Equine Urinary - Nout Loma Flashcards
What are the 4 most common equine renal/urinary conditions?
- Azotemia
- Hematuria, pigmentation
- Urinary incontinence
- PU/PD
Weight loss and abnormal urination are ____
The most common clinical signs of renal/urinary disease
Besides weight loss and abnormal urination, what are some other clinical signs that may be noticed?
Lethargy, anorexia, ventral edema, urine scalding (acidic urine), excessive dental tartar, colic, abnormal or excessive posturing, and excessively wet stall
The normal water intake for a horse is _____ ml/kg/day
60-65
Normal equine urine is ______ to ______ and often ____ because of _____ crystals and mucus
pale yellow to deep tan
turbid
CaCO3
What two drugs are of particular importance when getting a history of drug administration?
Aminoglycosides and NSAIDs
Lab abnormalities that may indicate renal or urinary disease in the horse:
CBC
Chem
CBC:
- anemia
Chem:
- azotemia (primarily creatinine, BUN may or may not be increased)
- hyponatremia
- hyperkalemia
- hypocalcemia (ARF)
- hypercalcemia (CRF)
- Albumin > Globulins
Normal USG for horses is: 1.020-1.050
What do these suggest:
Hyposthenuria
Isosthenuria
Hypersthenuria
Hyposthenuria < 1.008 - normal in foals
Isosthenuria 1.008-1.014 - chronic renal failure
Hypersthenuria > 1.014
The normal pH of horse urine is
7-9
Exercise and bacteriuria may lead to acidification
What three pertinent structures can you palpate on rectal exam?
- Bladder
- Left kidney
- Ureter - palpable when enlarged!
Prerenal azotemia is characterized by concurrent elevation of ____ and USG > ____.
Note that USG should be determined prior to fluids and/or a-2 agonsts
Creatinine
> 1.020
If the azotemia is renal, ___% of the nephrons are nonfunctional and often USG is < _____ since concentrating fxn is often lost
75%
< 1.020
Postrenal azotemia is a result of continued absorption of ___ from urine that is not voided
Creatinine
This can occur when the bladder is ruptured or when there is obstruction of urine outflow
_____ is the result of sudden, major damage to the kidneys. Damage is usually caused by severe dehydration but is also frequently caused by drugs/toxins, and pigmenturia.
Acute Renal Failure or AKI
What are the clinical signs of ARF?
Clinical signs are usually related to the inciting problem, and thus ARF may not be suspected or detected unless specifically looked for
How do you tx ARF?
Should focus on reversing inciting or underlying problem, correcting fluid and electrolyte imbalances.
_____ is a syndrome of progressive loss of renal function that results in loss of urinary concentrating ability, retention of nitrogenous and other metabolic end products, alterations in electrolyte and acid-base status, and dysfunction of several hormone systems
Chronic Renal Failure
_____ is a clinical syndrome of multiple organ dysfunction, that develops with CRF
Uremia
Are most cases of CRF due to congenital or acquired disease?
Acquired (~84%)
Whats the prognosis for horses with CRF?
Long-term prognosis is grave
Short-term is more favorable
CRF is often not diagnosed until the horse is in end stage renal failure
In animals with CRF, the gross examination revealed ____ kidneys, that are _____, and ____, and may have an ____ surface and an adherent capsule
pale
shrunken
firm
irregular
Histologically, kidneys from an animal with CRF have severe _____ and extensive ____
glomerulosclerosis
interstitial fibrosis
_____ is the most common presenting complaint for horses with CRF
Chronic weight loss
Excessive dental tartar (esp on canine teeth) and uremic odor are signs that should may you think of..
CRF
The presence of red or brown discoloration of freshly voided urine indicates ____ or _____(hemoglobin, myoglobin, or plant-derived pigments)
Hematuria or pigmenturia
How do you differentiate hematuria from hemoglobinuria or myoglobinuria?
Centrifuge sample… if sample separates (layer of RBCs covered by clear urine) = hematuria
If the sample remains discolored after centrifugation = hemoglobinuria or myoglobinuria is the cause
Clinical signs of myopathy and markedly increased serum ____ indicate myoglobinuria as a cause of urine discoloration
CK
You are trying to differentiate hemoglobinuria from myoglobinuria - in which case would the SERUM be clear? pink or red?
Clear = myoglobinuria; pigment is rapidly cleared from the serum
Pink to red = hemoglobinuria; systemic hemolysis
Causes of hematuria include… (9)
urolithiasis cystitis urethral rents pyelonephiritis idiopathic hematuria verminous nephritis renal and vesicular neoplasia Blister beetle toxicosis
The most common clinical sign displayed by horses affected with cystic calculus is _____
hematuria observed after exercise
Almost all uroliths of horses are composed of ______, and thus a low-Ca diet is recommended to prevent recurrence
Ca Carbonate
How can urinary incontinence be divided?
Neurological, non-neurological, and idiopathic
Urinary incontinence due to developmental anomalies (ectopic ureter), cystolithiasis, and consequential to pregnancy and parturition are classified as _____
Non-neurological
Urinary incontinence due to EHV-1 myelencephalopathy, cauda equina neuritis, intoxications, and sacral trauma are classified as _____
Neurological
Traditionally, neurological categorization of urinary incontinence includes an ___ bladder or a _____ bladder
UMN or LMN
Incontinence that is manifested as intermittent squirts of urine is the classic finding for an _____ bladder
UMN
A large bladder and flaccid urethral sphincter is seen with _____ bladder
LMN
Prognosis for Urinary Incontinence - pretty straightforward
Prognosis is generally favorable if the underlying cause can be resolved
Prognosis is generally poor in those with long-standing UI
Common dz related causes for PU/PD in the horse are _______ and ______
PPID and Psychogenic PD
PD in adult horses can be defined as water consumption _____ ml/kg/day
> 100
> ~10% of BW
PU is defined as urine production > ____ ml/kg/day
50
5% BW
Normal urine production is typically between ____ and _____ ml/kg/day
15-30
What represents the major route of water loss in normal horses?
feces
