Equine Urinary - Nout Loma

Question 1

What are the 4 most common equine renal/urinary conditions?

Answer 1

1. Azotemia
2. Hematuria, pigmentation
3. Urinary incontinence
4. PU/PD

Question 2

Weight loss and abnormal urination are ____

Answer 2

The most common clinical signs of renal/urinary disease

Question 3

Besides weight loss and abnormal urination, what are some other clinical signs that may be noticed?

Answer 3

Lethargy, anorexia, ventral edema, urine scalding (acidic urine), excessive dental tartar, colic, abnormal or excessive posturing, and excessively wet stall

Question 4

The normal water intake for a horse is _____ ml/kg/day

Answer 4

60-65

Question 5

Normal equine urine is ______ to ______ and often ____ because of _____ crystals and mucus

Answer 5

pale yellow to deep tan

turbid

CaCO3

Question 6

What two drugs are of particular importance when getting a history of drug administration?

Answer 6

Aminoglycosides and NSAIDs

Question 7

Lab abnormalities that may indicate renal or urinary disease in the horse:
CBC
Chem

Answer 7

CBC:
- anemia

Chem:

• azotemia (primarily creatinine, BUN may or may not be increased)
• hyponatremia
• hyperkalemia
• hypocalcemia (ARF)
• hypercalcemia (CRF)
• Albumin > Globulins

Question 8

Normal USG for horses is: 1.020-1.050

What do these suggest:
Hyposthenuria
Isosthenuria
Hypersthenuria

Answer 8

Hyposthenuria < 1.008 - normal in foals

Isosthenuria 1.008-1.014 - chronic renal failure

Hypersthenuria > 1.014

Question 9

The normal pH of horse urine is

Answer 9

7-9

Exercise and bacteriuria may lead to acidification

Question 10

What three pertinent structures can you palpate on rectal exam?

Answer 10

1. Bladder
2. Left kidney
3. Ureter - palpable when enlarged!

Question 11

Prerenal azotemia is characterized by concurrent elevation of ____ and USG > ____.

Note that USG should be determined prior to fluids and/or a-2 agonsts

Answer 11

Creatinine

> 1.020

Question 12

If the azotemia is renal, ___% of the nephrons are nonfunctional and often USG is < _____ since concentrating fxn is often lost

Answer 12

75%

< 1.020

Question 13

Postrenal azotemia is a result of continued absorption of ___ from urine that is not voided

Answer 13

Creatinine

This can occur when the bladder is ruptured or when there is obstruction of urine outflow

Question 14

_____ 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.

Answer 14

Acute Renal Failure or AKI

Question 15

What are the clinical signs of ARF?

Answer 15

Clinical signs are usually related to the inciting problem, and thus ARF may not be suspected or detected unless specifically looked for

Question 16

How do you tx ARF?

Answer 16

Should focus on reversing inciting or underlying problem, correcting fluid and electrolyte imbalances.

Question 17

_____ 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

Answer 17

Chronic Renal Failure

Question 18

_____ is a clinical syndrome of multiple organ dysfunction, that develops with CRF

Answer 18

Uremia

Question 19

Are most cases of CRF due to congenital or acquired disease?

Answer 19

Acquired (~84%)

Question 20

Whats the prognosis for horses with CRF?

Answer 20

Long-term prognosis is grave

Short-term is more favorable

CRF is often not diagnosed until the horse is in end stage renal failure

Question 21

In animals with CRF, the gross examination revealed ____ kidneys, that are _____, and ____, and may have an ____ surface and an adherent capsule

Answer 21

pale

shrunken

firm

irregular

Question 22

Histologically, kidneys from an animal with CRF have severe _____ and extensive ____

Answer 22

glomerulosclerosis

interstitial fibrosis

Question 23

_____ is the most common presenting complaint for horses with CRF

Answer 23

Chronic weight loss

Question 24

Excessive dental tartar (esp on canine teeth) and uremic odor are signs that should may you think of..

Answer 24

CRF

Question 25

The presence of red or brown discoloration of freshly voided urine indicates ____ or _____(hemoglobin, myoglobin, or plant-derived pigments)

Answer 25

Hematuria or pigmenturia

Question 26

How do you differentiate hematuria from hemoglobinuria or myoglobinuria?

Answer 26

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

Question 27

Clinical signs of myopathy and markedly increased serum ____ indicate myoglobinuria as a cause of urine discoloration

Answer 27

CK

Question 28

You are trying to differentiate hemoglobinuria from myoglobinuria - in which case would the SERUM be clear? pink or red?

Answer 28

Clear = myoglobinuria; pigment is rapidly cleared from the serum Pink to red = hemoglobinuria; systemic hemolysis

Question 29

Causes of hematuria include... (9)

Answer 29

``` urolithiasis cystitis urethral rents pyelonephiritis idiopathic hematuria verminous nephritis renal and vesicular neoplasia Blister beetle toxicosis ```

Question 30

The most common clinical sign displayed by horses affected with cystic calculus is _____

Answer 30

hematuria observed after exercise

Question 31

Almost all uroliths of horses are composed of ______, and thus a low-Ca diet is recommended to prevent recurrence

Answer 31

Ca Carbonate

Question 32

How can urinary incontinence be divided?

Answer 32

Neurological, non-neurological, and idiopathic

Question 33

Urinary incontinence due to developmental anomalies (ectopic ureter), cystolithiasis, and consequential to pregnancy and parturition are classified as _____

Answer 33

Non-neurological

Question 34

Urinary incontinence due to EHV-1 myelencephalopathy, cauda equina neuritis, intoxications, and sacral trauma are classified as _____

Answer 34

Neurological

Question 35

Traditionally, neurological categorization of urinary incontinence includes an ___ bladder or a _____ bladder

Answer 35

UMN or LMN

Question 36

Incontinence that is manifested as intermittent squirts of urine is the classic finding for an _____ bladder

Answer 36

UMN

Question 37

A large bladder and flaccid urethral sphincter is seen with _____ bladder

Answer 37

LMN

Question 38

Prognosis for Urinary Incontinence - pretty straightforward

Answer 38

Prognosis is generally favorable if the underlying cause can be resolved Prognosis is generally poor in those with long-standing UI

Question 39

Common dz related causes for PU/PD in the horse are _______ and ______

Answer 39

PPID and Psychogenic PD

Question 40

PD in adult horses can be defined as water consumption _____ ml/kg/day

Answer 40

> 100 | > ~10% of BW

Question 41

PU is defined as urine production > ____ ml/kg/day

Answer 41

50 | 5% BW

Question 42

Normal urine production is typically between ____ and _____ ml/kg/day

Answer 42

15-30

Question 43

What represents the major route of water loss in normal horses?

Answer 43

feces