8. Reproduction Flashcards
When in the cycle does oestrus occur
The latter part of the follicular phase
When is the optimal time to mate a female
Just before follicle ovulates
What is the fertilisation period
The time when oocytes are available to be fertilised by sperm
What is the fertile period
The time when mating could result in pregnancy
What hormones can be monitored to suggest correct time for mating
Progesterone - decreases before oestrus (apart from in dogs where it increases)
LH - surge triggers ovulation
Ovarian structures seen on ultrasound
Corpus Luteum - ovulation cannot occur
Antral follicles - Cow (16-20mm) Mare (30-50mm)
Rectal palpation to determine stage of cycle in the cow
If oestrogen is dominant - narrow and tense cervix
progesterone dominant - cervix and uterus are flaccid and soft
Rectal palpation to determine stage of cycle in the mare
oestrogen dominant - cervix is broad and soft, uterus is soft
progesterone dominant - cervix is hard and narrow, uterus has increased tone
Cells on vaginal cytology to suggest stage of cycle - anoestrus, proestrus, early oestrus, late oestrus
Anoestrus - small, nucleated cells
Proestrus - RBC
Early oestrus - less RBC, larger cells, some anuclear
Late oestrus - low RBC, mostly large and anuclear
Pharmacological control of ovulation
GnRH => LH surge => ovulation
HCG - has LH like activity => induce ovulation
Breeding soundness exam - female, general process
Clinical history - previous pregnancy, could the animal be pregnant
Risk of infection/zoonosis
Any pathogen screening required - e.g. horses
General clinical exam
Mammary glands, perineum, vulva, vestibule, cervix, uterus, ovaries
Pathogen screening required in the female
Bacteria - CEMO, Klebsiella and Pseudomonas in the horse
Viral - FeLV in the cat
Cervix exam - what to look for
Evaluation of cervical opening - stage of the cycle
Abnormal - discharge, trauma, fibrosis
DONT breech unless 100% sure not pregnant
Uterine exam - methods
Trans-rectal palpation
Trans-abdominal palpation
Radiography
Ultrasonography
Endoscopy
Cytology
Biopsy
Ovarian exam - methods
Palpation - rectally
Ultrasound
Radiography
Pregnancy diagnosis - main methods
Absence of oestrus
Detection of hormones/proteins associated with pregnancy
Detection of the foetus or foetal membrane
Physical changes in the dam
Maternal changes secondary to endocrinological changes
Endocrinological changes in the mare - pregnant vs not pregnant
If not pregnant - progesterone falls
If pregnant:
Progesterone high from the primary CL
primary CL wanes - lower progesterone
Endometrial cups => eCG => high progesterone
Cups wane - progesterone drops
Oestrogen high
Specific marker of pregnancy in the bitch
Relaxin - increases around day 24
Most common methods of PD in a cow and when
Transrectal ultrasound - day 28
Transrectal palpation - day 35
Most common method of PD in a ewe and when
Transabdominal ultrasound - day 30
Most common methods of PD in a mare and when
Transrectal ultrasound - day 15
transrectal palpation - day 21
eCG - day 60-120
Most common methods of PD in a bitch/queen and when
Transabdominal ultrasound - day 25
plasma relaxin - day 25
Most common method of PD in a sow and when
transabdominal B-mode ultrasound - day 20
Breeding soundness exam - Male, general process
Clinical history
Any infectious risk
Pathogen screening required
General clinical exam
Observation of Libido
Exam of the scrotum, testes, sheath, penis, and accessory glands
Collect and testing of ejaculate
Pathogen screening - male
Bacteria - CEMO, Klebsiella and Pseudomonas in horse
Virus - porcine reproductive and respiratory syndrome (PRRS) in boars
Aspects of libido to look for
Interest in female
Detection of oestrus by the male
Mounting behaviour
Erection
Intromission
Ejaculation
Interest after mounting
Examination of ejaculate
Number of sperm
Motility
Morphology
Live staining
Other
Endocrinology testing of cryptorchidism
Rig Test
Use hCG or GnRH stimulation test
See if testosterone increases
Why monitor fertility in the male
Important driver of efficacy - profit
Hard to see externally
Types of measures of fertility
Measuring number of offspring
- lambing percentage
- piglets/sow/year
Not measuring the number of offspring:
- birthing interval
- proportion pregnant in a season
What is a conception rate
Proportion of cows that are served that become pregnant
What is the submission rate
Proportion of eligible cows are we serving
3 events that occur during normal sexual development
- establishment of sex chromosomes
- modelling of embryonic gonadal tissue
- recession and growth of external genital tissue
What is chimerism? and give an example
A chimera is an organism whose cells are derived from two or more zygotes.
