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Renal > Large Animal UT Dz > Flashcards

Large Animal UT Dz Flashcards

1
Q

What is the leading cause of urinary obstruction in farm (and sometime horses) animals?

A

> urolithiasis

  • esp small ruminants d/t dietary imbalance (small holdings, pets)
  • only males show obstruction signs
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2
Q

Pdf for urolithiasis

A

> castrated males
- development of urethra testosterone dependent
diet
- high conc/low roughage
- high phosphate/low calcium [phosphate recycled in saliva into GIT, saliva dependent on roughage chewing]
- high magnesium [struvite]
- alkaline urine [some types of crystals]
dehydration
UTI

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3
Q

Outline types of uroliths

A 
> calcium (apatite and carbonate) 
- smooth round egg shaped
> phosphate (calcium phosphate and mg ammonium phosphate) 
- = struvite
- grit like 
> oxalate 
- spiky 
- can cause haematuria 
> silicate
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4
Q

Where is a common site of obstruction in small ruminants?

A
  • urethral (vermiform) process in small ruminants and sigmoid
  • distal sigmoid flexure in cattle (no vermiform process)
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5
Q

Clinical signs of urolithiasis

A 
> early (blockage)
- hameaturia, dysuria, cystals on prepuce
- urine dribbling
- tail flagging, colic signs
> later 2-3d (azotemia)
- anorexia, depression 
- preputial swelling (urethral rupture)
- abdominal distension (bladder rupture) 
- recumbent, seziures, death
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6
Q

How can urolithiasis be dx?

A
  • hx and clinical signs
  • azotaemia, hyperkalaemia, hyponatraemia, acidosis
  • ultrasonography (ibnly simple probe needed)
  • radiography
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7
Q

Give 3 complications of urolithiasis

A 
> bladder upture
- painful becoming comfortable (~1 day) then sick d/t azotameia
- abdo distenion and uroperitoneum 
> urethral rupture 
- swollen prepuce
> hydronephrosis
- chronic obstruction 
- dx via ultrasonogrpahy
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8
Q

Medical management of urolithiasis. Is this useful for obstructed animals?

A

> medical management

  • increase diet Ca:P ratio
  • urinary acidifciation (ammonium chloride, not very palatable)
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9
Q

Surgical managmeent of urolithiasis. Is this useful for obstructed animals?

A

> salvage prcedures, most appropriate for finshing animals for slaughter but not long term

  • urethral process amputation
  • perineal urethrostomy (infection risk, looks gross)
  • tube cystotomy (more suitable for pets, allow urethral spasm to stop, let stones pass - leave for 1-2weeks, problems with bladder necrosis and peritonitis)
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10
Q

Which animals commonly get amyloidosis?

A

> cattle
with chronic sepsis
- mastitis, metritis, pneumonia, pericarditis

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11
Q

Pathogenesis of amyloidosis. Clinical signs.

A
  • inflam -> ^ SAA -> glomerulopathy
  • loss of glomerular function -> PLN
  • oedema, weight loss, chronic D+
  • proteinuria, hypoalbumenaemia, azotaemia
  • raised serum fibrinogen, SAA, globulins
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12
Q

Tx amyloidosis

A

NO TX

  • tx underlying infectious/inflammatory causes on farm to protect others
  • cull
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13
Q

Causes of enzootic haematuria

A 
> cattle and sheep grazing bracken 
- requires chronic >12months exposure
- multiple cases
> ptaquiloside carcinogens 
-> bladder wall neoplasia 
- haemorrhagic cystitis
- haematuria
> anaemia
> ddx: Haemaglobinuria (dipstick)
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14
Q

What is ulcerative posthitis? PDf?

A

> Pizzle rot
ulcerative bacterial infection of prepuce and vulva mucous membranes
- corynebacterium renale
- high protein diets predispose

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15
Q

Clinical signs ulcerative posthitits

A
  • pain
  • loss of condition
  • decreased fertility and libido
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16
Q

Tx ulcerative posthitits

A
  • penicillin
  • NSAIDs
  • reduce dietary protein
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17
Q

What is the most common renal disease in cattle? When is this commonly seen?

A

Pyelonephritis

  • ascending (usually) infection
  • post-parturition and post service/covering
  • following metritis and urolithiasis
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18
Q

CS of pyelonephritis

A 
> acute
- pyrexia
- anorexia
- depression 
- colic
- v milk yield
- stranguria, polyuria, haematuria, pyuria
> chronic (harder to spot, more in cattle than horse) 
- weight loss
- colic
- v mili yeild
- diarrhoea
- polyuria
- anaemia
- less obvious UTI signs 
- painful, distorted kidneys on rectal
19
Q

WHich bacteria are commonly implicated in pyelonephritis?

A

> G-
- coliforms, proteus, klebsiella, enterobacter
G+
- A. pyogenes, rarely c. renale

20
Q

Dx of pyelonephitis?

A
  • clinical signs, rectal palaption
  • pyuria, haematuria, proteinuria
  • azotaemia
  • urine culure?
21
Q

Tx pyelonephritis

A
  • long term (14-21d) BS ABx

- oxytetracycline BEST or penicillin/aminoglycosides

22
Q

How does umbilical infection occour?

