Diseases of the kidney and the excretory system in ruminants

Question 1

Structure

Answer 1

• Renal diseases
o Non-purulentrenaldiseases ▪ Acute nephrosis
▪ Renal amyloidosis
▪ Non purulent nephritis
o Purulentrenaldiseases
▪ Purulent nephritis
▪ Contagious bovine pyelonephritis

• Urolithiasis

Question 2

Non-purulent renal diseases

Answer 2

1. Acute nephrosis
2. Renal amyloidosis
3. Non purulent nephritis

Question 3

Non-purulent renal diseases

Common characteristics

Answer 3

• Subclinical course, usually not diagnosed in vivo
• Symptoms of underlying disease are dominant (common)
• Clinical signs of renal disease (rare)

Question 4

Non-purulent renal diseases

1. Acute nephrosis

Cause:

Answer 4

• Intoxication
• Pb/As/Cu toxicosis
• hemoglobin nephrosis
• monensin
• tannins (foliage of oak trees and acorns)
• unidenfied toxin of Amaranthus retroflexus
• ochratoxin

Question 5

Non-purulent renal diseases

1. Acute nephrosis

Characteristics

Answer 5

• Rarely diagnosed clinically (no obvious signs)

* Urine: proteinuria, renal epithelial cells/cylinders (casts)

Question 6

Non-purulent renal diseases

2. Renal amyloidosis

Cause

Answer 6

➢ Chronic inflammatory (purulent) diseases of other organs immunological processes abnormal antigen- antibody reaction
➢ hyperglobulinemia amyloid protein deposition (causing acute kideny failure)
➢ (systemic disease)

Question 7

Non-purulent renal diseases

2. Renal amyloidosis

Sequela

Answer 7

• Renal enlargement (kidney can be evaluated -> rectal palpation -> size, lobulated, pressure for presence of pain)
• Weight loss
• Nephrotic syndrome: massive proteinuria + edema formation
• Uremia: halitosis, uremic stomatitis, diarrhoea

Question 8

Non-purulent renal diseases

2. Renal amyloidosis

Differential diagnosis

Answer 8

• perform rectal examination, urinalysis!

* traumatic pericarditis, paratuberculosis

Question 9

Non-purulent renal diseases

3. Non-purulent nephritis

Answer 9

(= glomerulonephritis, interstitial nephritis)
• primary disease or component of systemic diseases
• immun-complex formation (glomerulonephritis)
• infectious diseases (interstitial nephritis, e.g. leptospirosis)

Question 10

Non-purulent renal diseases

3. Non-purulent nephritis

Characteristics

Answer 10

• Rarely diagnosed clinically (no obvious signs)
• Can be detected by ultrasound-guided biopsy if necessary
• Urine: proteinuria, renal epithelial cells/cylinders (casts)

Question 11

Purulent renal diseases

Answer 11

1. Purulent nephritis

2. Contagious bovine pyelonephritis

Question 12

Purulent renal diseases

1. Purulent nephritis

Answer 12

• (embolic nephritis) -> mostly

* (embolic suppurative nephritis or renal abscess)

Question 13

Purulent renal diseases

1. Purulent nephritis

Occurrence and etiology

Answer 13

bacterial (metastatic emboli), hematogenous route from
• valvular endocarditis
• suppurative lesions in uterus, udder, navel (umbilicus)
• septicemias in calves/ lambs

Question 14

Purulent renal diseases

1. Purulent nephritis

Characteristics

Answer 14

• rarely diagnosed clinically (no obvious signs)
• but: +/- rectal finding,
• urine: proteinuria, pyuria, (microsc.) hematuria, bacteruria

Question 15

Purulent renal diseases

1. Purulent nephritis

Treatment

Answer 15

antibiotics (sensitivity test; no nephrotoxic drugs)

Question 16

Purulent renal diseases

2. Contagious bovine pyelonephritis

Occurrence and etiology

Answer 16

milking cows of 4-8 years, after calving, (after repeated antibiotics!), especially in autumn/winter

Question 17

Purulent renal diseases

2. Contagious bovine pyelonephritis

Corynebacterium renale (C. bovis renalis), serotypes I. and III.

