will be reviewed at the end in a group session to illustrate salient points.  The level is aimed at practitioners familiar with normal cell morphology but wanting to improve their identification of common disease processes, both red and white cell.  It will include more challenging leukaemic cases