Disease of the ruminant urinary system including urolithiasis Flashcards
How would you examine the urinary system?
- History - how long /other signs
- Frequency / ease of urination
- Urine - smell / appearance
- Rectal examination - L kidney, bladder, diseased ureters
- Catheterisation
- Prepuce
What should ruminant urinalysis be?
- SG = 1.020- 1.045
- pH - alkaline
- Protein - usually trace only
- Glucose - usually trace
What are clinical signs of urinary disease?
- Abdominal pain - pyelonephritis, calculi
- Dysuria - pyelonephritis, calculi, cystitis
- Haematuria
- Polyuria - diabetes mellitus (post FMD) diabetes insipidus, idiopathic
- Anuria - obstruction by calculi
- Oliguria - prerenal, renal or post renal
- Proteinuria - renal amyloidosis
What causes haematuria?
– Pyelonephritis (+ pus)
– Cystitis
– Urolithiasis
– Enzootic haematuria
– Acute bracken poisoning
– Toxic nephrosis (Acorn)
– Glomerulonephritis, renal infarction
What causes haemoglobinuria?
- Babesiosis - redwater
- Post-parturient haemoglobinuria
- Bacilliary haemoglobinuria
-clostriudum haemoliticum
What are congenital abnormalities of urinary tract?
- Hypospadia - failure of closure of male urethra
- Patent urachus - urine from umbilicus
What usually cause pyelonephritis?
- Corynebacterium renale
-more common in sucklers = venereal spread
-secondary to trauma (dystocia)
What are signs of pyelonephritis?
- Chronic weight loss
- +/-mild pyrexia
- Appetite usually OK
- Dysuria
- Blood + pus in urine (check vulval hairs)
- Examine per-rectum - swollen kidney, bladder thickening
What is treatment of pyelonephritis?
- Long course of antibiotic - penicillin / oxytet
- C. renale = sensitive to most AB
- E. coli = more resistant = amoxicillin / clavulanic acid
What can cause cystitis? CS? Tx?
- Associated with pyelonephritis
- secondary to dystocia - ascending infection
- CS = similar to pyelonephritis - more straining
- Tx = ABs, same as pyelonephritis
What are CS of amyloidosis?
- Off food & ill
- Profuse diarrhoea (DDX Johne’s disease)
- Generalised subcutaneous Oedema
- Polydipsia/polyuria
- Proteinuria
- Low plasma albumin
- Pale swollen kidneys
What can cause haematuria?
- Enzootic haematuria
- Bracken poisoning
- Toxic nephrosis
- Pyelonephritis (+pus)
What can cause enzootic haematuria?
- Benign tumours of blood vessels in bladder (haemangioma)
- Long term ingestion of bracken
- Older cows
- Teart pastures = high molybdenum
- Blood clots in urine
- Tumours in guts - SCC
What does bracken poisoning cause?
- Contain thiaminase = toxic in horses
- Bright blindness = sheep retinal atrophy
- Enzootic haematuria = long term ingestion
- ## Gut tumours = sheep + cattle = long term
- Bone marrow toxicity
- Pancytopaenia & thrombocytopaenia
- Petechiae in mouth, conjunctiva, vulva etc
- Subcutaneous bruising
- Blood clots – nose, faeces
- Pyrexia & depression
- Diarrhoea (bloody)
- Haematuria
- Death
What causes toxic nephrosis? CS?
- Oak (acorn) poisoning
-tannins in acorns = kidney damage
-sudden death
-anorexia, depression, bloat (ruminal stasis), constipation
-tarry diarrhoea
What causes bacilliary haemoglobinuria? CS? Control?
- Wet, High pH land in Southwest UK
- Cl. haemolyticum - in soil + dormant in liver
- migrating fluke = trigger spores (blacks disease)
- CS = pyrexia, jaundice, anaemia, oedema, Hburia
- Control = Vaccinate (blacks disease), fluke control
What causes babesiosis? What animals are effected?
- Babesia divergens - tick borne
- CS in older non-immune animals
-premunity in young - from early infection
What are clinical signs of babesia?
- Pyrexia
- Anaemia + Hb-uria (port-wine urine)
- Diarrhoea (pipe stem faeces)
- Later =
-constipated
-temperature drop
-anaemic / jaundice
Dx of babesia? Tx?
- Dx =
-Blood smear - capillary blood from ear
-Thin smear
-Parasites in RBC
-Evidence of anaemia - Tx = Imidocarb
What causes post-partum haemoglobinuria?
- Low phosphorus diet = lush spring grass + sugar beet pulp
- Kale, rape, turnips
CS + Tx of post=partum haemoglobinuria?
- CS =
-sudden onset
-haemoglobinuria, pallor, jaundice
-collapse, dyspnoea + death - Tx = Phosphorus + Blood transfusion
-One transfusion is safe
-use Sodium citrate as anti-coagulant
-raise jugular + collect 5L into empty + cleaned drench bottle
What ruminants tend to get urolithiasis?
- 2-4 month old ram lambs
- Mature goats that were castrated in first few days of life
- Bull beef calves on high concentrate diet
What are urolithiasis associated with?
- Ca:P imbalance in diet
- High concentrate diet
- Water deprivation
- Interactions e.g. forage quality and concentrate intake
- History of diet change in mature animals
- Inappropriate material used in feeds
What are signs associated with calculi?
- Restlessness – mild to severe
- Abdominal pain (kicking) & straining (hiccups)
- Dysuria or anuria – dry floor - management
- Preputial crystals/sand
- Progressive till urethra and/or bladder ruptures.
- Is swelling in abdomen or under skin ?
- Bladder rupture – initially brighter!
-high urea & creatinine in plasma/abdominal fluid
Where are calculi likely to be?
- Sigmoid flexure
- Vermiform appendage
- Pelvic urethra
How do you diagnose urolithiasis?
- Abdominal palpation
-distended bladder, free fluid wave, SC fluid pitting - Hair of ventral abdomen - ‘sand’ around preputial orifice
- Examination of penis - exteriorise
- Radiography +/- contrast - replaced by US
- US - SC tissue, free fluid, bladder, kidney
- Abdominocentesis
- Palpate urethra per rectum
- Blood sample = urea/creatinine, potassium, PCV, TP
What is treatment of urolithiasis?
- Relaxants = buscopan / xylazine
- Casualty slaughter
- DO NOT send home + ignore
What should be done if bladder rupture or cannot be catheterized?
- GA, laparotomy + repair bladder
- Can also flush stone from bladder out of urethra
How would you perform urethostomy?
- Standing & epidural anaesthesia.
- Mid-line incision from 4” below anus in cattle.
- Identify penis & blunt dissect.
- Transect penis distally to leave a 4” proximal stump.
- Suture stump to skin – not through urethra.
- Leave indwelling catheter for a few days.
- Do NOT allow to scab over
If waterbelly / SC oedema, what should be done?
- incise skin in multiple sites to produce drainage.
- Necrosis, slough off and re-epithelialize.
- Worse if a lot of s/c fat.
- Bath/spray with salt water regularly
How do you prevent reoccurence of uroliths?
- Urinary acidification = ammonium chloride / acid sodium phosphate
- Check diet - might be on wrong mix (lambs on ewe nuts)
