urinary 1 Flashcards

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1
Q

endocrine and autocrine hormones of the urinary system

A

Endocrine
* Erythropoietin
* Renin
* Angiotensin
* Aldosterone
<><>
Autocrine
* Prostaglandin

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2
Q

Elevations in BUN, creatinine - causes, broadly

A
  • Extra-renal – dietary (urea)
  • Prerenal – dehydration, shock
  • Renal – infectious, toxic, hypoxic
  • Post-renal - obstructions
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3
Q

what is the origin of creatinine?

A

creatine (hepatic) > phosphocreatine (muscle) > creatinine

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4
Q

some important ways in which a urolith nidus can form

A

Desquamated epithelial cells
* Normal turnover
* Infection
* Estrogens in feed
<><>
Precipitation of solutes
* Protective colloids
* pH
* Decreased water intake

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5
Q

signalment of urolithiasis ruminants
- what species, age breed, sex get them most?

A
  • Species – bovine, ovine, caprine
  • Age – young, any age
  • Breed - any
  • Sex
    > Castrated males - most
    > Intact males - fewer
    > Females – least frequent
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6
Q

feeds / dietary factors that can contribute to urolithiasis
- or at least that we should know about for our history

A
  • 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
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7
Q

urolithiasis client history / presenting complaints

A
  • Inappetance/Anorexia
  • Depressed demeanour
  • Vague gastrointestinal complaint
  • Mild abdominal distension
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8
Q

clinical signs for urolith can depend on what?

A
  • Level of blockage
  • Unilateral or bilateral
  • Complete or incomplete
  • Duration of problem
  • Timing of intervention
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9
Q

urolithiasis clinical signs

A
  • Anxious
  • Tachycardia
  • Tachypnea
  • Treading
  • Swishing tail
  • Vocalizing (goats)
  • Stretching
  • Rumen hypomotility
  • Abdominal distension
  • Discolored urine
  • Stranguria
  • Dysuria
  • Anuria
  • Oliguria
  • Tenesmus
  • Rectal prolapse
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10
Q

urolithiasis physical exam - sedative and anesthesia options

A
  • 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)
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11
Q

urolithiasis ddx for incomplete blockage

A
  • Infection - cystitis, vulvovaginitis, balanoposthitis, urethritis
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12
Q

does infection cause urolith formation, or the other way around?

A

both!

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13
Q

ddx for urolith complete blockage

A
  • Gastrointestinal Disease
  • Neurologic Disease
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14
Q

Urolithiasis - Ancillary Tests

A
  • Urinalysis
  • Packed cell volume/ total protein
  • Serum biochemistry profile
  • Ultrasound
  • Radiographs
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15
Q

urolithiasis medical management options

A
  • Symptomatic treatment
  • Remove urethral process (sheep & goats)
  • Retrograde flushing
  • Anterograde flushing – “Bonano” catheter
  • Urinary acidifier
  • Antispasmodic medication > Acepromazine maleate, (Acepromazine fumarate)
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16
Q

urolithiasis surgical treatment options

A
  • Perineal urethrotomy
  • Perineal urethrostomy
  • Laparocystomy
  • Tube cystotomy
17
Q

sequelae to bladder rupture

A
  • Abdominal distension
  • Progression of depression
  • Recumbency
18
Q

sequelae to urethral rupture

A
  • “Water belly” (ventral, preputial, perineal swelling)
  • Necrosis & sloughing
  • Fistula formation
19
Q

types of calculi we see in ruminnats

A
  • Magnesium ammonium phosphate
  • Silicate
  • Calcium carbonate
  • Calcium oxalate
20
Q

struvite stone
- composition
- cause, mechanism
-dietary risk factors

A
  • 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
21
Q

risk factors for silica urolith formation?

A
  • 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
22
Q

dietary management for phosphatic uroliths - how to prevent them

A
  • 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)
23
Q

dietary management for silica uroliths - how to prevent them

A
  • NaCl supplementation (<15% in
    creep)
  • Ammonium Chloride (1%)
  • Ca:P ratio?
  • Cu,Zn