e.g. bovine freemartin
What is a true hermaphrodite
Histological evidence of both ovarian and testicular tissue
Karyotype is often XX
ambiguity of external/internal genitalia or both
What is a male pseudohermaphrodite
Incompletely masculinised and ambiguous external and internal genitalia
Karyotype is XY
Gonads look like testes
What is a female pseudohermaphrodite
Karyotype is XX
Feminine (ambiguous in a few cases) internal genitalia, masculinised external genitalia.
Common pathologies of the ovaries
Ovotestis
Ovarian cysts/para ovarian cysts
Neoplasms e.g. granulose cell tumour
congenital lesions of the uterus
Segmental aplasia
Mesonephric cysts
inflammatory disorders of the uterus
Endometritis - inflammation of the endometrium
Metritis - inflammation has extended to the myometrium
Pyometra - suppurative infection of the uterus
Common neoplasm of the uterus
Leiomyoma - smooth muscle tumours
Endometrial carcinoma - cows
Common neoplasm of the external genitalia
Leiomyoma - smooth muscle tumour
Squamous cell carcinoma
Canine transmissible venereal tumour
Fibropapiloma - cow vulva
Common mammary gland pathology
mastitis
Mammary tumours in small animals
benign - adenomas (epithelial), and mixed tumours
metastatic - carcinomas
What is cryptorchidism
Incomplete decent of one or both of the testes
what is testicular hypoplasia and what are the causes
Testes appear smaller than normal, congenital or pre-puberty
causes - poor nutrition, zinc deficiency, genetic, endocrine disorders
what is testicular atrophy/degeneration and what are the causes
After puberty reduction in size of the testes
small and firm consistency
Causes - infection, increased scrotal temperature, decreased blood supply, radiation damage
inflammation of testes and epididymis real name
Orchitis (testes), epididymitis (epididymus)
causes of epididymitis in the ram
Brucella ovis - Notifiable
Haematogenous spread to testes
3 types of testicular neoplasia
Interstitial (Leydig) cell tumour
Seminoma
Sertoli cell tumour
Types of prostatic disease
Hyperplasia
Prostatitis
Neoplasia
Prostatitis - how does it develop and what can it lead to
Ascending bacterial infection
Can develop to peritonitis, septicaemia/toxaemia
Conception failure vs Embryonic death
Conception failure = not fertilisation so no zygote forms
Embryonic death = loss of embryo before organogenesis completes
Early pregnancy loss causes (3) in cows
Negative energy balance
Ovarian pathology
Nutrition
Early pregnancy loss causes (2) in pigs
Ovarian pathologies
Uterine capacity
Nutrition issues leading to early pregnancy loss in cows
Negative energy balance
High non-esterified fatty acids
High protein => elevated urea => toxic to oocytes
Infectious diseases causing embryonic death in sheep
Toxoplasmosis
Schmallenberg
Boarder disease
What hormone stimulates follicular growth
FSH
What hormone stimulates ovulation
LH and hCG
what hormone stimulates luteolysis
PGF2A (prostaglandin)
What are the short term effects of GnRH in females
Hasten oestrus or ovulation by inducing LH surge
Force ovulation or luteinization of cystic structures
What are the long term actions of GnRH in females e.g. desorelin implant
Initial stimulation of HPG axis
Then down-regulation of GnRH receptor so surpasses the axis
Controlling breeding behaviour
Use of FSH pharmacologically in females
Superovulation
eCG has FSH like activity
Use of LH pharmacologically in females, and what has LH like activity
Stimulates maturation of follicles
hCH has LH like activity
Use of progesterone pharmacologically in females
Suppresses the HPG axis - treat/prevent pseudopregnancy
Inducing/ synchronising oestrus with progesterone withdrawal
What are progesterone receptor antagonists used for in females
terminating pregnancy in dogs
what are oestrogens used for in females (hint - focus on target tissues)
Control of urinary incontinence
What Is PGF2A used for in females
Terminating luteal phase to synchronise oestrus
Induction of abortion
Induction of parturition
