Lecture 6 and 7 - Urinary Flashcards
- State the toxin that is implicated in the pathology below and how you came to that conclusion
- Provide the pathogenesis
- State the sequela that are likely to occur
Ethylene glycol toxicity - band of pale, linear streaks within the cortex - represents tubules filled with crystals
Pathogenesis:
- Ingested and absorbed in GIT - most excreted in urine
- Some oxidised by liver
- Binds with calcium
- Filtered by glomeruli
- H2O reabsorbed by tubules
- pH decreases
- Calcium oxalate precipitates to form crystals
- Tubular degeneration and necrosis
Sequelae:
- Metabolic acidosis
- Hypocalcemia
- Azotemia
- Hyperphosphatemia
- Hyperkalaemia
For the image below:
- Name the toxic that is implicated
- Explain the pahtogenesis of this condition
- Haemolytic crisis of chronic copper poisoning in sheep - heme proteins can reduce renal blood flow and are directly cytotoxic
Pathogenesis of condition:
- Excessive copper intake +/- increased copper accumulation due to Mb deficiency +/- other toxins
- Cu builds up in liver
- Hepatic necrosis
- Cu released into circulation
- Intravascular haemolysis
- Haemoglobinuric nephrosis
Name the condition shown below and state how it is toxic to kindeys:
Rhabdomyolysis - results in release of massive amount of myoglobin - toxic to kidneys (like haemoglobin)
For image below:
- Name the aetologic agent responsible
- Provide the pathogenesis
- What part of the kidney appear to be affected here - why?
- NSAID toxicosis
- Pathogenesis: prostaglandins control medullary blood flow –> NSAID’s interfere with PG production, combine with hypoperfusin –> medullary necrosis (any drug that infecters with PG production will interfere with medullary perfusion
- Medulla is particularly vunerable to ischaemic injury due to: Low hametocrit in medullary capillaries, considerably less blood flow than renal cortex
Name the condition that is shown below and explain how uroliths can cause this:
Hydronephrosis and pyelectasia caused by backing up of urine - explaining condition seen
Name the condition that is shown below and suggest a possible cause of it:
Renal infarct - caused by anything that results in reduced/compromised renal blood flow:
- Hypovolaemia (e.g. acute haemorrhage)
- Hypotension (Anaesthesia, drugs)
- Thrombosis/embolism
- Neoplasia
- Shock
- Reduced cardiac output (i.e. CHF)
What are the main defense mechanisms of the lower urinary tract?
- Mucoproteins
- Sloughing of surface urothelium
- Goblet cell metaplasia
- Phagocytosis by surface urothelium
What is dysuria?
Painful or difficult urination
What is stranguria?
Slow and painful discharge of urine
What is pollakiuria?
Abnormally freqeunt passage of urine
What is anuria?
Complete supression of urine production by kidney
What is oliguria?
Reduced urine output
What is polyuria?
The formation and excretion of large volumes of urine
What is periuria?
Inappropriate urination (urinating on the furniture or other inappropriate places)
Name the condition that is shown below:
Patent urachus - patient is dribbling urine - urine in dribbling out making the patient prone to developing omphalophlebitis
Name the condition that is shown below:
Urothelial cell carcinoma - used to be called transitional cell carcinoma
Name and infectious agent and a toxin that could explain the findings seen in the cow below:
Access to bracken fern (containing ptaquiloside & quercetin) +/- infection with bovine papillomavirus type 2
Name the condition shown below and state the clinical signs and laboratory findings that would be seen:
Feline lower urinary tract disorder:
- Clinical signs - pollakiuria, stranguria, periuria, dysuria, haemoturia, anuria (urinary obstruction males)
- Laboratory findings - depend on underlying cause but may include - haematuria, crystalluria, pyuria
Causes:
- Feline idiopathic cystitis
- Underlying causes - bacterial infection, urolithiasis, must also exclude neoplasia and neurogenic disorders
- males may also present as FIC - medical emergency
What are the clinical signs that are seen with urinary tract obstruction in males?
Clinical signs:
- Dysuria, failure to urinate (onstruction)
- Discoloured urine (red, brown)
What pH of urine do oxalates typically form in?
Oxalates from in acidic urine
What pH of urine do struvite and carbonates form in?
Alkaline urine
Breifly explain how urinalysis, CBC/Biochem and radiology appear in cases of urinary tract obstruction:
Urinalysis: haematuria, possible crysaluria, cystitis concurrently
CBC/Biochem: unremarkable unless concurrent disease
Radiology: may appear
Why are dalmations prone to developing uroliths?
problems with their urate metabolism
How does sorghum lead to the developement of urinary crystals?
Sorghum is high in phosphate leading to the developement of struvite crystals
