PATHOLOGY - Bovine Urinary and Hepatic Disease Flashcards
What are the potential clinical signs of urinary disease in cattle?
Weight loss
Abdominal pain
Diarrhoea
Abnormal urine
Enlarged kidney on rectal palpation
Enlarged bladder on rectal palpation
Dysuria
Stranguira
Pollakuria
Crystals on the preputial hair
Urine scalding
Which portion of the kidney can you palpate on rectal examination?
You can palpate the caudal region of the left kidney
Which diagnostic tests can be done to investigate urinary disease in ruminants?
Urine sample
Urinalysis
Urine culture and sensitivity
Biochemistry
Ultrasound
Which methods can you use to collect a urine sample in ruminants?
Free catch
Urinary catheterisation
What are the benefits of urinalysis as a diagnostic tests in ruminants?
Cheap (approximately £10-15)
Can be done on the farm
What are the normal urinalysis ranges in ruminants?
Urine specific gravity: can be variable (1.015 - 1.035)
Protein: Trace or +
pH: 7.8 (ruminants have more alkaline urine than most species)
Ketones: Trace (normal in freshly calved dairy cows)
Glucose: Negative
Leukocytes: Negative
Haematura: Negative
Haemaglobinuria: Negative
How much does a urine culture and sensitivity cost for ruminants?
Approximately £40
What are the differential diagnoses for ruminant kidney disease?
Pyelonephritis
Renal amyloidosis
Nephrosis
Embolic nephritis
Hydronephrosis
Renal neoplasia
What are the main causes of pyelonephritis in ruminants?
Ascending bacterial infection from the uterus
Haematogenous bacterial infection
Corynebacterium renale
What are the clinical signs of pyelonephritis in ruminants?
Lethargy
Pyrexia
Abdominal pain
Pyruria
Haematuria
Enlarged, painful kidneys on rectal palpation
How do you diagnose pyelonephritis in ruminants?
Clinical examination
Urinalysis
What would you typically find on urinalysis in a ruminant with pyelonephritis?
Protein
Leukocytes
Haematuria
How do you treat pyelonephritis?
3 week course of broad spectum antibiotics
Which antibiotics could you use to treat pyelonephritis?
Trimethroprim-sulphonamides (TMPS)
Amoxicillin clavulanic acid
Which classification on antibiotics should you avoid when treating kidney disease?
Aminoglycosides as they are nephrotoxic
What is the pathophysiology of renal amyloidosis?
In response to persistent antigenic stimulation (i.e. due to chronic inflammation or chronic infection) antibodies will be produced against these antigens and form antigen-antibody complexes which can trigger excessive amyloid deposition in the kidneys resulting in renal amyloidosis, renal dysfunction and protein-losing nephropathy
What are the clinical signs of renal amyloidosis?
Lethargy
Diarrhoea
Frothy urine
Enlarged kidney on rectal palpation
Oedema
How do you diagnose renal amyloidosis?
Clinical examination
Urinalysis
Biochemistry
What would you typically find on urinalysis in a ruminant with renal amyloidosis?
Low urine specific gravity (USG)
Protein
What would you typically find on biochemistry in a ruminant with renal amyloidosis?
Azotaemia
Hypoalbuminaemia
Hyperglobulinaemia
How do you treat renal amyloidosis?
There is no treatment for renal amyloidosis
What is embolic nephritis?
Embolic nephritis is when septic emboli block blood vessels in the kidney resulting in wedge shaped ischaemia
What are the differential diagnoses for ruminants presenting with dysuria?
Urolithaisis
Cystitis
Trauma
Congenital malformations
Which signalement typically presents with urolithiasis?
Castrated bulls
Castrated tups
Where do uroliths tend to cause urethral obstructions in bulls?
Uroliths tend to obstruct in the urethra at the sigmoid flexure in bulls
Where do uroliths tend to cause urethral obstructions in tups?
Uroliths tend to obstruct the urethra at the urethral appendage
The urethral appendage can be cut off if obstructed
What are the risk factors for urolithiasis in ruminants?
High calcium diets
High concentrate diets
Restricted water intake
Nidus
What are the clinical signs of urolithiasis in ruminants?