What are prolactin inhibitors used for, and how do they work
Removes CL support => luteolysis => end of luteal phase
Terminating pregnancy
Treating pyometras
Reduce behaviour of pseudopregnancy
Stop milk production
What is melatonin used for in ewes and mares
Ewe - bring on cyclicality
Mare - suppresses oestrus
What is oxytocin used for in the female
Initiates strong contractions of uterine muscles
Aid passage of retained placenta
Promotes milk let-down
What are progestogens used for in males
Decrease testosterone levels (negative feedback)
Suppress spermatogenesis
What is a GnRH depot injection used for in males
Initial stimulation of the axis
Receptor down-regulation => down regulated testosterone production for a limited amount of time
Will giving gonadotropins improve semen quality
No
What is LH (hCG) used for pharmacologically in males
Confirming presence of testicular tissue (rig test)
How to simulate onset of cyclicality early in sheep
Melatonin
Progestogen sponges - them removal
Ram effect
How to synchronise groups of sows/gilts pharmacologically
Progestogen for 14-18 days
can also use eCG just before P4 removal
How to control cyclicality in cows pharmacologically
Ovsynch (GnRH, PGF2A, GnRH)
Progestogen and PGF
2 doses of PGF 12 days apart
How to suppress oestrus in mares
Daily treatments of progestogen 10-15 days
How to stimulate onset of cyclicity in mares
Daylight
Oral progestogen for 10 days
how to suppress oestrus in the bitch
Progestogen depots for 6 months
GnRH agonist implant - takes time to act
How to induce oestrus in bitches
Prolactin inhibitors
GnRH agonist implant
hCG induces ovulation
how to suppress oestrus in the queen
GnRH agonist implant
GnRH antagonists
Melatonin implants
How to induce oestrus in the queen
Exposure to daylight
hCG induces ovulation
how to treat anovulatory anoestrus pharmacologically
Stimulate ovarian follicle wave development
Ovsynch and progesterone
Progesterone and eCG
How to treat cystic ovarian disease (follicular or luteal)
If follicular - GnRH or hCG to induce luteinisation
In luteal - PGF2A to stimulate luteolysis
How to treat persistent CL/prolonged dioestrus
Induce luteolysis - PGF2A
What is immunoconception
Vaccination against key reproductive proteins
2 common targets for immunoconception
Zona pellucida vaccines
Anti-GnRH vaccines
how to treat pseudopregnancy
Block action of progesterone
terminate luteal function (PGF2A or prolactin inhibitors)
Mimic fetal signal (corticosteroids)
Types of surgical neutering in the female
Ovariohysterectomy
Ovariectomy
Hysterectomy
What time to surgically neuter in the cycling bitch
> 12 weeks after oestrus - spaying in anoestrus
3 weeks post oestrus - removal of ovaries before prolactin starts so no risk of pseudopregnancy
When to neuter a cycling queen
Avoid oestrus - uterus is more vascular and friable
types of surgical neutering in the male
Orchidectomy (castration)
Vasectomy - teaser rams
Crushing of spermatic cord - calves
Inducing ischaemic necrosis of scrotum - lambs
Injection of irritants into testis - chemical castration
Castration types
Open - enter the parietal vaginal tunic
Closed - don’t enter the parietal vaginal tunic
what type of castration is used in rodents and why
Closed or modified technique
Rodents have open inguinal canal so risk of hernia
Complications of neutering during surgery
Anaesthesia related
Bleeding
Damage to other organs
Complications of neutering during recovery
Anaesthesia related
Bleeding
Herniation
Complications of neutering shortly after surgery
wound inflammation
scrotal haematoma
wound infection
wound breakdown
dogs licking scrotum
Longer term complications from neutering
Surgical material left behind
Pyogranuloma
Incomplete removal of gonad
Consequences of removing the gonads
Increased risk of some diseases e.g. urinary incontinence, neoplasia, growth plate fractures
body conformational changes e.g. loss of male characteristics
3 main categories of causes of infertility in the female
Anatomical
Physiological
Management
