Equine Urinary Tract Flashcards
what are the main urinary tract disorders in horses?
PUPD pigmenturia renal disease neoplasia urolithiasis UTI developmental disorders
what history taking is needed when investigating equine urinary problems?
standard history abnormal urination abnormal colour any other problems measure water intake over 24hrs
what water intake is classed as polydipsia in horses?
> 100ml/kg/day
what will owners of horses with urinary issues most often confuse?
polyuria (increased volume)
pollakuria (increased frequency)
what are the most common problems associated with urinary issues?
abnormal urination
weight loss
what is involved in the clinical exam of a horse with urinary issues?
standard
rectal
examination of penis
passing of urinary catheter
what is a rectal exam used for in the urinary patient?
bladder: size, wall thickness, uroliths (bladder stones), masses
caudal pole of left kidney
how should the horse be restrained for examination of the penis?
sedate with alpha 2 agonist
ACP to encourage protrusion
when should a urinary catheter be passed in horses?
if obstruction suspected
what blood tests will be performed on equine urinary patients?
haematology
biochem
what is found on haematology that may indicate UTI or infection?
leukocytosis
what would anaemia in the urinary patient indicate?
chronic disease
chronic renal failure leading to reduction in production of erythropoetin (EPO)
what does raised urea and creatinine indicate?
azotemai
when will urea and creatinine levels increase?
once 75% of nephrons are non-functional
is urea/creatinine useful in early kidney disease?
no
what is indicated by a doubling of urea and creatinine values once they are elevated?
50% decline in remaining kidney function
how is a urine sample obtained from a horse for urinalysis?
caught midstream (container on a stick) catheterisation
is cystocentesis performed in horses?
no
what can be done to encourage horses to urinate?
freshly bedded stable
what should be noted if pigmenturia is present?
timing
duration of passage
what is involved in urinalysis?
USG
dip stick (biochemistry)
sediment analysis of casts
what is USG a measure of?
urine concentration
what is used to measure USG?
refractometer
what is hyposthenuria?
urine that is more dilute than serum (<1.008)
what is isosthenuria?
urine and serum have similar osmolality - indicates kidney is unable to have any effect on urine
>1.008-1.014
what is hypersthenuria?
urine more concentrated than serum
what is the concentration of normal horse and foal urine like?
adult normally concentrated
foal dilute
what can ultrasonography be used for in urinary diagnosis?
uroliths in kidney and sometimes bladder
size and architecture of kidneys
what is cystoscopy useful for?
investigation of abnormal urination
what can be examined during cystoscopy?
urethra
bladder
watching and sampling urine from ureters
what will sedation for cystoscopy need to include if patient is male?
ACP
what is a water deprivation test used for?
test for diabetes insipidus or psychogenic polydipsia once all other causes of PUPD are ruled out
what must be checked before a water deprivation test is performed?
urea and creatinine
USG
weight
when should you not proceed with a water deprivation test?
if urea and creatinine increased
USG >1.008
how is a water deprivation test performed?
weighed
water is removed
USG, urea and creatinine checked regularly
monitor for signs of dehydration
when is a water deprivation test stopped?
24 hours reached USG rises to above 1.020 Azotaemia Clinical signs of dehydration Loss of 5% BW
what is involved in the modified water deprivation test?
water is restricted to 4% of BW over 24 hours rather than being totally removed
what are the main types of haematuria seen?
myoglobin
haemoglobin
haematuria
what does myoglobin in urine indicate?
myopathy
what does haemoglobin in urine indicate?
haemolysis
what does haematuria throughout urination suggest?
haemorrhage from kidneys, ureters or bladder
what does haematuria at the beginning of urination suggest?
haemorrhage from distal urethra
what does haematuria at the end of urination suggest?
haemorrhage in proximal urethra
what can cause PUPD in horses?
renal failure PPID primary/psychogenic polydipsia central nephrogenic diabetes insipidus DM
what is diabetes insipidus caused by?
lack of ADH
what should you look for on the bloods of a horse with PUPD?
renal failure
isosthenuria
azotemia
PPID in older horses
when is water deprivation testing only performed?
if other causes ruled out
if not azotaemic
USG of >1.008
what is acute renal failure?
clinical syndrome associated with abrupt reduction in glomerular filtration