Answer 17

• urease positive→NH3 production→tissue necrosis
36
• attaches to the epithelium
• resistant to phagocytosis
(+ Arcanobacterium/Corynebacterium pyogenes, E. coli) usually ascending and
rarely hematogenous route
Cystitis, urethritis, pyelitis→nephritis (usullay bilateral)
Abscess in kidney, very painful, first acute than chronic kidney failure

Question 18

Purulent renal diseases

2. Contagious bovine pyelonephritis

Clinical signs

Answer 18

• subacute coursedecreased milk production
• after calving; fluctuating fever, anorexia, dullness, weight loss,
• signs of renal pain: kyphosis, stranguria + colic

Question 19

Purulent renal diseases

2. Contagious bovine pyelonephritis

Rectal examination

Answer 19

painful, enlarged (left)

• kidney with abnormal consistency and irregular surface ( +/- enlarged ureter)

Question 20

Purulent renal diseases

2. Contagious bovine pyelonephritis

Ultrasound examination

Answer 20

kidneys, bladderendoscopy

Question 21

Purulent renal diseases

2. Contagious bovine pyelonephritis

Laboratory examination

Answer 21

• Blood: anemia, neutrophilia, uremia
• Urine:
o macroscopic abnormalities: smell, color, debris, pus, mucus detection of free NH3 with HCl (hydrochlorid acid)
o pH: 8.0-9.0; detection of protein, blood, neutrophils (Donne-test)
o Detection of C. renale: microscope, IF method, culture
Glass stick probe with HCL:
detection of free NH3 NH3 + HCL = NH3Cl „smoke” not used any more

Question 22

Purulent renal diseases

2. Contagious bovine pyelonephritis

Diagnosis

Answer 22

• History
• clinical signs
• urinalysis
• ultrasonography: linear transducer that is used for reproduction can be used but sometimes
you can’t reach kidney only caudal lobe of left kidney
• differentiate from RPT, other urinary diseases

Question 23

Purulent renal diseases

2. Contagious bovine pyelonephritis

Treatment

Answer 23

indication of treatment (?), early diagnosis!

• antibiotics (resistance test): penicillin (+ streptomycin?)
o sterile urine collection for urine culture -> catheterization but very difficult in standing
position for bull
• acidification 10-14 (21) days (sodium phosphate, 100 g/24h)
• nephrectomy

Question 24

Purulent renal diseases

2. Contagious bovine pyelonephritis

Prevention

Answer 24

• good hygiene at calving

* avoid catheterization and breeding with a bull

Question 25

Purulent renal diseases 2. Contagious bovine pyelonephritis Prognosis

Answer 25

* early phase: favourable | * later phase: questionable – poor

Question 26

Urolithiasis Occurrence

Answer 26

``` • feedlot bulls: o in vivo 0 -10% o post mortem can be 75 - 80% • feedlot lambs: o in vivo 12 - 15% o post mortem can be 85 - 100% • onset: mainly between October – March ```

Question 27

Urolithiasis Uroliths

Answer 27

magnesium-ammonium-phosphate (struvit) = most common + Ca phosphate, Mg carbonate, Ca carbonate, silica, Ca oxalate • stone formation: kidney (bladder) • accumulation within the bladder • urethral obstruction

Question 28

Urolithiasis Pathogenesis

Answer 28

* (++) grain, i.e. minerals, (- -) water ® (++) saturated urine * effect of pH (crystal formation, stability of protective colloids) * nidus formation: inflammation (adenovirus, bacteria) vitamin A deficiency, estrogens (synchronization, clover)→precipitation of solutes→sand, stone formation

Question 29

Urolithiasis Consequences

Answer 29

* hydronephrosis, pyelitis, cystitis | * urethral obstruction, bladder rupture

Question 30

Urolithiasis Clinical signs

Answer 30

• Maybe silent or can occur with abdominal pain • Signs of cystitis ( several animals affected ) • Signs of urethral obstruction: o sudden colic, dysuria, stranguria, hematuria, cristals on preputium, o sign of urethral dilatation in bulls at the perineum • Rupture of the urethra: infiltration with urine: abdomen, perineum→uremia→death • Rupture of the bladder: uroperitoneum→uremia, +-/ undulation, abdominocentesis

Question 31

Urolithiasis Diagnosis

Answer 31

• clinical signs, catheterization, bladder ultrasonography

Question 32

Urolithiasis Treatment

Answer 32

* obstruction→surgery or slaughter for salvage (spasmolytics might be tried in partial obstruction) * to dissolve struvit (?!): NH4Cl (10 g/sheep) per os (for flocks 1% of DM)