Blocked bladders

Question 1

What are uroliths made of? Why do they form?

Answer 1

• Magnesium ammonium phosphate complex – STRUVITES
• Normal function – phosphorus is removed in salvia and faeces
• Incorrect diet - high grain, phosphorus and magnesium
  ◦ low roughage diet
• High grain/low roughage = decrease saliva production
• Phosphorus now removed by kidneys in urine
• Increase in urine phosphorus levels
• Phosphorus consolidates into stones that can not pass – increase in UTI’s and blockages

Question 2

What are the early clinical signs?

Answer 2

• Colic/abdominal pain -Lying down, Stretching, Standing, Kicking
• Straining to urinate
• Crystals on preputial hair
• Blood in urine
• Decreased urine production
• Dribbling urine

Question 3

What are the late clinical signs?

Answer 3

• Loss of appetite
• Lethargy
• Depression
• Abdominal swelling – bladder rupture
• Swelling around prepuce

Question 4

What diagnostics are available?

Answer 4

• Clinical exam – increased HR, RR, large bladder, positive on ballotment if rupture
• Common sites for uroliths – urethral process/veriform appendage – felt of clinical exam
  ◦ Distal sigmoid flexure
• Blood work – increased blood urea nitrogen BUN, creatinine, potassium – normally excreted in urine. Increased muscle enzymes CK, decreased sodium and chloride, acidosis
• US – distended bladder
• Contrast studies – ruptured bladder
• Xray – may be able to visualise some stones

Question 5

How are blockages treated?

Answer 5

• Emergency surgery
• Milked out under sedation
• Pain relief
• Spasmolytics
• Cystocentesis
• IV fluids – uraemic, high creatatine, hyponatraemic, hypochloraemic, hyperkalaemic
• Abx – broad spectrum – neutrophilia

Question 6

How can you prevent blockages from ocurring?

Answer 6

• Adequate water intake – keep water clean and change regularly
• Increase fodder feed intake
• Increase grass feed
• Decrease coarse mix feed
• Increase salt intake 2 – 5% to increase urine formation
• Add ammonium chloride to diet 0.5 – 1% to acidify urine