Urinary Flashcards
Foal 3 days old
Colt
Depressed, off suck, abdominal distension
mild/ mod colic signs
increased urination with small volumes passed
Biochem and haem:
increased K+
decreased Na and Cl
dehydration
metabolic acidosis
peritoneal fluid: creatine>, clear with low USG
top ddx?
Ruptured Bladder
Treatment for ruptured bladder in colt?
stabilise first
correct hyperkalaemia with calcium borogluconate or insulin/ glucose
drain abdomen
ABs and check IgG
surgery: midline laparotomy +/- resection of umbilicus and urachus at same time
Stallion 8 years
haematuria
stranguria +/- pollakuria
pyuria or incontinence
ddx?
tx?
urolithiasis
surgical removal
which of these is type 1 or type 2 calcium carbonate uroliths affecting the bladder
more common, spiculated yellow/ green, easily fragmented
smooth and grey/white, harder and contain more phosphate
sludge and usually secondary to bladder paralysis
more common, spiculated yellow/ green - type 1
smooth and white - type 2
sludge and usually secondary to bladder paralysis - type 3
geldings» mares
bladder»> kidneys
most common neoplasia in bladder?
SCC
when can bladder eversion occur?
excessive straining in parturition
when can sabulous cystitis occur in horses?
sequalae to incomplete bladder empting
when does the umbilicus normally break?
when should the stump have gone by?
straight after parturition
4-6 weeks
foal
moisture around umbilicus +/- dripping urine
possible concurrent septicaemia/ septic arthritis or physitis
ddx?
tx?
patent urachus (connecting bladder and umbilicus)
often self resolves
medical: topical cauterising agents= phenol or iodine solution + silver nitrate
surgical: resection of urachus
foal depressed and off suck
swollen and painful urachus
US: enlarged umbilical blood vessel
ddx?
tx?
umbilical sepsis
systemic ABs
when should you surgically repair an umbilical hernia?
large, persists > 6 months
defect enlarges
asc with colic
can cause strangulation of bowel care,
with any urinary condition/ infection
what should all foals be checked for?
concurrent sepsis or septic joints or physitis
hypovolaemia
effusions
decreased CO
sepsis and endotoxaemia» inc vascular resistance
primary acute tubular necrosis (2ndry to ischaemia, nephrotoxin exposure),
glomerulonephritis
interstitial nephritis
all causes of what
acute renal failure
which antibiotic is most nephrotoxic
neomycin> polymyxin
infectious cause of glomerulonephritis?
EIA
anorexia depression
uraemia
fluid electrolyte acid base disturbances hypoatraemia hypocholraemia hypocalcaemia and hyperphosphataemia metabolic acidosis
may have hyperkalaemia
ddx?
acute renal failure
tx for acute renal failure
fluids, hartmans
discontinue nephrotoxic drugs
if horse has acute renal failure + oliguric, what should you do?
furosemide - care
why give dopamine to foals with acute renal failure
renal vasodilator
chronic weight loss lethargy poor coat pupd oral ulceration Gastroenteritis excessive tartar and halitosis ventral oedema
persistent isosthenuria (1.008-1.014) + azotaemia
mild anaemia and mild hypoalbuminaemia
hypercalcaemia and hypo phosphateameia, low na,cl, bicarbonate
rare
chronic renal failure
how are electrolytes different in horse chronic renal failure than in small animal
hypercalcaemia
horses normally excrete calcium bicarbonate in urine (can see sediment of this usually)
with CKD they cant as much, so calcium increases in blood
Normal USG of a horse
- 008-1.040 in adult horses
1. 001-1.025 in foals
normal pH of urine of horse
- 5-8.5 in adult horses
5. 5-8.0 in foals
tx of CKD horse?
palliative
decrease calcium in diet (alfalfa decrease)
water and salt always available
tx of CKD horse?
palliative
decrease calcium in diet (alfalfa decrease)
water and salt always available
creatine >800U/L prognosis in CKD?
grave pgx
3 main ddx for PUPD in horses
renal failure
Equine cushings/ PPID
pyschogenic- behaviour inc water consumption
diabetes insipidus, mellitus, inc salt, alpha 2 agonists, gram negative sepsis or endotoxaemia
what is the water deprivation test used to diagnose?
distinguish renal failure vs other causes of PUPD
if urins spG > 1.025 or >12-15% loss of BWT or 12 g/l increase in TPP or azotaemia = renal
if concentrates normally, cushings or psychogenic
horse with PUPD
responds to additional ADH
dx?
Diabetes insipidus
USG or <1.008
rule out renal disease?
yes,
red urine ddx
haematuria: whole red blood cells,
cystitis, pyelonephritis, drug toxicity, urinary tract neoplasia
pigmenturia: myoglobinuria
myopathy, exercise induced, sycamore poisoning (very ill horse)
haemoglobinuria:
IMHA, notifiables: EIA, piroplasmosis
older gelding with maloderous sheath and swelling
red discharge on legs
ddx?
urethritis
clean + topical abs, dont overclean
urine sediment > 10 leucocytes HPF + >20 organisms / HPF
top urinary ddx
cystitis
posturing to urinate, dysuria, haematuria, stranguria, colic, urine scalding, loss of condition
dx by palpation or endoscopy
cystic and urethral calculi