Anatomical causes of infertility in females - congenital vs acquired
Congenital - ovarian hypoplasia, free-martinism, persistence of hymen (mare)
Acquired - adhesions, endometrial fibrosis, cystic endometrial hyperplasia
Physiological causes of infertility in females
Ovarian pathology
Uterine infection
Failure to establish pregnancy
Management causes of infertility in females
Nutrition
Poor oestrus detection
Stress
Types of ovarian pathology which cause infertility in females
Anovulatory anoestrus
Cystic ovarian disease
persistent CL
2 aspects of ‘failure to establish pregnancy’
conception failure
early embryonic death
Nutritional influences on infertility
Negative energy balance
vitamin or mineral deficiencies or toxicity
oestrogen substances in plants - red clover
increased dietary proteins => increase urea => toxic to oocyte
definition of fertility
capability of producing offspring
definition of sterility
absolute inability to producing offspring
definition of subfertility/infertility
less than average ability to produce offspring
classification of infertility in the male (2 categories)
Inability to achieve coitus
Inability to fertilise
Examples of abnormalities of coitus in the male
Immaturity
Inability or unwilling to mount
inability to achieve intromission
Haematospermia
examples of failure of fertilisation in the male
Testicular disease
sperm abnormalities
accessory gland disease
epididymal lesions
Causes of inability to achieve intromission in the male
Failure of erection
Penile deviations
Penile trauma
Preputial abnormalities
Definition of resorption (of an embryo)
Death and resorption of an embryo - before mineralisation occurs
Definition of mummification
death of an embryo with the maintenance of progesterone => rapid absorption of fluid => mummify
Definition of maceration
Autolysis/putrefaction of the dead foetus that has not been expelled
Fetal death vs stillbirth
Fetal death - death of the foetus
Stillbirth - fetus reaches term but dies during process of delivery
Types of infectious causes of pregnancy loss
Reproductive pathogens
Recrudescence of latent viral infections
Ascending infections
non infectious causes of pregnancy loss
Stress
Maternal illness => pyrexia
Nutritional phytotoxins
Genetic abnormalities
Uterine disease - cannot form a placenta
significance of the lute-placental shift
time frame where progesterone production switches from CL to the placenta
This means that f the foetus dies after the shift, there is nothing producing progesterone as the placenta dies too - so the foetus will be expulsed
if there is no shift and foetus dies, CL will contuse to produce P4 so foetus will be retained => mummification/maceration
Which species do NOT have a luteo-placental shift
goat, dog, pig
4 stages of parturition
Preparation - production of relaxin
First stage - onset of uterine contraction
Second stage - onset of abdominal contractions and delivery of foetus
Third stage - delivery of placenta
Main causes of dystocia - maternal
Inadequate expulsive forces - uterine inertia, weak abdominal straining
Inadequate size of birth canal - incomplete dilation, inadequate pelvis
Main causes of dystocia - fetal
Oversized
fault disposition - wrong presentation
6 main postpartum conditions
Haemorrhage
Trauma/laceraltions
Prolapse
Placental retention
Metritis
Recumbency/nerve damage
Degrees of laceration of the perineum
first degree - skin and mucosa
second degree - involves muscle of perineal body
third degree - torn vagina and rectal wall (cloaca)
Vagino-rectal fistula -penetration from vaginal cavity into the rectum
causes of post partum haemorrhage
breakage of the umbilicus and blood leaking from placenta
Uterine or vaginal laceration
Types of prolapses
uterus
bladder
vagina and cervix
Consequences of retained foetal membranes
Increases risk of bacterial invasion as cervix stays open
Risk of metritis
Why are retained foetal membranes an emergency in the mare
Metritis => laminitis which can be severe
Most common causes of recumbency post partum