A
  • localises following haematogenous spread from gut, other sites of sepsis or generalised septicaemia
  • can act as a portal for infection but less common than you would imagine
  • arteries and urachus most commonly infected (cf. vein)
23
Q

Tx umbilical infection

A
  • if serious needs surgery
24
Q

Where are the veins and urachus?

A

Caudal

- arteries cranially

25
Q

Which bacteria are likely to cause umbilical infections?

A
  • VERY MIXED
  • G- (E coli, actinobacullus equiuli, klebsiella spp, pseudomonas spp, bacillus spp.)
  • G+ (staph aureus, strep, enterococcus
  • anaerobes (clostrdiu, spp)
    > likely mixed
26
Q

Clinical signs of umbilical infection? Ddx?

A

> ddx hernia
- well
- not hot etc.
infection
- fever, mallaise, lethargy, off suck
- heat, pain, swelling, discharge from umbilicus
- localising signs not present in every case (esp with generalised septicaemia)
~ NB check other organ and joint involvement is sepsis suspected

27
Q

How can umbilical infection be dx?

A

> ultrasound

- enlargement of veins and areriers (should be

28
Q

Tx umbilical infection

A

> surgical resection
- prevents spread of infection to other sites
- generalised septicaemia not good candidates for anaesthesia, tx septicaemia first
BS Abx
- monitor response wiht ultrasonography, if not improving change abx or consider surgery
- ceftiofur (foals need 2x adult dose)
- TMPS (economical, oral, inactivated in pus, organisms may not be sensitive)
- aminoglycosides (care young animals nephrotoxic, need to use in conjunction with G+ cover)
- penicililns and B lactams
- cephalosporins (3rd/4th gen ceftiofur)

29
Q

Tx umbilical hernia

A
  • small
30
Q

What is the difference between patent and persistnet urachus?

A 
> patent
- has been closed then opens 
- infection 
- prolonged recumbency
> persistnat
- open since birth 
- excessive torsion during parturition? 
- may need cautery or surgical resection
31
Q

Do you commonly see renal failure in horses?

A

PRE-RENAL most common, 1* renal fialure very rare
- 2* to hypovlolaemia with surgical colics etc.
RENAL disease lcinical signs and clin path only seen with renal failure (70% nephrons lost)

32
Q

Causes of 1* renal failure

A

> as smallies

  • congenital
  • interstitial nephritis
  • glomerulitis
  • pyelonephritis
  • amyloidosis
  • neoplaisa
33
Q

Clinical signs with renal failure in horses

A
  • depression, anorexia, weight loss
  • PUPD
  • oedema and D+ (protein losing nephrotpathy)
  • pyrexia and colic (pyrexia)
  • encephalopathy, mucosal ulceration and excessive toth tartar (azotaemia)
34
Q

What is seen on urinalysis with renal fialure in horses?

A
  • proteinuria
  • casts
  • WBCs and bacteria
  • haematuria
  • inability to concentrate (USG 1.008-1.014 isosthenuric)
  • ^ urine GGT: creatinine ratio to correct for urine flow
    (liver, bile tree and renal tubules)
35
Q

Serum biochem findings with renal failure

A
  • azotaemia
  • hyperkalameia
  • hyponatraemia (kidney excretes ca and absorbs Na)
  • hypercalcaemia ***
  • hypophosphataemia ***
  • ** cf. small animals excretes ca, absorbs Ph
36
Q

Tx renal failure

A 
> acute 
- restore circulatin volume (0.9% NacL) 
- diuresis  (mannitol and furosemide)
> chronic
 - no specific tx
- supportive only 
- ad lib salt and water 
- high quality diet  (low protein)??
37
Q

When does bladder rupture occour in foals?

A
  • during/soon after parturition (inherant bladder wall weakness?)
  • hx previous normal urination does NOT r/o ruptured bladder as cases can rupture later (2* to infection etc.)
38
Q

Ddx bladder rupture?

A

Meconium impaction
- tenesmus
> caudal position of legs if foals urinating

39
Q

Pdf bladder rupture detected soon after parturition? WHere does the tear occour?

A
  • no sex pdf (previously thought colts)

- tear dorsal aspect bladder

40
Q

clinical signs of bladder rupture

A
  • normally present within first 2-3d of life
  • dysuria
  • progressive depression and abdo distension
  • ventral and preputial oedema
    > matabolic derangements
  • azotaemia
  • hyperkalameia (-> dysrhythmias)
  • hyponatraemia (loss of renal regulation, PD)
  • metabolic acidosis (loss of renal reg, 3rd spacing -> hypovolaemia and poor perfusion)
  • respiratory acidosis (d/t compression of diaphragm)
41
Q

What can UTI pdf bladder to?

A

rupture
- later than spontaneous after foaling
-

42
Q

Dx bladder rupture?

A
  • peritoneal fluid (serum creatinine ratio >2:1)

- ultrasound free fluid

43
Q

Management of bladder rupture?

A
  • not emergency surgery
  • manage medically first to stabilise
  • IV fluids, peritoneal drainage (0.9%NaCL, HArtmanns)
  • Dextrose and insulin to promote intracellular movement of potassium (calcium or bicarb if not successful)
  • drian abdo, peritoneal lavage
  • intranasal oxygen
    > good outcome majority of surgeries if stabilised first

Renal (23 decks)

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