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Renal > LA Urinary tract diseases > Flashcards

LA Urinary tract diseases Flashcards

1
Q

Outline urolithiasis in farm animals

A
  • leading cause of obstruction
  • v common in small ruminants d/t dietary imbalances
  • males and females develop uroliths, generally only males show signs of urinary obstruction
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2
Q

Predisposing factors - farm animal urolithiasis

A 
> Castrated males
• Diet has major influence
– high concentrate / low roughage
– high phosphate diets/low calcium diet
– high magnesium diets
– alkaline urine
• Dehydration
• Urinary tract infection
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3
Q

Types of farm animal uroliths

A

DIET DEPENDENT:

  • calcium (apatite and carbonate)
  • phosphate (calcium and magnesium ammonium = struvite types)
  • silicate
  • oxalate
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4
Q

Site of urolithiasis obstruction - cattle and small ruminants

A
  • CATTLE: distal sigmoid flexure

- SMALL RUMINANTS: urethral (vermiform) process in small ruminants > distal sigmoid flexure

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5
Q

CS - farm animal urolithiasis

A 
• Early clinical signs
– haematuria, dysuria, crystals on prepuce
– urine dribbling
– tail flagging & colic signs
• Later clinical signs
– anorexia, depression
– preputial swelling
– abdominal distension
– recumbent, seizures and death
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6
Q

Dx - farm animal urolithiasis

A
  • hx and CS
  • axotaemia, hyperkalaemia, hyponatraemia, acidosis
  • ultrasound
  • radiograph
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7
Q

Complications - farm animal urolithiasis

A 
• bladder rupture
– painful becoming comfortable then sick
– abdominal distension and uroperitoneum
• urethral rupture
– swollen prepuce
• hydronephrosis
– requires chronic obstruction
– diagnosis via ultrasonography
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8
Q

Managemetn - farm animal urolithiasis

A 
• Medical management
– increase diet Ca: P ratio
– urinary acidification
• Surgical management
– urethral process amputation
– perineal urethrostomy
– tube cystotomy
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9
Q

How common is amyloidosis in cattle? what is it associated with>

A
  • common in cattle

- assoc with chronic sepsis (metritis, mastitis, pneumonia, pericarditis)

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10
Q

Outline amyloidosis in catlle

A
  • inflammation drives SAA production –> glomerulopathy
  • loss of glomerular function –> PLN
  • oedema, wt loss, chronic diarrhoea
  • proteinuria, hypoalbuminaemia, azotaemia
  • raised serum fibrinogen, SAA, globulins
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11
Q

Tx - cattle amyloidosos

A

None

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12
Q

Outline enzootic haematuria in cattle

A
  • cattle and sheep grazing bracken
  • requires chronic (>12 months exposure)
  • multiple cases
  • contains ptaquiloside carcinogens
  • bladder wall neoplasia (haemorrhagic cystitis, haematuria)
  • anaemia
  • differentiate from haemoglobinuria
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13
Q

Ddx - enzootic haematuria

A

haemoglobinuria

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14
Q

Proper name for ‘pizzle rot’

A

= ulcerative posthitis/ vulvitis

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15
Q

Outline pizzle rot in small ruminants

A
  • ulcerative bacterial infection of prepuce and vulva MM (C. renale, high protein diets seem to predispose)
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16
Q

CS - pizzle rot

A
  • pain
  • loss of condition
  • decreased fertility/ libido
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17
Q

Management - pizzle rot

A
  • penicillin
  • NSAIDs
  • reduce dietary protein
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18
Q

Outline pyelonephritis in FA and horses

A
  • ascending (usually) infection of urinary tract
  • commonest renal dz in cattle
  • post-parturition and post service/ covering
  • following metritis and urolithiasis
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19
Q

Acute PN CS

A

– pyrexia, anorexia, depression, colic signs
– decreased milk yield
– stranguria, polyuria, hematuria, pyuria

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20
Q

Chronic PN CS

A

weight loss, colic, decreased milk yield, diarrhoea, polyuria,
anemia, less obvious signs of urinary tract infection

21
Q

Which bacteria cause PN in cattle?

A
  • mainly GRAM NEGATIVE (coliforms, Proteus sp, Klebsiella sp, Enterobacter sp)
  • also GRAM POSITIVE: (A.pyogenes, rarely C. renale)
22
Q

Dx - bovine PN

A

– clinical signs and rectal palpation
– pyuria, haematuria, proteinuria
– azotaemia
– urine culture?

23
Q

Tx - bovine PN

A

– long term (14-21 days) broad spectrum AB’s

– oxytetracycline or penicillin/aminoglycosides

24
Q

How can infection establish in umbilicus?

A
  • umbilicus as portal of entry

- localise following haematogenous spread from GIT, other sites of sepsis or generalised septicaemia

25
Q

What part of umbillicus tends to be most commonly infected?

