| Hemorrhagic ulcerative (uremic) gastritis
(→ vomition) (dogs/cats)
and colitis
(horses/cattle), due to:
- degeneration of arterioles in mucosa / submucosa with resultant infarction;
- mineralization;
- chemical irritation of gastric and colonic mucosa by circulating uremic toxins;
- in stomach, excessive production of gastric acid resulting from decreased renal excretion of
the hormone gastrin.
3.
Endocarditis / Mucoarteritis
- starts with subendothelial deposition of glycosaminoglycans, followed by fibrosis of repair
or, more often, by necrosis of cellular elements and stroma and ulceration of the endothelial
surface; especially left atrium, also large elastic arteries.
4
Tissue mineralization
- mainly in dogs; seen in pleura, pericardium, and soft tissues, e.g. stomach, kidney
(nephrocalcinosis), arteries, lung (uremic pneumopathy);
- pathogenesis →
metastatic, because of altered calcium-phosporus metabolism: initial
increase in blood phosphorus (because of inadequate glomerular
filtration), but normal or decreased blood calcium (as phosphorus
precipitates with calcium); subsequently, secondary
hyperparathyroidism, which can cause an increase in blood calcium
(see: 7. Fibrous osteodystrophy);
→
some mineralization is also dystrophic;
- the regularity with which certain tissues and organs are mineralized is likely related to local
characteristics such as tissue glycosaminoglycans, pH, and cellular factors.
5.
Pulmonary edema
- uremic damage to the air-blood barrier → plasma fluid leaks into the alveoli;
- sustained aortic hypertension (see: 7) → left-sided heart failure → pulmonary congestion and
edema (see also: 7. heart failure);
- in conjunction with uremia-induced depression of pulmonary defense mechanisms, can lead
to pneumonia;
- often the cause of death in uremic animals.
6.
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