Crystals on the preputial hair
Dysuria
Stranguria
Pollakuria
Abdominal pain
Swelling of the ventrum
Enlarged bladder on rectal palpation
What are the main risks of urolithiasis in ruminants?
Bladder rupture
Urethral rupture
How do you treat urolithiasis?
Urolithiasis often requires surgical intervention
How do you prevent urolithiasis?
Decrease dietary concentrates
Balance dietary calcium and phophorus
Increase ammonium chloride in the diet
Free access to water or provide salt licks to encourage water intake
What are the benefits of increasing dietary ammonium chloride to prevent urolithiasis in ruminants?
Ammonium chloride will help to decrease the pH of the urine to helo neutralise it as ruminants pH is typically alkaline, predisposing them to struvite uroliths
What causes cystitis in ruminants?
Ascending bacterial infection from the uterus
Haematogenous bacterial infection
Ascending bacterial infection due to naval ill in calves
What are the clinical signs of cystitis in ruminants?
Lethargy
Pyrexia
Abdominal pain
Pyruria
Haematuria
Enlarged, painful bladder on rectal palpation
How do you diagnose cystitis?
Clinical examination
Urinalysis
What would you typically find on urinalysis in a ruminant with cystitis?
Protein
Leukocytes
Haematuria
How do you treat cystitis in ruminants?
7 day course of broad spectrum antibiotics
Which antibiotics could you use to treat cystitis?
Trimethroprim-sulphonamides (TMPS)
Amoxicillin clavulanic acid
What are the differential diagnoses for haematuria in ruminants?
Pyelonephritis
Cystitis
Trauma
Leptospirosis
Bracken poisoning
What is the most common form of bracken toxicity?
Enzootic haematuria
What is the pathogenesis for enzootic haematura?
Prolonged exposure and ingestion of bracken results in bladder or gastrointestinal wall thickening, metaplasia and the formation of bladder or gastrointestinal carcinomas which bleed into the lumen causing haematuria and anaemia
What is the signalement for enzootic haematuria?
Enzootic haematuria is typically seen in older cattle as this disease requires prolonged exposures and ingestion of bracken before the disease develops
What are the three characteristic clinical signs of enzootic haematuria?
Intermittent haematuria
Anaemia
Gradual loss of body condition
What is the signalement for acute bracken toxicity?
Younger cattle that have taken a liking to and have ingested large quantities of bracken
Describe the pathogenesis of acute bracken toxicity
When animals ingest high quantities of bracken, the bracken has a radiomimetic affect on the bone marrow which causes thrombocytopenia, leukopenia and anaemia (pancytopenia) resulting in a range of clinical signs and secondary infections
What are the clinical signs of acute bracken toxicity?
Anaemia
Pyrexia
Inappetence
Ecchymoses
Petechiae
Haematuria
Haematochezia
Fibrinous broncho-pnuemonia
What can you use to manage acute bracken toxicity?
Activated charcoal
Blood transfusion
However often treatment is unsuccessful
What are the differential diagnoses for haemaglobinuria in ruminants?
Babesiosis
Post parturient haemaglobinuria
Bassicas poisoning
Bacillary haemaglobinuria
Copper poisoning
(T/F) Babesiosis can only affect adult cattle
TRUE. Calves have an innate immunity to babesiosis which wears off in adult cattle
What are clinical signs of babesiosis?
Lethargy
Pyrexia
Anaemia
Haemaglobinuria
Weight loss
Pipe stem faeces
How do you diagnose babesiosis?
History
Clinical examination
Blood smear
How do you treat babesiosis?
Imidocarb
Blood transfusion
What is the meat and mild withdrawal period for imidocarb?
213 days
What is post parturient haemaglobinuria?
This is a relatively rare condition
Post parturient haemaglobinuria is a condition typically seen in recently calved high yielding dairy cows, characterised by the development of intravascular haemolysis, associated with hypophosphataemia
What are the clinical signs of post parturient haemaglobinuria?
Haemaglobinuria
Anaemia
‘Downer cow’
How do you diagnose post parturient haemaglobinuria?
History
Clinical examination
Biochemistry
What would you typically find on urinalysis in a ruminant with post parturient haemaglobinuria?
Hypophosphataemia
How do you treat post parturient haemaglobinuria?
