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
penile squamous cell carcinoma treatment
- depends on position and extent of tumour - local excision - penile resection high rate of recurrence although slow metastasis (to inguinal lymph nodes)
26
urolithiasis
- less common in horses than small animals - more common in males than females (females have shorter and wider urethra)
27
types of urolithiasis
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
clinical signs of cystic calculi (bladder stones)
- dysuria (haematuria, stranguria, incontinence) - exacerbated during/after exercise - work up includes rectal, endoscopy, ultrasound
29
treatment of cystic calculi
- laparotomy and cystotomy - recovery as for colic surgery - impossible to dissolve stones in horses
30
urethral calculi
- usually in males - small cystoliths that pass into urethra - present with dysuria - if blocked: colic, ARF, risk of rupture
31
urethral calculi treatment
- pass a catheter - perineal urethrotomy (if repeated)
32
urinary incontinence
- uncommon in horses - signs exacerbated by coughing/exercise - signs similar to urolithiasis which is more common
33
causes of urinary incontinence
- upper motor neuron (equine herpes virus), lower motor neuron, myogenic disorders - sabulous urolithiasis
34
bladder paralysis
- feature of neurological diseases - urinary incontinence, urine scalding, loss of anal/tail muscle tone
35
nursing considerations for urinary incontinence and bladder paralysis
- cleaning of perineum/hindlimbs - protection from urine scalding - management of urinary catheter (if necessary) - monitor urine output, urine
36
urinary tract conditions in foals
- patent urachus - ruptured bladder
37
patent urachus
- 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
bladder rupture in foals
- occurs during parturition, usually in males - progressive dullness over first 72hrs - results in hyperkalaemia, uroabdomen - surgical correction after fluid therapy