A

arteries and urachus > vein

26
Q

Common umbilical pathogens

A
  • E. coli, Actinobacillus equuli, Klebsiella spp, Pseudomonas spp
  • Bacillus spp, S. aureus, Strep spp, Enterococcus spp
  • Clostridium spp
  • mixed infections common
27
Q

CS - umbilical pathogens

A
  • fever, malaise, lethargy
  • heat, pain, swelling and discharge from umbilicus
  • localising signs aren’t present in every case, particularly when there is generalised septicaemia
28
Q

Why is ultrasound useful for diagnosis of umbilical infection?

A
  • enlargement of BVs (normal A and V
29
Q

Tx - umbilical infection

A
  • SURGICAL RESECTION: presents spread to other sites, animals with generalised septicaemia may not be good candidates for anaesthesia
  • BS AB Tx: monitor response with ultrasound, if umbilicus continues to enlarge, change AB or consider sx
30
Q

ABs for umbilical infection

A
  • CEFTIOFUR: in foals require 2x adult horse dose
  • TRIMETHOPRIM-SULPHONAMIDE: economical and given orally but organisms may not be sensitive
  • AMINOGLYCOSDIES: care in v young animals (nephrotoxic), used in conjunction with gram positive cover
  • PENICILLINS and other BETA-LACTAMS
  • CEPHALOSPORINS
31
Q

Ddx - umbilical infection

A

umbilical hernia

32
Q

Outline umbilical hernia

A
  • small hernias
33
Q

Differentiate patent and persistent urachus

A
  • PATENT: has been closed then opens d/t infection or prolonged recumbency
  • PERSISTENT: open since birth, excessive torsion in parturition? may need cautery or sx resection
34
Q

Outline renal failure in horses

A
  • primary renal failure less common than renal failure secondary to hypovolaemia (i.e. pre-renal failure –> renal failure)
  • renal dz without renal failure usually doesn;t cause obvious CS or clinical pathology changes
  • renal failure when >70% nephrons lost
35
Q

Causes - primary renal failure

A
  • congenital
  • interstitial nephritis
  • GN
  • PN
  • amyloidosis
  • neoplasia
36
Q

CS - primary renal failure

A
  • depression, anorexia, weight loss
  • polydipsia and polydipsia
  • oedema and diarrhoea
  • pyrexia and colic signs
  • encephalopathy
  • oral mucosal ulceration
  • excessive tooth tartar
37
Q

Urinalysis - primary renal failure

A
  • proteinuria
  • casts
  • wbcs and bacteria
  • haematuria
  • inability to concentrate urine (isossthenuria is SG 1.008 - 1.014)
  • increased urine GGT (GGT: creatinine ratio to correct for variations in urine flow)
38
Q

Serum biochem - primary renal failure

A 
• azotaemia
– increased urea and creatinine
• hyperkalaemia
• hyponatraemia
• hypercalcaemia
• hypophosphataemia
39
Q

Tx - ARF

A

– restore circulating volume (0.9% NaCl 40-80
ml/kg/day)
– diuresis (20% mannitol and furosemide IV)

40
Q

Tx - CRF

A

– no specific treatment
– supportive only
– ad lib salt and water
– high quality diet

41
Q

When do foals bladders tend to rupture?

A

usually during or soon after parturition - inherent bladder wall weakness?

42
Q

Ddx - ruptured bladder

A
  • tenesmus
  • straining to defaecate (e.g. retained meconium)
  • note the caudal position of the HL in foals straining to urinate
43
Q

Outline bladder rupture in foals

A
  • no sex predisposition
  • previosuly thought more common in colts (narrow pelvis and long urethra)
  • tears on dorsal aspect of bladder
44
Q

CS - ruptured bladder in foal

A
  • within first 2-3 days of life
  • dysuria: frequent attempts to urinate with only small amounts voided
  • progressive depression and abdominal distension
  • ventral and preputial oedema
45
Q

Outline urinary tract rupture secondary to infection

A
  • urachus, bladder or ureters
  • birth to 2 months old
  • hx of other illness
  • easy to miss because deterioration in clinical status can be mistakenly attributed to pre-existing dz
46
Q

Dx - ruptured bladder

A
  • peritoneal fluid: serum creatinine ratio >2.1

- ultrasound

47
Q

Aid-base and electrolyte derangements in ruptured bladders

A
  • azotaemia (failure to excrete)
  • hyperkalaemia (failure to excrete, leads to cardiac arrhythmias)
  • hyponatraemia (loss of renal regulation, continued intake of water)
  • metabolic acidosis (loss of renal regulation, third spacing causes hypovolaemia and poor perfusion)
  • respiratory acidosis (compression of diaphragm)
48
Q

Management - ruptured bladder

A

• Emergency surgery is usually not required
– manage medically first and stabilise before
surgery
– IV fluids
– peritoneal drainage
• Good outcome (>80%) with surgery if
performed on a stabilised foal

49
Q

Pre-operative stabilisation for ruptured bladder

A 
• Restore circulating volume
– 0.9% NaCl
– Hartmann’s solution
• Dextrose and insulin to promote
intracellular movement of potassium
– if not successful - calcium or bicarbonate
• Drain abdomen and peritoneal lavage
• Intranasal oxygen

Renal (30 decks)

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