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medications (e.g., metoclopramide, ondansetron, Maropitant).
Metabolic acidosis
Metabolic acidosis is a common acid-base disorder
of patients with AKI. Metabolic acidosis results from retention of acids in the blood, decreased bicarbonate reabsorption in the proximal tubule, decreased bicarbonate production and decreased hydrogen excretion. Correction of dehydration will eliminate lactic acidosis but patients that remain acidotic need to be treated with bicarbonate, as follows:
Treatment should be performed cautiously and over few hours. Rapid bicarbonate administration may lead to paradoxical cerebellar acidosis or metabolic alkalosis.
Hyperkalemia is a common complication of patients with AKI, which results mostly from decreased renal potassium excretion and acidosis. The treatment is determined by the severity of the hyperkalemia and the degree of cardiotoxicity. In mild cases, potassium- free fluids may correct hyperkalemia. In more severe cases dextrose (with or without insulin) and bicarbonate administration are used to shift the potassium intracellularly. When cardiotoxicity is already present, calcium is indicated to protect the heart.
Your Singapore, the Tropical Garden City
R. Maguire1
Learning objectives for Rabbit and Rodent Dentistry
This lecture will cover the pathophysiology, clinical presentation and approach to staging dental disease in rabbits and commonly seen herbivorous rodents such as guinea pigs and chinchillas. Diagnostic modalities include extraoral and intraoral radiographic techniques, endoscopy as well as computed tomography scans. Treatment of dental disease will be described but prognosis of patients varies greatly based on the
stage in which the diagnosis is made. Prophylactic diet adjustments to a high fibre diet should be recommended for all pet rabbits and herbivorous species as dietary habits must be considered as one of the major potential factors resulting in acquired dental disease.
Rabbits and herbivorous rodents such as guinea pigs and chinchillas have completely elodont dentition. The incisors, premolars and molars are continuously erupting and the clinical crown will gradually wear down and be replaced by the reserve crown. Dental disease in these species are caused by varying factors however emphasis should be placed at addressing inadequate dietary
fibre as this is the leading cause of acquired dental disease. Treatment of affected animals consists of dental procedures such as occlusal adjustments, incisor height adjustments, extractions of severely affected incisor/ cheek teeth and surgical treatment of any periapical abscessations. The goal of treatment for dental disease is restoration of elodont teeth to normal length and shape; therefore, improving function. Secondary control of inflammation and infection should also be initiated. Diet adjustments post operatively is also necessary for the full recovery of patients.
Clinical presentations
Rabbits affected by dental disease may present with poor body condition, anorexia, chewing disturbances, changes in food preferences (soft and palatable foods) and hypersalivation. Dental disease can also be accompanied by the development of facial abscesses, wet dermatitis, epiphora, exophthalmia and damage
to the temporomandibular joint. Guinea pigs affected by dental disease most commonly present with anorexia and emaciation. They rarely show skin or ocular presentations. Chinchillas with dental disease usually present for weight loss, reduced appetite, poor fur quality, epiphora and hypersalivation. Signs of gastrointestinal disease signs should be closely
   Hypertension is a common complication in AKI. Hypertension may cause severe damage to end organs (eyes, heart, kidneys and brain). In most cases treatment with the calcium channel blocker (e.g., amlodipine) controls hypertension. In refractory cases, hydralazine and nitroprusside can also be considered. Angiotensin converting enzyme inhibitors are recommended as
part of the management of hypertension in patients
with chronic kidney disease, but should be carefully considered in cases of AKI as they may further decrease GFR and worsen azotemia.
Segev G, Bruchim Y, Berl N, Cohen A, Aroch I. Effects of fenoldopam on kidney function parameters and its therapeutic efficacy in the management of acute kidney injury in dogs with heatstroke. J Vet Intern Med. 2018 Mar 25.

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