Equine urinary tract Flashcards
urinary tract disorders
- PU/PD
- pigmenturia
- renal disease
- neoplasia
- urolithiasis
- urinary tract infection
- developmental disorders
history taking
- abnormal urination?
- abnormal colour?
- polyuria? (increased vol)
- pollakuria? (increased freq)
- polydipsia (>100ml/kg/day)
clinical exam
- rectal to feel bladder:
- size, wall thickness, uroliths, masses
- examine penis under sedation
- pass catheter if obstruction is suspected
blood tests
haematology:
- WBC count for evidence of leukocytosis
- RBC count for evidence of anaemia
urea/creatinine:
- azotaemia
- doesn’t increase until >75% nephrons non-functional
urinalysis
- free catch sample or catheter
- no cystocentesis in horses
- USG, biochemistry (dipstick), sediment
hyposthenuria
- urine that is more dilute than serum
<1.008 - foals usually have dilute urine
isothenuria
- urine that has similar osmolarity to serum
1.008-1.014
water deprivation test
- 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
pigmenturia causes
- myoglobin (muscle breakdown)
- haemoglobin (RBC breakdown)
- haematuria
- start of urination (distal urethra)
- end of urination (proximal urethra)
- throughout urination (kidneys, ureters, bladder)
PU and PD causes
- renal failure
- PPID
- primary/psychogenic polydipsia
- diabetes insipidus/mellitus
acute renal failure
- associated with abrupt reduction in glomerular filtration
- leads to failure of excretion of nitrogenous waste causing azotaemia (uraemic syndrome)
pre-renal causes of acute renal failure
- decreased renal perfusion from conditions causing decreased cardiac output/increased renal vascular resistance
(dehydration, diarrhoea)
intra-renal causes of acute renal failure
- ischaemic or toxic damage to tubules
- obstruction of tubules
- acute glomerulonephritis
- inflammation)
post-renal causes of acute renal failure
- obstruction or disruption of urinary outflow tract
clinical signs of acute renal failure
- lethargy
- inappetence
- dehydration
- oliguria
diagnosis of acute renal failure
- casts in urine
- azotaemia
- imaging (ultrasound)
- biopsy?
acute renal failure treatment
- treat underlying cause
- correct fluid and electrolyte imbalances
- if insufficient response give dopamine infusion to improve renal blood flow
nursing considerations for acute renal failure
- monitor urine output, signs of oedema
- encourage appetite
- monitor complications (laminitis, thrombophlebitis)
chronic renal failure cause
glomerulonephritis (most common)
clinical signs of chronic renal failure
- present late in disease course
- lethargy (anaemia)
- anorexia
- weight loss
- PU/PD
- dental tarter
- azotaemia + inability to concentrate urine
- poor prognosis
nursing considerations for chronic renal failure
- fluid therapy to rule out acute renal failure
- access to water
- encourage eating
- reduce protein in diet (avoid alfalfa)
urinary tract infections
- not very common
- present with dysuria
- diagnose with mid-stream urine sample for bacteriology
neoplasia of the urinary tract
- uncommon other than penile tumours
- melanoma, sarcoid, papilloma
- usually squamous cell carcinoma in older geldings
penile squamous cell carcinoma
- malodourous/swollen sheath
- haematuria if distal urethra involved
- obstruction of urinary tract uncommon unless large tumours