Hypocalcaemia
Hypomagnesia
Leg/nerve injury
Other injury
Causes of dystocia in the cow
Breed - Holsteins have a high incidence
Beef sires - feto-maternal disposition common
Heifers bred at an early age
Twin pregnancies
Causes of dystocia in the mare
Faulty disposition - fetus has to rotate during delivery
Second stage of parturition is very short - obstructive dystocia due to faulty disposition
Causes of dystocia in the bitch
Primary uterine inertia
Faulty disposition
Feto-maternal disproportion - especially for bully breeds
Causes of dystocia in the queen
Primary uterine inertia
Faulty disposition
Fetal monsters
Previous pelvic trauma
Causes of dystocia in the sheep
Feto-maternal disproportion
Faulty disposition
Causes of dystocia in the sow
Uterine inertia
Simultaneous presentation of foetuses
Treatment options for dystocia
Manipulation
Fetotomy
Caesarean section
Indications for caesarean - cow
calf cannot be delivered with traction and mutation
uterine torsion
incomplete dilation of cervix
When fetotomy would be traumatic, expensive and more time-consuming
Indications for caesarean - mare
Abnormal disposition which cannot be corrected
Uterine torsion
Severe deformities
Vaginal or vestibular obstruction
Indications for caesarean - bitch and queen
primary uterine inertia
obstructive dystocia than cannot be corrected or large litter
fetal distress
signs of placental separation with more of the litter to be born
Indications for caesarean - ewe
feto-maternal disproportion
ring womb
traumatised vaginal prolapse
Indications for caesarean - sow
prolonged parturition >12 hours
fetomaternal disproportion
secondary uterine inertia
Changes with pregnancy that affect anaesthesia
increased oxygen requirements
decreased functional residual capacity
increase cardiac output
delayed gastric emptying
Anaesthesia for c section - drug considerations
Chose drugs with short duration of action
lowest possible doses
oxygenate
use a cuffed tube - reduce regurgitation
local anaesthetics to reduce MAC
What are the 3 options of local anaesthetic for ruminant c section
Inverted L block
Proximal paravertebral block
Distal paravertebral block
steps in anaesthesia for a c section
Premedication
Check equipment and place IV cannula
Preoxygenation
Induce
Monitor
Post op recovery
differenced between neonates and adults
Can’t thermoregulate well
Immature renal and hepatic function
High risk of hypovolaemia and hypoglycaemia
Immunological immaturity
How passive immunity is acquired
Transplacental
Colostrum
Types of immunoglobulins in colostrum
Mainly IgG
some IgM and IgE
when to vaccinate neonates
In the immunity gap
between decline in maternal antibodies and increase in making their own antibodies
Causes of failure of passive transfer (FPT)
Poor quality colostrum
Not enough colostrum
Not enough colostrum quick enough
Consequences of failure of passive transfer (FPT)
increased likelihood of infection
GI and respiratory disease
Joint sepsis
Umbilical abscess
Treatment of Failure of passive transfer
Donor colostrum (before 12 hours)
Hyperimmune plasma (after 12 hours)
Common problems sick in foals
Meconium impaction
Failure passive transfer
Sepsis
Hernia
Perinatal asphyxia syndrome
Steps in clinical exam of mammary gland
Look a the skin
Palpation of the gland
Examination of the teat and teat canal
Expression of milk (in lactating animals)
Milk production data (dairy cows mostly)
Tests to look for mammary gland disease
California mastitis test
Ultrasound exam
Fine needle aspiration
Common mammry disorders
Disease of the skin
Damage to the suspensory apparatus
Damage to skin/teat
Inverted nipple
Mastitis
Mammary enlargement
Neoplasia
Agalactia
what is the TNM system for classification and staging of tumors
T = primary tumour
N = regional lymph nodes affected
M = distant matastasis
2 causes of agalactia and how to treat
Failure of milk production - give prolactin agonist e.g. metaclopramide
Failure of milk let down - give oxytocin
2 pathogeneses of kidney disease
