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Module 17 > Approach to Urinary Tract & Liver Disease in Cows > Flashcards

Approach to Urinary Tract & Liver Disease in Cows Flashcards

1
Q

what are the main differences between sa/equine and farm animal

A

rare

cattle dont live long enough to get CRF and not stressed enough to get FLUTD type disease

PUPD hard to assess

other signs vague

diagnostic relatively basic compared to other species

often underdiagnosed

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2
Q

what are the clinical signs of urinary disease in cattle

A
  1. non specific: weight loss, diarrhea, abdominal pain
  2. specific: enlarged kidney on rectal,abnormal urine (pus, blood), stranguria, pollakiuria, crystals on prepuce
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3
Q

which kidney can you palpate on rectal

A

left kidney

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4
Q

what is the normal SG

A

1.015-1.035

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5
Q

what is the normal pH of urine in cows

A

7-8 (more alkali than other species)

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6
Q

are ketones in freshly calved dairy cows in the urine normal

A

yes

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7
Q

what bacteria can cause pyelonephritis in carrier animals/bulls servicing

A

Corynebacterium renale (+, aerobe)

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8
Q

how does pyelonephritis occur

A

hematogenous spread (bacterium common in dairy cows) or

ascending from uterus (bad calving, retained fetal membrane)

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9
Q

what bacteriacancause pyelonephritis ascending from uterus

A

E. coli

T. pyogenes

staph

step

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10
Q

what are the clinical signs of pyelonephritis (4)

A
  1. ill thrift
  2. intermittent pyrexia
  3. colic
  4. enlarged kidney on rectal
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11
Q

what are the findings in urinalysis of pyelonephritis

A

leukocytes, hematuria, protein

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12
Q

how is pyelonephritis treated

A

3 week course borad spectrum antibiotics that is excreted via urine (amoxicillin/clavulanic acid or trimethoprim/sulfamethoxazole)

or if have C+S can be more specific

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13
Q

what antibiotic is not to be used in pyelonephritis

A

aminoglycosides (Penicillin Streptomycin) because it is nephrotoxic

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14
Q

what reproductive disease can look like pyelonephritis

A

endometritis and metritis

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15
Q

what is amyloidosis

A

chronic inflammation and repeated antigen exposure

antibody/antigen –> amyloid deposition –> proteinuria

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16
Q

what are the clinical signs of amyloidosis (5)

A
  1. ill thrift
  2. frothy urine
  3. enlarged kidney
  4. diarrhea
  5. edema (low albumin)
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17
Q

what are the urinalysis findings of amyloidosis

A

protein ++

low SG

no blood or WBC

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18
Q

what are the biochem findings of amyloidosis

A

hypoalbuminemia

hyperglobinemia

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19
Q

what is the treatment of amyloidosis

A

none

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20
Q

what are the main ddx of amyloidosis

A

pyelonephritis (enlarged kidney) or heart disease (edema)

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21
Q

when are urolithiasis mainly seen

A

young bulls/tups and goats

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22
Q

what are urolithiasis associated with

A

high ca or conentration ration

or restricted water

high phosphates (calcium, mag, ammonium)

calcium carbonate

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23
Q

what are the clinical signs of urolithiasis (3)

A
  1. cyrstals on preuptial hair
  2. colic
  3. swelling in ventrum = bladder/urethral rupture
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24
Q

how do you treat a urethroliasis

A
  1. administer smooth muscle relaxant: ACP, xylazine, clenbuterol
  2. broad spectrum antibiotic for secondary cystitis and NSAID for pain

surgical treatment –> sigmoid flexure is common site for stone formation

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25
Q

what are the causes of cystitis

A

previous navel ill

ascending infection from metritis/endometritis

mainly E.coli

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26
Q

what are traumatic causes of dysuria/stranguria

A
  1. ruptured bladder (difficult calving, urolithiasis)
  2. ruptured urethra (urolithiasis)
  3. penis hematoma
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27
Q

what are congenital malfmorations that can cause dysuria/stranguria (2)

A
  1. persistent urachus (leak urine, scald)
  2. hypospadia
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28
Q

what are ddx for red urine

A

BBBBPPCCLT

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29
Q

what ddx of red urine will have hemoglobinuria on urine dipstick

A
  1. babesoisis
  2. brassicas poisoning
  3. bacillary hemoglobinuria
  4. post paturient hemoglobinuria
  5. copper poisoning

BBBPC

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30
Q

what causes babesia

A

hemotrophic parasite

babesia divergens

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31
Q

what are the clinical signs of babesia (4)

