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Renal > Large Animal Urinary Tract Diseases > Flashcards

Large Animal Urinary Tract Diseases Flashcards

1
Q

Which LA is urolithiasis most common in and why?

A

Pet sheep/goats

Being fed inappropriate diet too high in conc/too low in roughage

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2
Q

Where do uroliths most commonly occur in the LA male?

A 
Sigmoid flexure
Urethral process (sheep)
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3
Q

What are the predisposing factors to developing uroliths in the LA?

A

Castrated male
Inappropriate diet
Dehydration
UTI

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4
Q

What kind of LA diets predispose to urolithiasis?

A

High conc/low roughage
High Ph/low Ca
High Mg
Alkaline urine

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5
Q

How does low roughage diet contribute to the development of uroliths in LA?

A

Low roughage > less chewing > less saliva produced > Phosphate not used in saliva and remains in the system > more excreted in urine > urolith formation

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6
Q

What types of uroliths occur in LAs? Which is the most damaging?

A

Ca apatite, carbonate
Ca phosphate, struvite
Silicate
Oxalate - less smooth, more damaging

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7
Q

What are the early clinical signs of urolithiasis in LAs?

A

Haematuria, dysuria, crystals on prepuce
Dribbling urine
Tail flagging, colic/abdo pain

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8
Q

What are the later clinical signs of urolithiasis in LAs?

A

Anorexia, depression
Preputial swelling
Abdo distension
Recumbent, seizure, death

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9
Q

How is urolithiasis diagnosed in the LA?

A

Hx and clinical signs
Azotaemia, hyperK, hypoN, acidosis
US
Radiographs

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10
Q

What are the possible complications of urolithiasis of LAs?

A

Bladder rupture
Urethral rupture
Hydronephrosis

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11
Q

What are the clinical signs of bladder rupture in LAs?

A

Pain > comfort > sick

Abdo distension, uroperitoneum

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12
Q

How is urolithiasis medically managed in the LA?

A

Increased dietary Ca:P ratio

Acidify urine

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13
Q

How is urolithiasis surgically managed in LAs?

A

Urethral process amputation
Perineal urethrostomy
Tube cystotomy

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14
Q

Outline a perineal urethrostomy used to manage urolithiasis. Why is this method unpopular in the pet LA?

A

Urethra is pulled out, dissected proximal to sigmoid flexure and stitched to perineum. Doesn’t look visually pleasing

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15
Q

Which species is amyloidosis common in? What is it associated with and how is it treated?

A

Cattle, associated with chronic sepsis. No tx -> cull

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16
Q

Outline the pathophysiology of amyloidosis…

A

Chronic sepsis > inflam increased serum amyloid A production > glomerulopathy > PLN

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17
Q

What are the clinical signs of amyloidosis?

A

Metritis, mastitis, pneumonia, pericarditis -> Chronic sepsis
Oedema
Weight loss
Chronic D

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18
Q

What are the diagnostic signs of amyloidosis?

A

Proteinuria
Hypoalbuminaemia, azotaemia
Reaised serum fibrinogen, serum amyloid A and globulins

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19
Q

What causes enzootic haematuria in LAs? Outline the pathogenesis…

A

Chronic ingestion of bracken
Bracken contains ptaquiloside carcinogen > DNA alkylating agent > interferes with DNA replication > bladder wall neoplasia

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20
Q

What are the clinical signs of haematuria? What are the DDx?

A

Haemorrhagic cystitis
Haematuria
Anaemia
Haemoglobinuria

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21
Q

What is the scientific name for pizzle rot? Which species does it affect? What pathogen is responsible?

A

Ulceratice posthitis/vulvitis
Sheeps/goats
Corynebacterium renale

22
Q

What are the clinical signs of pizzle rot?

A

Pain
Loss of BCS
Decreased fertility

23
Q

How is pizzle rot treated?

A

Penicillin
NSAIDs
Reduce dietary protein

24
Q

Which species suffer from pyelonephritis? What is the most common cause? What are the predisposing factors?

A 
Sheep, cattle and horses
Ascending infection
Post-parturition
Post service/covering
Metritis 
Urolithiasis
25
Q

What are the clinical signs of acute pyelonephritis?

A

Pyrexia, anorexia, depression
Decreased milk yield
Stranguria, polyuria, haematuria, pyuria

26
Q

What are the clinical signs of chronic pyelonephritis?

A 
Weight loss
Decrease milk yield
D+
Polyuria
Anaemia
Colic
Non-specific signs!
27
Q

Which bacteria are responsible for pyelonephritis?