Haematogenous (descending infection)
Urinary (ascending infection)
Viral aetiologies of kidney disease
Canine herpesvirus 1
Ovine herpesvirus 2
Canine adenovirus 1
Bacteria aetiologies of kidney disease
Escherichia coli
Leptospira interrogans
Actinobacillus equuli
Corynebacterium renale
Parasitic aetiologies of kidney disease
Toxocara canis
Halicephalobus gingivalis
Encephalitozoon cuniculi
Leishmania spp.
Causes of non-suppurative tubulointerstitial nephritis
E. coli
Canine herpesvirus 1
canine adenovirus 1
L. interrogans
what type of inflammation is caused by non-suppurative tubulointerstitial nephritis
Lympho-histiocytic inflammation
Appearance of kidneys with non-suppurative tubulointerstitial nephritis
swollen
pale tan colour
grey mottling of capsular surface
Causes of suppurative embolic nephritis
Actinobacillus equuli
Erysipelothrix rhusiopathiae
Trueperella pyogenes.
what kidney disease has ‘showers of septic emboli’
Suppurative embolic nephritis
Causes of pyelonephritis (bacterial)
E. coli
Staphylococci
Streptococci
Pseudomonas
Enterobacter
Pathogenesis of lower urinary tract infections
Ascending - from urethra
descending - from nephritis or pyelonephritis
Causes of cystitis (inflammation of the bladder) - pathogens
E. coli
Streptococcus
Staphylococcus
Enterococci
Proteus vulgaris
Predisposing factors for cystitis
Stagnatio of urine
uroliths causing trauma
catheterisation
diabete mellitus
corticosteroids
hyperoestrogenism
being female
what is an amyloid
misfolded, abnormal proteinaceous material associated with chronic inflammation
what is amyloidosis
Extracellular deposition of amyloid
When amyloids lodge in glomerulus, it becomes permanently open and no longer functions
How to identify amyloids
Congo red stain
Glow apple green under polarised light
what is nephrotic syndrome and how it develops
Damage to glomerular filtration barrier =>
Leakage of low molecular weight proteins into glomerular filtrate e.g. albumin =>
Protein rich filtrate in tubules =>
Protein in urine
4 causes of nephrotic syndrome
Amyloidosis
Glomerularnephritis
Neoplasia
Diabetes Mellitus
Clinical signs of nephrotic syndrome
Proteinuria
Hypoprotenaemia
Hyperlipidemia
Generalised oedema
how does nephrotic syndrome cause hyperlipidaemia
Hepatic response to hypoproteinaemia
Generalised increase in production of proteins
Lipoproteins => hyperlipoproteinaemia and hypercholesterolemia
How does nephrotic syndrome cause oedema
Decreased plasma colloid osmotic pressure
Stimulates RAAS
Stimulates release of ADH in response to hypovolaemia
Body retains water
How glomerulonephritis causes nephrotic. syndrome
Damages glomerular filtration barrier => proteinuria or protein losing nephropathy
if this gets severe enough = nephrotic syndrome
Common causes of glomerulonephritis
Chronic immune repose => deposition of immune complexes
Viral infections - FeLV, FIV, FIPV, BVDV, canine adenovirus 1
Bacterial infections - pyometra, pyoderma
Parasitism - dirofilariasis, Leishmaniasis
Neoplasia
Glomerulosclerosis cause
Chronic glomerulonephritis
common causes of acute tubular necrosis
Hypoxia/ischaemia
Nephrotoxicity
2 types of tubulointersistial nephritis
Suppurative
Non-suppurative
Embolic suppurative nephritis consequences
Bacteraemia or septic thromboembolism
Multiple small accesses (micro abscesses) or some large ones
Name the agent causing embolic suppurative nephritis in the following species - horse, swine, cattle, sheep/goat
Horse - Actinobacillus equuli
Swine - secondary to Erysipelothrix rhusiopathiae
Cattle - Trueperella pyogenes
Sheep/Goat - Corynebacterium pseudotuberculosis
What is pyelonephritis and how does the infection arrive
Inflammation of the pelvis and renal parenchyma
Ascending infection
Risk factors for pyelonephritis
Urine stasis/obstruction
Being female
Diabetes
Congenoital malformations e.g. ectopic ureters
Endogenous and specific urinary pathogens that cause pyelonephritis
Endogenous - E. coli, staphylococci, streptococci, Enterobacter spp.