A
  1. pipestem diarrhea
  2. spring and autumn (needs tick to feed)
  3. tick area
  4. pyrexic
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32
Q

what causes post partuirent hemoglobinuria

A

low phosphorus

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33
Q

what are the clinical clues of post partuirent hemoglobinuria

A

adult dairy cow 2-4 weeks after calving (or 2y old)

rare

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34
Q

what are the clinical clues of brassicas poisoning

A

diet history of rape/kale type feeding only

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35
Q

what are the cuases of bacillary hemoglobinuria

A

clostridium hemolyticum

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36
Q

what are the clinical clues of bacillary hemoglobinuria

A

rare

certain parts of UK

death

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37
Q

what are the causes of copper poisoning

A

over supplementation

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38
Q

what are the clinical clues of copper poisoning

A

jaundiced (chronic)

death if acute but rare

39
Q

what are the clinical signs of babesiosis (7)

A
  1. dull
  2. hemoglobinuria
  3. fever
  4. anemia
  5. weight loss
  6. death 1-3 weeks post infection
  7. pipestem feces
40
Q

how do you diagnose babesia (5)

A
  1. history
  2. clinical signs
  3. stained blood smear
  4. low HCT
  5. PCR
41
Q

how do you treat babesia

A
  1. imidocarb (imizol) double dose for previous

long meat/milk wd

notifity

  1. blood transfusion?
42
Q

what are the clinical signs of post parturient hemaglobinuria

A
  1. hemaglobinuria
  2. anemia
  3. down cow
43
Q

how do you diagnose post parturient hemaglobinuria

A

biochem phosphorua (Ca/Mg)

44
Q

how do you treat post parturient hemaglobinuria

A

phosphorus (Foston)

45
Q

what are the clinical signs of brassicas poisoning

A
  1. death
  2. hemaglobinuria
  3. anemia + associated signs
46
Q

how do you treat brassicas poisoning

A
  1. blood transfusion
  2. supportive
47
Q

what are the clinical signs of bacillary hemoglobinuria (4)

A
  1. sudden death
  2. hemaglobinuria
  3. anemia
  4. jaundice
48
Q

how is bacillary hemoglobinuria treated

A

penicillin

49
Q

how do you prevent bacillary hemoglobinuria

A

vaccination

50
Q

what are the clinical signs of copper poisoning

A
  1. acute = death
  2. chronic = sick, jaundiced, anemia, hemoglobinuria
51
Q

is copper poisoning more common in sheep or cattle

A

sheep

52
Q

how do you diagnose copper poisoining

A

liver copper biopsy

53
Q

how do you prevent copper poisoning

A

ensure deficient before supplement

54
Q

what are the clinical signs of brassicas poisoning (6)

A
  1. acute leukopenia
  2. thrombocytopenia
  3. hemorrhage
  4. pyrexia
  5. bladder tumour
  6. hematuria
55
Q

how do you treat brassicas poisoning

A
  1. supportive
  2. remove from bracken
56
Q

if you are presented with a freshly calved down cow what ddx is mostly likely (hemoglobinuria vs hematuria)

A

post-parturient hemaglobinuria

57
Q

if you are presented with a dead cow which ddx is most likely (hemaglobinuria vs hematuria)

A

bacillary hemoglobinuria (clostridium chauvei)

58
Q

if you are presented with an old, hill cow which ddx is most likley ((hemaglobinuria vs hematuria)

A

bracken poisining/enzootic hematuria

59
Q

if the cow is pyrexic which ddx is most likely (hemaglobinuria vs hematuria)

A

babesia

60
Q

if you are presented with a cow straining which ddx is most likey (hemaglobinuria vs hematuria)

A

cystitis

61
Q

what are the clinical signs of liver disease (14)

A
  1. non specific
  2. weight loss
  3. lethargy
  4. anoreixa
  5. milk drop
  6. diarrhea
  7. ascites
  8. edema
  9. photosensitixation
  10. epistaxis
  11. encephalopathy
  12. LDA
  13. jaundice
  14. enlarged liver behind last rib (rare)
62
Q

which liver enzyme is liver specific for disease

A

GLDH

glutamate dehydrogenase

hepatocellular –> quite specific

63
Q

which liver enzyme is indicator of bile duct and cholestasis

A

GGT

gamma glutamyltransferase

NB normal high in neonate (colostrum)

64
Q

where is alkaline phosphatase synthesized and what can it measure

A

liver and bone

measures cholestasis

65
Q

in order for makred damage by what elevation do the liver enzymes need to be

A

10times reference range for marked damage

3 times for moderate

66
Q

what are the biochem changes that might suggest liver disease (4)

