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Hypertension, Systemic: Target Organ Damage 1238.e1
Hypertension, Systemic: Target Organ Damage
VetBooks.ir Overt and Subtle Signs of Target Organ Damage With Recommended Testing Required to Assess Extent of Damage
Organ System Affected Overt Clinical Signs Subtle Clinical Signs Recommended Tests
Eyes • Acute blindness • Behavioral changes related to unrecognized • Detailed direct or indirect funduscopic exam
• Complete or near-complete vision loss
retinal detachment • Bullous retinal detachment
• Hyphema • Retinal hemorrhages
• Tortuous retinal arteries
• Periarterial subretinal infiltrates
• Papilledema
Kidneys • Weight loss/inappetence • Decreased urine-concentrating ability with • Assessment of creatinine and serum urea
• Polyuria/polydipsia normal creatinine/BUN nitrogen concentrations
• Palpable renal abnormalities • Increased urine protein/creatinine ratio with • Urinalysis, with particular attention to urine
• Azotemia normal creatinine/BUN specific gravity and protein content
• Increased urine protein/ • Urine culture if required to rule out infection
creatinine ratio as a cause of proteinuria
• Urine protein/creatinine ratio or other
assessment of urine protein loss
• Imaging, typically ultrasound, ± renal biopsy
Brain • Seizures • Focal facial seizures • Detailed neurologic examination
• Changes in mentation • Depression • Serum chemistry to rule out electrolyte and
• Obtundation/coma • Photophobia glucose abnormalities
• Behavioral changes (e.g., hiding) • Brain imaging (e.g., MRI)
Heart • New murmur • Acute heart failure after fluid administration • Echocardiographic examination Differentials, Lists,
• New gallop heart sound • Left ventricular hypertrophy on echocardiogram and Mnemonics
BUN, Blood urea nitrogen; MRI, magnetic resonance imaging.
From Stepien RL: Blood pressure measurement. In Ettinger SJ, Feldman EC, Côté E, editors: Textbook of veterinary internal medicine: diseases of the dog and cat, ed 8, St. Louis, 2017, Elsevier, p. 378.
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