Large Animal Urinary Tract Disease

Question 1

What urinary diseases do farm animals get?

Answer 1

Urolithiasis 
Amyloidosis 
Enzootic haematuria 
Ulcerative posthitis/vulvitis 
Pyelonephritis 
Umbilical disease

Question 2

What large animals most commonly get uroliths?

Answer 2

Small Ruminants

Question 3

What predisposes these animals to getting uroliths ?

Answer 3

Castrated 
Male 
Obese
Diet imbalance 
Alkaline urine 
Hard water (high calcium)
Dehydration 
UTI

Question 4

What dietary factors predispose to uroliths?

Answer 4

High concentrate/low roughage
Imbalanced phosphate / calcium
High Magnesium

Question 5

What types of uroliths do large animals get?

Answer 5

Calcium carbonate and apatite
Phosphate - calcium phosphate, STRUVITE
Silicate
Oxalate

Question 6

Where do small ruminants get obstructions from uroliths?

Answer 6

Urethral process or distal sigmoid flexure

Question 7

Where do cows get urolith obstructions

Answer 7

Sigmoid flexure

Question 8

What are the early clinical signs associated with urolithiasis?

Answer 8

Haematuria
Dysuria 
Crystals on prepuce 
Tail flagging and colic signs 
Tenesmus

Question 9

What are the late clinical signs associated with urolithiasis?

Answer 9

Anorexia 
Depression
Prenuptial swelling 
Abdominal distension 
Recumbent, seizures, death

Question 10

How can you diagnose uroliths?

Answer 10

History and CS
Azotaemia, hyperkalaemia, hyponatraemia, acidosis
US and rads

Question 11

What are the complications associated with urolithiasis

Answer 11

Bladder/urethral Rupture

Hydronephrosis

Question 12

How should you manage urolithiasis

Answer 12

Medical (not great)

• antispasmodic
• urinary acidification

Surgical management

• urethral process amputation
• tube cystotomy
• perineal urethrostomy

Question 13

What species commonly gets amyloidosis?

What is associated with?

What does it cause?

Answer 13

COWS

Chronic sepsis e.g. metritis, mastitis, pneumonia, pericarditis

PLN

Question 14

What clinical signs are associated with amyloidosis?

Answer 14

Oedema
Weight loss
Chronic diarrhoea

Proteinuria
Hypoalbuminaemia
Azotaemia

Question 15

What causes enzootic haematuria?

What are the clinical signs?

Answer 15

CHRONIC BRACKEN GRAZING

Haemorrhagic cystitis, haematuria

Question 16

What is the colloquial name for ulcerative posthitis?

Answer 16

Pizzle rot

Question 17

What causes pizzle rot?

Answer 17

Corynebacterium renale

• High protein diets increase urea,
• bacteria break down to ammonia
• scald skin and bacteria infect

Question 18

What clinical signs are associated with pizzle rot?

Answer 18

Pain
Loss of condition
Decreased fertility/libido

Question 19

How do you manage pizzle rot?

Answer 19

Clean and debride
Penicillin
NSAIDs
Reduce dietary protein

Question 20

What urinary diseases do horses get?

Answer 20

Pyelonephritis
Umbilical disease
Renal failure
Bladder rupture (foals)

Question 21

What is the most common renal disease in cows?

Answer 21

Pyelonephritis

Question 22

What are the acute signs of pyelonephritis

Answer 22

Pyrexia, anorexia, depression
Colic signs 
Decreased milk yield 
Stranguria, haematuria, pyuria 
Polyuria

Question 23

What are the chronic PN clinical signs ?

Answer 23

Weight loss
Colic
Decreased yield
Diarrhoea 
Polyuria 
Anaemia

Question 24

What bacteria are associated with PN in LAs?

Answer 24

Mainly G-ve
- coliforms, proteus, klebsiella, enterobacter

Some G+

Trueperella pyogenes, C renale

Question 25

How can you diagnose pyelonephritis in LAs?

Answer 25

``` CS+ rectal palpation - feel left kidney Pyuria, haematuria, proteinuria Azotaemia US and endoscopy (horse) Urine culture? ```

Question 26

How do you treat PN?

Answer 26

Long term broad spectrum ABs Tetracyclines Cephalosporins

Question 27

What clinical signs are associated with umbilical infection?

Answer 27

If septic - fever malaise lethargy petechial haemorrhage Heat, pain, swelling and discharge from umbilicus

Question 28

How do you diagnose umbilical infection?

Answer 28

US - enlargement of vessels Anechoic or hyperechoic material seen

Question 29

How do you treat umbilical infection?

Answer 29

Broad spectrum antibiotic therapy - Cephalosporins, Penicillins Surgical resection (not if septic)

Question 30

What is the difference between a patent and persistent urachus?

Answer 30

Patent - has been closed then opens Persistent - open since birth

Question 31

What is the more common cause of renal insult in horses?

Answer 31

Renal failure secondary to hypovolaemia (Pre-renal)

Question 32

What toxic insults can cause acute renal failure in horses?

Answer 32

Aminoglycosides ONLY give SID NSAIDs Acorn

Question 33

What clinical signs are associated with renal failure in horses?

Answer 33

``` Depression, anorexia weight loss PUPD Oedema and diarrhoea Pyrexia and Colic signs Encephalopathy Oral mucosal ulceration Excessive tooth tartar ```

Question 34

What specific LA perameter is raised in urinalysis in renal failure?

Answer 34

GGT | GGT:Createnine ratio

Question 35

How can you treat acute renal failure?

Answer 35

IVFT | Diuretics - IV (only) furosemide

Question 36

When should you be suspicious of bladder rupture in a foal?

Answer 36

Soon after parturition Tenesmus BUT caudal position of hind limbs to differentiate from straining to defaecate Progressive depression and abdominal distension Ventral and prenuptial oedema

Question 37

How can you diagnose bladder rupture?

Answer 37

Abdominocentesis | Ultrasonography

Question 38

How do you manage a foal with bladder rupture?

Answer 38

``` IVFT Peritoneal drainage + lavage Dextrose and insulin - promote intracellular movement of potassium Intranasal oxygen SURGERY on STABILISED foal ```

Question 39

What acid-base and electrolyte abnormalities occur in bladder rupture?

Answer 39

Hyperkalaemia -failure to excrete Hyponatraemia - loss of regulation, continued water intake Metabolic acidosis - loss of renal regulation Respiratory acidosis - compression of diaphragm