A 
G-ve
Coliforms
Proteus
Klebsiella
Enterobacter

G+ve
Arcanobacterium pyogenes
Corynebacterium renale

28
Q

How is pyelonephritis treated?

A

Oxytetracycline or pen and aminoglycosides for 14-21 days

29
Q

How can umbilical infections come about in LAs? What parts of the umbilicus tend to get infected?

A

Umbilicus acts as a portal of entry. Infection localises at umbilicus following haematogenous spread

Arteries and urachus

30
Q

What bacteria can cause umbilical infections? What does this mean about choosing an AB?

A 
E. coli
Actinobacillus equuli
Klebsiella spp.
Pseudomonas spp.
Bacillus spp.
S. aureus 
Strep spp.
Enterococcus spp.
Clostridum spp.

1st line AB needs to have broad spectrum!

31
Q

What are the clinical signs of umbilical infection?

A

Pyrexia, malaise, lethargy
Heat, pain, swelling or discharge from umbilicus
Signs of sepsis - swollen/painful joints, petechiae

32
Q

What are signs of umbilical infection on US?

A

Enlarged umbilical arteries >1cm

Hypoechoic material +/- gas in umbilical structures (mottled appearance)

33
Q

How can umbilical infection be treated?

A

Surgical resection

Broad spec ABs and US monitoring

34
Q

Outline the possible AB choice for umbilical infections and rationale for using them…

A

Penicillins+aminoglycosides or 1st/2nd gen cephalosporins - combo provides broad spectrum, not encouraging of resistance

TMS - cheap but ineffective against pus

Ceftiofur (3rd gen cephalosporin) - effective but critical ab

35
Q

How do the clinical signs of umbilical hernia differ from infection? How are small and large hernias treated? When can they be dangerous?

A

No pain, heat or discharge from umbilicus and animal clinically well

Small - resolve over 2m
Large - surgery

Dangerous if strangulating!

36
Q

Define patent and persistent urachus

A

Patent - has closed then reopened due to infection, prolonged recumbency

Persistent - open since birth, needs cautery/surgical resection

37
Q

What is the most common cause of renal failure in horses?

A

Secondary to hypovolaemia

pre-renal

38
Q

What can cause primary renal failure in horses?

A 
Congenital
Interstital nephritis 
Glomerulonephritis 
Pyelonephritis 
Amyloidosis
Neoplasia
39
Q

What are the clinical signs of renal failure in horses? When do clinical signs occur?

A 
Depression, anorexia, weight loss
PUPD
Oedema and D+
Pyrexia, colic
Encephalopathy
Oral mucosal ulceration
Excessive tooth tarttar

Occurs when >70% nephrons loss

40
Q

What are signs of renal failure in horses on UA>?

A 
Proteinuria
Casta
WBCs, bacteria
Haematuria
Isothernuria (1.008-1.014)
High urine GGT
41
Q

What are signs of renal failure in horses on serum biochemistry?

A 
Azotaemia
HyperK
HypoN
HyperCa
HypoP
42
Q

How is acute renal failure in horses treated?

A

Restore vol - 0.9% saline @ 40-80ml/kg/d

Diuresis - 20% mannitol and furosemide IV

43
Q

How is chronic renal failure in horses treated?

A

Supportive treatment
Ablib salt and water
High quality diet

44
Q

Distended abdomen in foals - DDx?

A

Ruptured bladder

45
Q

When does ruptured bladder tend to occur in foals? Why should it be a DDx in foals <2m?

A

During or soon after birth

Can have normal urination and then occur secondary to infection

46
Q

What are the clinical signs of a ruptured bladder in foals?

A 
Within 2-3d of life
Dysuria
Progressive depression
Progressive abdo distension
Ventral and prepuital oedema
47
Q

Where in the UT can rupture secondary to infection in foals? Why is it easily missed?

A

Urachus
Bladder
Ureters

Deteriorating clinical signs can be attributed to infection

48
Q

How is bladder rupture in foals diagnosed?

A

Peritoneal fluid:serum creatinine ratio >2:1

US

49
Q

What complication can be caused by bladder rupture in foals?

A 
Azotaemia
HyperK
HypoNa
Metabolic acidosis
Resp acidosis
50
Q

How are ruptured bladders in foals treated? What is the prognosis?

A

Stabilise - NaCl/Hartmanns IVFT, peritoneal drainage/lavage, dextrose and insulin, O2
Surgery
>80% surgeries succesful

Renal (12 decks)

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