urinary 1 Flashcards
endocrine and autocrine hormones of the urinary system
Endocrine
* Erythropoietin
* Renin
* Angiotensin
* Aldosterone
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Autocrine
* Prostaglandin
Elevations in BUN, creatinine - causes, broadly
- Extra-renal – dietary (urea)
- Prerenal – dehydration, shock
- Renal – infectious, toxic, hypoxic
- Post-renal - obstructions
what is the origin of creatinine?
creatine (hepatic) > phosphocreatine (muscle) > creatinine
some important ways in which a urolith nidus can form
Desquamated epithelial cells
* Normal turnover
* Infection
* Estrogens in feed
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Precipitation of solutes
* Protective colloids
* pH
* Decreased water intake
signalment of urolithiasis ruminants
- what species, age breed, sex get them most?
- Species – bovine, ovine, caprine
- Age – young, any age
- Breed - any
- Sex
> Castrated males - most
> Intact males - fewer
> Females – least frequent
feeds / dietary factors that can contribute to urolithiasis
- or at least that we should know about for our history
- Milk replacers - magnesium
- Forages – silica, estrogens, oxalates
- Grains/concentrates - phosphates
- Pelleted feeds
- Feeding practices – pasture to feedlot, meal feeding
- Water – access, quality, mineral content
- Salt
urolithiasis client history / presenting complaints
- Inappetance/Anorexia
- Depressed demeanour
- Vague gastrointestinal complaint
- Mild abdominal distension
clinical signs for urolith can depend on what?
- Level of blockage
- Unilateral or bilateral
- Complete or incomplete
- Duration of problem
- Timing of intervention
urolithiasis clinical signs
- Anxious
- Tachycardia
- Tachypnea
- Treading
- Swishing tail
- Vocalizing (goats)
- Stretching
- Rumen hypomotility
- Abdominal distension
- Discolored urine
- Stranguria
- Dysuria
- Anuria
- Oliguria
- Tenesmus
- Rectal prolapse
urolithiasis physical exam - sedative and anesthesia options
- Sedation - small ruminant
> diazepam 5-15 mg total dose
> xylazine 0.05 mg/kg IV
> acepromazine 0.1 mg/kg IV - Epidural anesthesia
- Internal pudendal nerve block (bovine& ovine)
urolithiasis ddx for incomplete blockage
- Infection - cystitis, vulvovaginitis, balanoposthitis, urethritis
does infection cause urolith formation, or the other way around?
both!
ddx for urolith complete blockage
- Gastrointestinal Disease
- Neurologic Disease
Urolithiasis - Ancillary Tests
- Urinalysis
- Packed cell volume/ total protein
- Serum biochemistry profile
- Ultrasound
- Radiographs
urolithiasis medical management options
- Symptomatic treatment
- Remove urethral process (sheep & goats)
- Retrograde flushing
- Anterograde flushing – “Bonano” catheter
- Urinary acidifier
- Antispasmodic medication > Acepromazine maleate, (Acepromazine fumarate)
urolithiasis surgical treatment options
- Perineal urethrotomy
- Perineal urethrostomy
- Laparocystomy
- Tube cystotomy
sequelae to bladder rupture
- Abdominal distension
- Progression of depression
- Recumbency
sequelae to urethral rupture
- “Water belly” (ventral, preputial, perineal swelling)
- Necrosis & sloughing
- Fistula formation
types of calculi we see in ruminnats
- Magnesium ammonium phosphate
- Silicate
- Calcium carbonate
- Calcium oxalate
struvite stone
- composition
- cause, mechanism
-dietary risk factors
- Magnesium ammonium phosphate
Ø High phosphorus diet (cereal grains)
Ø Calcium opposes gi absorption of phosphate
Ø Magnesium levels also play a role
Ø Pelleted feeds also increase formation
risk factors for silica urolith formation?
- Grasses of western North America
- Content increases with maturity
- Silica content may be up to 4-8%
- Increased occurrence with low water intake
- High calcium to phosphorus ratio may play a role
dietary management for phosphatic uroliths - how to prevent them
- Ca:P 2:1 or greater
- Maintain recommended Mg levels
- Increase forage, decrease pelleted feed
- NaCl at 3-5%
- Ammonium chloride 0.5-1.0%
- (Ammonium sulfate)
dietary management for silica uroliths - how to prevent them
- NaCl supplementation (<15% in
creep) - Ammonium Chloride (1%)
- Ca:P ratio?
- Cu,Zn