Phosphorus administration
List two examples of brassicas plants
Kale
Rape
What is brassicas poisoning?
Brassicas poisoning is the development of intravascular haemolysis as a result of ruminants being fed only on brassicas for at least three weeks
What are the clinical signs of brassicas poisoning?
Haemaglobinuria
Anaemia
Sudden death
How do you treat brassicas poisoning?
Blood transfusion
Supportive case
How do you prevent brassicas poisoning?
Do not feed just brassicas plants, combine them with other forage
What is bacillary haemaglobinuria?
Bacillary haemaglobinuria is rare in the UK
Bacillary haemaglobinuria is intravascular haemolysis caused by toxins produced by clostridium novyi type D. Clostridium novyi type D is found in soil where it is ingested and becomes a latent infection in the liver and can be reactivated by hepatopathies
What are the clinical signs of bacillary haemaglobinuria?
Haemaglobinuria
Anaemia
Jaundice
Oedema
Diarrhoea
Sudden death
How do you treat bacillary haemaglobinuria?
Penicillin. However often these animals are found dead
How do you prevent bacillary haemaglobinuria?
Vaccination
What is one of the most common causes of haemaglobinuria?
Copper toxicity
Which species is more prone to copper toxicity?
Sheep
What are the clinical signs of acute copper toxicity?
Sudden death
What are the clinical signs of chronic copper toxicity?
Lethargy
Haemaglobinuria
Anaemia
Jaundice
What are the potential clinical signs of hepatopathies in ruminants?
Weight loss
Lethargy
Anorexia
Diarrhoea
Decreased milk yield
Oedema
Ascites
Photosensitisation
Epistaxis
Hepatic encephalopathy
Jaundice (very rare in ruminants)
What is type I photosensitisation?
Type I photosensitisation is caused by the ingestion of photodynamic toxic plants
What is type II photosensitisation?
Type II photosensitisation is caused by congenital conditions which impair metabolism of photodynamic agents
Give an example of a congenital disease which causes type II photosensitisation
Bovine congenital erythropoietic protoporphyria
What is type III photosensitivity?
Type III photosensitivity is where liver dysfunction impairs the metabolism of photodynamic agents
What is type IV photosensitisation?
Type IV photosensitisation is idiopathic photosensitisation
How do you treat photosensitisation?
Move animal inside away from UV light and potential toxins
Treat underlying hepatic disease if possible
Which diagnostic tests can be done to investigate hepatic disease in ruminants?
Biochemistry
Liver palpation
Ultrasound
Liver biopsy
Which liver enzyme is a marker of hepatocellular damage in ruminants?
Glutamate dehydrogenase (GLDH)
Which liver enzyme is a marker of cholestasis in ruminants?
Gamma glutamyl dehydrogenase (GGT)
What are the boundaries for a liver ultrasound in ruminants?
When ultrasounding the liver in ruminants, place the ultasound probe between the 9th and 11th intercostal spaces on the right side
What are the differential diagnoses for hepatic disease in ruminants?
Liver abscess
Toxicity
Infection
Shock
Liver fluke
Hepatic lipidosis
Cobalt deficiency
Portosystemic shunt
What are the main causes of liver abscesses in ruminants?
Bacteraemia due to naval ill
Metabolic acidosis
How can metabolic acidosis cause liver abscesses in ruminants?
Metabolic acidosis will cause ruminal dysbiosis and ruminitis which will allow for the translocation of bacteria into the hepatic portal circulation and travel to the liver where is can cause liver abscesses. These liver abscesses often form near the caudal vena cava and septic emboli can be released into the circulation, travel to the lungs and cause a suppurative bronchopneumonia, and get lodged in the pulmonary vessels causing vessel rupture and epistaxis
What are the clinical signs of an acute liver abscess?
Pyrexia
Lethargy
Decreased milk yield
Abdominal pain
What are the clinical signs of a chronic liver abscess?
Anorexia
Weight loss
Diarrhoea
How do you diagnose a liver abscess?
Clinical examination
Ultrasound
How do you treat liver abscesses?
There is no treatment for liver abscesses
How do you prevent liver abscesses?
Prevent metabolic acidosis
Promptly treat infections
