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CVNT 2 > Equine urinary tract > Flashcards

Equine urinary tract Flashcards

1
Q

urinary tract disorders

A
  • PU/PD
  • pigmenturia
  • renal disease
  • neoplasia
  • urolithiasis
  • urinary tract infection
  • developmental disorders
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2
Q

history taking

A
  • abnormal urination?
  • abnormal colour?
  • polyuria? (increased vol)
  • pollakuria? (increased freq)
  • polydipsia (>100ml/kg/day)
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3
Q

clinical exam

A
  • rectal to feel bladder:
    • size, wall thickness, uroliths, masses
  • examine penis under sedation
  • pass catheter if obstruction is suspected
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4
Q

blood tests

A

haematology:
- WBC count for evidence of leukocytosis
- RBC count for evidence of anaemia
urea/creatinine:
- azotaemia
- doesn’t increase until >75% nephrons non-functional

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5
Q

urinalysis

A
  • free catch sample or catheter
  • no cystocentesis in horses
  • USG, biochemistry (dipstick), sediment
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6
Q

hyposthenuria

A
  • urine that is more dilute than serum
    <1.008
  • foals usually have dilute urine
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7
Q

isothenuria

A
  • urine that has similar osmolarity to serum
    1.008-1.014
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8
Q

water deprivation test

A
  • tests for diabetes insipidus and psychogenic polydipsia
    1. weigh horse
    2. check urea, creatinine, USG
  • don’t proceed if USG >1.008
    3. water removed and tests done regularly
    4. stop after 24hrs, USG >1.020, azotaemia, signs of dehydration, loss of 5% BW
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9
Q

pigmenturia causes

A
  • myoglobin (muscle breakdown)
  • haemoglobin (RBC breakdown)
  • haematuria
    • start of urination (distal urethra)
    • end of urination (proximal urethra)
    • throughout urination (kidneys, ureters, bladder)
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10
Q

PU and PD causes

A
  • renal failure
  • PPID
  • primary/psychogenic polydipsia
  • diabetes insipidus/mellitus
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11
Q

acute renal failure

A
  • associated with abrupt reduction in glomerular filtration
  • leads to failure of excretion of nitrogenous waste causing azotaemia (uraemic syndrome)
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12
Q

pre-renal causes of acute renal failure

A
  • decreased renal perfusion from conditions causing decreased cardiac output/increased renal vascular resistance
    (dehydration, diarrhoea)
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13
Q

intra-renal causes of acute renal failure

A
  • ischaemic or toxic damage to tubules
  • obstruction of tubules
  • acute glomerulonephritis
  • inflammation)
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14
Q

post-renal causes of acute renal failure

A
  • obstruction or disruption of urinary outflow tract
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15
Q

clinical signs of acute renal failure

A
  • lethargy
  • inappetence
  • dehydration
  • oliguria
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16
Q

diagnosis of acute renal failure

A
  • casts in urine
  • azotaemia
  • imaging (ultrasound)
  • biopsy?
17
Q

acute renal failure treatment

A
  • treat underlying cause
  • correct fluid and electrolyte imbalances
  • if insufficient response give dopamine infusion to improve renal blood flow
18
Q

nursing considerations for acute renal failure

A
  • monitor urine output, signs of oedema
  • encourage appetite
  • monitor complications (laminitis, thrombophlebitis)
19
Q

chronic renal failure cause

A

glomerulonephritis (most common)

20
Q

clinical signs of chronic renal failure

A
  • present late in disease course
  • lethargy (anaemia)
  • anorexia
  • weight loss
  • PU/PD
  • dental tarter
  • azotaemia + inability to concentrate urine
  • poor prognosis
21
Q

nursing considerations for chronic renal failure

A
  • fluid therapy to rule out acute renal failure
  • access to water
  • encourage eating
  • reduce protein in diet (avoid alfalfa)
22
Q

urinary tract infections

A
  • not very common
  • present with dysuria
  • diagnose with mid-stream urine sample for bacteriology
23
Q

neoplasia of the urinary tract

A
  • uncommon other than penile tumours
    • melanoma, sarcoid, papilloma
  • usually squamous cell carcinoma in older geldings
24
Q

penile squamous cell carcinoma

A
  • malodourous/swollen sheath
  • haematuria if distal urethra involved
  • obstruction of urinary tract uncommon unless large tumours
25
Q

penile squamous cell carcinoma treatment

A
  • depends on position and extent of tumour
  • local excision
  • penile resection
    high rate of recurrence although slow metastasis (to inguinal lymph nodes)
26
Q

urolithiasis

A
  • less common in horses than small animals
  • more common in males than females (females have shorter and wider urethra)
27
Q

types of urolithiasis

A

type 1 calcium carbonate
- >90% cases
- yellow, spiculated (spiky)
type 2 calcium carbonate
- grey, smooth
sabulous urolithiasis
- accumulation of urine sediment in ventral bladder

28
Q

clinical signs of cystic calculi (bladder stones)

A
  • dysuria (haematuria, stranguria, incontinence)
  • exacerbated during/after exercise
  • work up includes rectal, endoscopy, ultrasound
29
Q

treatment of cystic calculi

A
  • laparotomy and cystotomy
  • recovery as for colic surgery
  • impossible to dissolve stones in horses
30
Q

urethral calculi

A
  • usually in males
  • small cystoliths that pass into urethra
  • present with dysuria
  • if blocked: colic, ARF, risk of rupture
31
Q

urethral calculi treatment

A
  • pass a catheter
  • perineal urethrotomy (if repeated)
32
Q

urinary incontinence

A
  • uncommon in horses
  • signs exacerbated by coughing/exercise
  • signs similar to urolithiasis which is more common
33
Q

causes of urinary incontinence

A
  • upper motor neuron (equine herpes virus), lower motor neuron, myogenic disorders
  • sabulous urolithiasis
34
Q

bladder paralysis

A
  • feature of neurological diseases
  • urinary incontinence, urine scalding, loss of anal/tail muscle tone
35
Q

nursing considerations for urinary incontinence and bladder paralysis

A
  • cleaning of perineum/hindlimbs
  • protection from urine scalding
  • management of urinary catheter (if necessary)
  • monitor urine output, urine
36
Q

urinary tract conditions in foals

A
  • patent urachus
  • ruptured bladder
37
Q

patent urachus

A
  • in foetus urine passes from bladder to allantoic cavity via urachus
  • normally urachus closes at parturition
  • patent urachus is failure of closure
  • will see urine drip from umbilicus
  • usually close over time but prophylactic antibiotics may be considered
  • surgical correction if persists
38
Q

bladder rupture in foals

A
  • occurs during parturition, usually in males
  • progressive dullness over first 72hrs
  • results in hyperkalaemia, uroabdomen
  • surgical correction after fluid therapy

CVNT 2 (33 decks)

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