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Sigmoid colon and rectum, showing distribution of branches of inferior mesenteric artery and their anastomoses.
In human anatomy, the inferior mesenteric artery, often abbreviated as IMA, supplies the large intestine from the left colic (or splenic) flexure to the upper part of the rectum, which includes the descending colon, the sigmoid colon, and part of the rectum. The IMA branches off the anterior surface of the abdominal aorta below the renal artery branch points, and approximately midway between these and the aortic bifurcation (into the common iliac arteries). All these arterial branches further divide into arcades which then supply the colon at regular intervals. The IMA is accompanied along its course by a similarly named vein, the inferior mesenteric vein, which drains into the splenic vein. The IMV therefore drains to the portal vein and does not fully mirror the course of the IMA. A horseshoe kidney, a rare (1 in 600) anomaly of the kidneys, will be positioned below the IMA.
Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen). Routine complete blood count (CBC), basic metabolic profile, liver enzymes, and coagulation should be performed. Ultrasound investigation is often performed prior to attempts to remove fluid from the abdomen.
Portal hypertension plays an important role in the production of ascites by raising capillary hydrostatic pressure within the splanchnic bed. Regardless of the cause, sequestration of fluid within the abdomen leads to additional fluid retention by the kidneys due to stimulatory effect on blood pressure hormones, notably aldosterone. Ascites is generally treated while an underlying etiology is sought, in order to prevent complications, relieve symptoms, and prevent further progression.
Salt restriction is the initial treatment, which allows diuresis (production of urine) since the patient now has more fluid than salt concentration. Since salt restriction is the basic concept in treatment, and aldosterone is one of the hormones that acts to increase salt retention, a medication that counteracts aldosterone should be sought.
In those with severe (tense) ascites, therapeutic paracentesis may be needed in addition to medical treatments listed above.[8][9] As this may deplete serum albumin levels in the blood, albumin is generally administered intravenously in proportion to the amount of ascites removed. Ascites that is refractory to medical therapy is considered an indication for liver transplantation. In a minority of patients with advanced cirrhosis that have recurrent ascites, shunts may be used. Exudative ascites generally does not respond to manipulation of the salt balance or diuretic therapy.
Complications involve portal vein thrombosis and splenic vein thrombosis: clotting of blood affects the hepatic portal vein or varices associated with splenic vein.
Thomas: Chronic renal failure (CRF) is a progressive and fatal disease, but when diagnosed early and managed with treatments like subcutaneous fluids, a cat with CRF can live comfortably for anywhere from one to three years after diagnosis. Siouxsie: But now to answer your question, Dawn: Can kidney failure really come on so suddenly?
Siouxsie: The onset and progression of kidney disease seems to be determined by a combination of things from genetics to diet to environmental issues and stress.
Siouxsie: Clearly you did all the right things by making sure Gizzy had the appropriate lab tests.


Dahlia: If any of you other readers have a cat with CRF, we highly recommend you visit the Feline CRF Information Center website. Related Posts:Is It Time for Me To Release My Cat From Suffering?My Cat Has High Creatinine Levels.
I just read about the kidney failure, ironically my 17 year old cat, I just got 2 months ago (Oct.
About 7 months ago I found and rescued a 6 weeks old kitten who is getting all my attention.
Though his disease developed slowly over the years, unfortunately, like Dahlia said, his symptoms weren’t really indicative or specific to renal disease until he had lost more than half of his kidney function and he could never fully recover from that. About the Author: JaneA Kelley is a punk-rock cat mom, science nerd and all-around geek with a passion for bad puns, intelligent conversation, and role-play adventure games.
Proximally, its territory of distribution overlaps (forms a watershed) with the middle colic artery, and therefore the superior mesenteric artery. The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Most experts recommend a diagnostic paracentesis be performed if the ascites is new or if the patient with ascites is being admitted to the hospital. This may reveal the size and shape of the abdominal organs, and Doppler studies may show the direction of flow in the portal vein, as well as detecting Budd-Chiari syndrome and portal vein thrombosis. The sympathetic nervous system is also activated, and renin production is increased due to decreased perfusion of the kidney. Spironolactone (or other distal-tubule diuretics such as triamterene or amiloride) is the drug of choice since they block the aldosterone receptor in the collecting tubule.
In the United States, the MELD score (online calculator)[18] is used to prioritize patients for transplantation.
Typical shunts used are portacaval shunt, peritoneovenous shunt, and the transjugular intrahepatic portosystemic shunt (TIPS).
Because we were concerned about our other cat, Gizzy, we had the vet give him all the appropriate tests. Test results just slightly outside the normal range can be seen even in healthy cats and these are not generally viewed as alarming signs if the physical examination shows that the cat is otherwise in good shape. The point is that because cats age faster than humans, regular vet exams are especially important for senior cats. But we do want to reassure you that it is possible he was healthy a year ago and became that sick in such a short time. It’s a great resource for information on treatment and research, tips on how to give fluids and other home care, and a place for caretakers of CRF cats to find emotional support as they take this journey with their feline family members. As was mentioned, signs of CRF first occur when the cat has lost 70-80% of kidney function. He was was diagnosed in 2008 after an emergency visit to the vet (though at that point he had acute renal failure) and lived four more years with sub-q fluids and a special diet. I’m just happy for those extra four years we had together thanks to an amazing vet, and I know he enjoyed them and was a happy kitty. She gratefully and gracefully accepts her status as chief cat slave for her family of feline bloggers.
We make no pretense of being veterinarians and we don't know anything about your specific cat's health or behavior history.


We try to help you understand your cat and what may or may not be going on with him or her, but please discuss your concerns about your cat with your veterinarian! Although most commonly due to cirrhosis and severe liver disease, its presence can portend other significant medical problems. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. The fluid is then reviewed for its gross appearance, protein level, albumin, and cell counts (red and white).
Additionally, the sonographer can make an estimation of the amount of ascitic fluid, and difficult-to-drain ascites may be drained under ultrasound guidance.
However, none of these shunts has been shown to extend life expectancy, and are considered to be bridges to liver transplantation. When a liver cirrhosis patient is suffering from thrombosis, it is not possible to perform a liver transplant, unless the thrombosis is very minor. The information at Paws and Effect is not intended to diagnose, treat, cure, nor prevent any disease and is intended for educational purposes only.
Get books, music, cat care products and all sorts of other wonderful things, and help to support Paws and Effect at the same time. Photos with Creative Commons licenses must be shared with the original photo credits and links intact. The territory of distribution of the IMA is more or less equivalent to the embryonic hindgut. Diagnosis of the cause is usually with blood tests, an ultrasound scan of the abdomen, and direct removal of the fluid by needle or paracentesis (which may also be therapeutic). Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.
Abdominal CT scan is a more accurate alternate to reveal abdominal organ structure and morphology. Other complications of ascites include spontaneous bacterial peritonitis (SBP), due to decreased antibacterial factors in the ascitic fluid such as complement. In case of minor thrombosis, there are some chances of survival using cadaveric liver transplant. DO not give up on your cats with CRF… there are steps you can take to help them live a long life. Treatment may be with medication (diuretics), paracentesis, or other treatments directed at the cause.
Clinically, the most useful measure is the difference between ascitic and serum albumin concentrations. The owners and operators of Paws and Effect will not be liable in the event of incidental or consequential damages or loss in connection with, or arising out of, the furnishing, performance, or use of the instructions, suggestions or products on this website. Gizzy got worse that night, so we took him to an emergency clinic, where the vet told us the odor of his breath was evidence of kidney failure.
We took him back to our own vet the next day; she conducted another set of blood tests and confirmed that he was in the very late stages of kidney failure.



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