Pathogens - Corynebacterium renale (cattle)
Actinobaculum suis (swine)
What is the most common renal neoplasia
Renal carcinoma - highly malignant
What is the most common neoplasm of the urinary bladder
Urothelial cell carcinoma (epithelial cell tumour)
How renal damage alters Cs2+ and P metabolism
Renal damage => decreased GFR => retention of phosphate => hyperphosphatemia
Increased formation of hydroxyapatite crystals
Binds to calcium reducing free calcium in the blood
Crystal causes secondary systemic metastatic mineralization
Hypocalcemia stimulated parathyroid gland => hypoplastic => renal secondary hypoparathyroidism
Increased PTH => increased bone resorption
What 3 things cause umbilical swelling
Defect in umbilical wall
Infections
Persistent urachus
Treatment options for non-emergency hernias
Constricting bands
Surgery
Signs of persistent urachus
Dribbling of urine from urachus
Posturing to urinate and failing
Pain
Omphalophlebitis vs omphaloarteritis vs urachal sepsis
Omphalophlebitis - Infection of the umbilical veins
Omphaloarteritis - Infections of one or both of the umbilical arteries
Urachal sepsis - Infection of the urachus
How chronic kidney disease progressed to kidney failure
Destruction and loss of nephrons
Remaining nephrons hypertrophy
Progressive and irreversible loss of nephrons
End result is fibrosis
What is acute kidney injury
Sudden onset damage
Reversible
if progresses with permeant loss of nephrons => CKD
Rapidly fatal
Name 6 causes of acute kidney injury (AKI)
- Poor renal perfusion/ severe hypoxia
- Nephrotoxins e.g. ethylene glycol
- Obstructive disease of either ureter or urethra
- Infection
- Hypercalcaemia
- Cutaneous and renal glomerular vasculopathy (Alabama rot in dogs)
Name 5 causes of chronic kidney disease (CKD)
- Resulting from AKI
- Familial renal disease e.g. amyloidosis or renal dysplasia
- Inflammation or immune mediated disease
- Ischaemia. vascular injury
- Unknown
2 types of ectopic ureters
Extramural: inserts in urethra, vestibule or vagina (females) or ductus deferens (male)
Intramural: correct insertion site at trigone of bladder but tunnels in urethral wall to open distally
3 forms of ureteral obstruction
Intraluminal e.g. clots
Intramural e.g. neoplasia or stricture
Extramural e.g. post op ligation of ureter
Unilateral ureteral obstruction consequence
↑ ureteric pressure proximal to obstruction => ↑ renal tubular pressure => ↓GFR
Complete obstruction => hydronephrosis => fibrosis
Compensatory hypertrophy of kidney
Bilateral ureteral obstruction consequences
Life thretening
Renal pain and azotemia
AKI
