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Renal > Large animal urinary tract diseases > Flashcards

Large animal urinary tract diseases Flashcards

1
Q

urolithiasis - predisposing factors

A

Castrated males - narrower urethra
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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2
Q

urolithiasis - types of uroliths

A 
calcium (apatite and carbonate) 
phosphate (calcium phosphate and magnesium ammonium phosphate [struvite]) 
silicate 
oxylate 
diet dependent
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3
Q

urolithiasis - site of obstruction

A

urethral (vermiform) process in small ruminants > distal sigmoid flexure
distal sigmoid flexure in cattle

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4
Q

urolithiasis - clinical signs - early

A

haematuria, dysuria, crystals on prepuce
urine dribbling
tail flagging & colic signs

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5
Q

urolithiasis - clinical signs - later

A

anorexia, depression
preputial swelling
abdominal distension
recumbent, seizures and death

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6
Q

urolithiasis - diagnosis

A

history and clinical signs
azotaemia, hyperkalaemia, hyponatraemia, acidosis
ultrasonography
radiography

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7
Q

urolithiasis - complications

A

bladder rupture – abdominal distension and uroperitoneum
urethral rupture – swollen prepuce
hydronephrosis – requires chronic obstruction, diagnosis via ultrasonography

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8
Q

urolithiasis - management

A

Medical management – incr diet calcium: phosphate ratio, urinary acidification
Surgical managemen – urethral process amputation, perineal urethrostomy, tube cystotomy

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9
Q

Amyloidosis

A

inflammation drives serum amyloid A (SAA) production: glomerulopathy
loss of glomerular function results in protein losing nephropathy

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10
Q

amyloidosis - clinical signs

A

oedema, weight loss, chronic diarrhoea
proteinuria, hypoalbuminaemia, azotaemia
raised serum fibrinogen, SAA, globulins

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11
Q

amyloidosis - treatment

A

none

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12
Q

Enzootic haematuria - causes

A 
cattle and sheep grazing bracken - contains ptaquiloside carcinogens
requires chronic (>12 months exposure)
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13
Q

Enzootic haematuria - effects

A

bladder wall neoplasia – haemorrhagic cystitis, haematuria
anaemia
differentiate from haemoglobinuria

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14
Q

Ulcerative posthitis/vulvitis - define + cause

A

‘pizzle rot’ in small ruminants
ulcerative bacterial infection of prepuce and vulva mucous membranes
Corynebacterium renale
high protein diets appear to predispose

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15
Q

Ulcerative posthitis/vulvitis - clinical signs

A

pain, loss of condition, decreased fertility/libido

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16
Q

Ulcerative posthitis/vulvitis - management

A

penicillin, NSAIDs, reduce dietary protein <16%

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17
Q

Pyelonephritis

A

in FA & horses
ascending infection of the urinary tract
most common renal disease in cattle
post parturition and post service/covering
following metritis and urolithiasis

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18
Q

Pyelonephritis - acute clinical signs

A

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

19
Q

Pyelonephritis - chronic clinical signs

A

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

20
Q

Pyelonephritis - microbiology

A

coliforms, Proteus sp, Klebsiella sp, Enterobacter sp
A. pyogenes
rarely C. renale

21
Q

Pyelonephritis - diagnosis

A

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

22
Q

Pyelonephritis - treatment

A 
long term (14-21 days) broad spectrum AB’s 
oxytetracycline or penicillin/aminoglycosides
23
Q

umbilical infection

A

umbilicus can be portal of entry of infection
Infection can localise there following haematogenous spread from gut, other sites of sepsis or as part of generalised septicaemia
Arteries and urachus become infected more commonly than vein

24
Q

umbilical infection - common pathogens

A 
Escherichia coli 
Actinobacillus equuli 
klebsiella spp 
Pseudomonas spp. 
Bacillus spp. 
Staphylococcus aureus 
Streptococcus spp. 
Enterococcus spp 
Clostridium spp. 
mixed infections common
25
Q

umbilical infection - clinical signs

A

Fever, malaise, lethargy
Heat, pain, swelling and discharge from umbilicus
Localising signs are not present in every case, particularly when there is generalised septicaemia

26
Q

umbilical infection - treatment - surgical

A

resection
Prevents spread of infection to other sites
Animals with generalised septicaemia may not be good candidates for anaesthesia

27
Q

umbilical infection - treatment - medical

A

broad spec antibiotics

Monitor with ultrasonography, and if umbilicus continues to enlarge, change antibiotic or consider surgery

28
Q

umbilical infection - antibiotic choice

A 
Ceftiofur 
Trimethoprim-sulphonamide 
Aminoglycosides – care in very young animals- nephrotoxicity 
Penicillins and other beta-lactams 
Cephalosporins
29
Q

umbilical hernia

A

differentiate umbilical infection from hernia
small hernias (<2 cm) resolve over first 2 months
larger hernias may require surgical treatment
dangerous only if strangulating

30
Q

patent urachus

A

has been closed then opens
infection
prolonged recumbency

31
Q

persistent urachus

A

open since birth
excessive torsion during parturition?
may need cautery or surgical resection

32
Q

renal failure in horses

A

primary less common than failure secondary to hypovolaemia
renal disease without renal failure usually does not cause obvious clinical signs or clinical pathology changes
renal failure when >70% nephrons lost

33
Q

Causes of primary renal failure

A 
congenital 
interstitial nephritis 
glomerulonephritis 
pyelonephritis 
amyloidosis 
neoplasia
34
Q

clinical signs

A 
depression, anorexia, weight loss 
polydipsia and polydipsia 
oedema and diarrhoea 
pyrexia and colic signs 
encephalopathy 
oral mucosal ulceration 
excessive tooth tartar
35
Q

urinalysis

A

proteinuria
casts
white cells and bacteria
haematuria
inability to concentrate urine – isosthenuria: SG 1.008-1.014
increased urine GGT - GGT: creatinine ratio to correct for variations in urine flow

36
Q

serum biochemistry

A 
azotaemia – increased urea and creatinine 
hyperkalaemia 
hyponatraemia 
hypercalcaemia 
hypophosphataemia
37
Q

treatment - acute

A

restore circulating volume

diuresis (20% mannitol and furosemide IV)

38
Q

treatment - chronic

A

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

39
Q

Ruptured bladder and uroperitoneum in foals - timing of rupture

A

usually occurs during or soon after parturition
History of previously normal urination does not rule out ruptured bladder in cases that rupture later
Must differentiate from tenesmus/straining to defaecate

40
Q

Bladder rupture detected soon after parturition

A

No sex predisposition
Previously thought to be more common in colts - narrow pelvis and long urethra
Tears on dorsal aspect of bladder

41
Q

bladder rupture - clinical signs

A

Signs are normally present within the first 2–3 days of life
Dysuria: frequent attempts to urinate - small amounts voided
Progressive depression and abdominal distension
Ventral and preputial oedema

42
Q

Urinary tract rupture secondary to infection

A

Urachus, bladder or ureters
From birth to around two months of age
Usually history of other illness
Easy to miss because deterioration in clinical status can be mistakenly attributed to pre-existing disease

43
Q

bladder rupture - diagnosis

A

Peritoneal fluid: Serum creatinine ratio > 2:1

Ultrasonography

44
Q

bladder rupture - management

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

Renal (13 decks)

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