A
  1. albumin: low or not produced
  2. urea: low, ammonia not being converted to urea
  3. bilirubin: increased production (hemolysis), liver damage so can’t process (hepatopathy), bile duct blocked so can’t excrete (choleostasis)
  4. bile acids
67
Q

where do you palpate the liver

A

behind the last rib

68
Q

where do you US scan the liver

A

9-11th IC space on the right side

69
Q

where do you obtain a liver biopsy

A

10-11th IC space

line tuber coxae to shoulder

clip/scrub

local anesthetic

scapel skin

aim biopsy needle cranial and ventral to left shoulder (+/- US guide)

70
Q

what causes liver abscesses (5)

A
  1. bacteremia
  2. navel ill
  3. acidosis
  4. endocarditis
  5. pyelonephritis
71
Q

would you expect liver enzymes to be elevated with liver abscesses

A

not too bad because parenchyma in between is fine and the abscesses are walled off

72
Q

what bacteria are involved in liver abscesses

A

Trueperella pyogenes (+)

fusobacterium necrophorum (-)

73
Q

how do umbilical infections lead to liver abscesses

A

through the umbilical vein which leads to the liver

74
Q

how does acidosis cause liver abscesses and how this can lead to vena cava thrombosis (6)

A
  1. acidosis in rumen changes gut flora = ruminitis
  2. bacteria leak into portal circulation = liver abscess (often near vena cava)
  3. emboli from liver abscess are released into circulation
  4. emboli get trapped in lungs = suppurative bronchopneumonia
  5. emboli in pulmonary blood vessels cause blood vessels to burst = aneurism
  6. epistaxis
75
Q

how do you treat liver abscess

A

supportive

none

76
Q

how do you prevent liver abscesses

A

avoid acidosis and prompt treatment of infections that could lead to bacteriam

77
Q

how does photosensitization occur

A

photodynamic agent in skin, reacts with UV light, damages skin membranes

78
Q

what is type I photosensitization

A

eat a photodynamic poisonous plant

ex. st johns wart, some drugs

79
Q

what is type II photosensitization and what breeds are susceptible

A

congenital disease where photodynamic agent not processed

bovine congenital erythropoietic protoporphyria

can present with neurological signs

young animal

limousin and blonde D’acquataine

80
Q

what is type III photosensitization

A

liver damage from disease or poison so photodynamic agents not processed

many liver diseases to consider

biochem for liver enzymes are key here

81
Q

what is type IV photosensitization

A

idiopathic

82
Q

what are the clinical signs of photosensitization (5)

A
  1. unpigmented skin
  2. hairless skin (extremities)
  3. crusting
  4. inflammation
  5. infection
83
Q

how is photosensitization diagnosed

A

history of ingestion of plant

liver enzymes (raised in type III)

response to treatment

type II measure porphyrin in blood – difficult

84
Q

how do you treat photosensitization

A

inside to remove from UV light and possible poison

treat primary liver disease if type III

antibiotics for secondary infections

85
Q

how common is jaundice

A

rare

use first principles from SA

treat underlying condition

supportive care

86
Q

what are pre hepatic causes of jaundice

A

hemolysis (increased production of bilirubin)

ex. toxins (copper), blood borne parasites (babesia)

87
Q

how do you diagnose pre hepatic jaundice

A

HCT (low)

urobilinogen ++

hemoglobinuria

88
Q

what are hepatic causes of jaundice

A

unable to process bilirubin

fatty liver, liver fluke (acute), liver abscess, hepatitis, neoplasia

89
Q

what are post hepatic causes of jaundice

A

unable to excrete bilirubin

bile duct tumour, liver fluke (chronic)

90
Q

how do you diagnose hepatic jaundice

A

liver enzymes high (GLDH)

low albumin

US scan of liver

91
Q

how do you diagnose post hepatic jaundice

A

high liver GGT

US scan of bile ducts

92
Q

what are the clinical signs of hepatoencephalopathy (5)

A
  1. ataxia
  2. dull
  3. slow circling
  4. head pressing
  5. collapse
93
Q

what are ddx for ill thrift in the adult cow (15)

A
  1. amyloidosis
  2. BVD PI
  3. chronic fluke
  4. chronic pneumonia
  5. chronic LDA
  6. dental disease/oral trauma
  7. fatty liver
  8. general peritonitis
  9. Johne’s
  10. liver abscess
  11. lumpy jaw
  12. neoplasia
  13. under nutrition
  14. pyelonephritis
  15. wooden tongue
94
Q

what are ddx that do not cause ill thrift (4)

A
  1. Parasitic gastroenteritis
  2. mastitis
  3. metritis
  4. endometritis

Module 17 (31 decks)

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