Urinary & Repro Flashcards
The normal microbiome in the urinary tract includes:
commensal gram + and gram -, mycoplasma, aerobes, anaerobes
I think what he was trying to get at here is that the urinary tract has a plentiful microbiome
UTIs are more common in ____ than ____ (species), more common in ____ than ____ (sex), and more common in _____ than _____ (age).
dogs than cats
females than males
older than younger
UTIs are mostly _____ infections caused by ____ organisms. List some Gram + & gram - bacteria involved
single, commensal
Gram +: E. coli (UPEC), Proteus, Klebsiella, Pseudomonas, Enterobacter
Gram -: Staphylococci, Streptococci, Enterococci
tell me the most common portal of entry for UTIs and the 2 results that can come from it.
ascending infection
1) ascending urethra: cystitis
2) ascending ureter: pyelonephritis
What do you need to accomplish a UTI?
host factors (ex. frequent emptying of bladder, normal microbiota, age, sex, structural/functional/metabolic abnormalities, immunosuppression)
bacterial factors/virulence mechanisms (ex attachment and colonization of mucosa of urethral orifice, transport up urethra, attachment of uroepithelium)
What are the common clinical signs of a UTI?
cystitis: dysuria, pollakiuria, stranguria, hematuria, pain in causal abdomen/back
Pyelonephritis: kidney/flank pain, fever, sometimes vomit, PU/PD
How do you diagnose a UTI?
culture of urine (cystocentesis preferred)
Corynebacterium:
1. gram?
2. shape?
3. aerobic or anaerobic? facultative or obligate?
- gram +
- rod shaped/bacilli, but also pleiomorphic
- aerobic or facultative anaerobic
Are Corynebacterium host specific?
yes
Tell me the virulence from lowest to highest of Corynebacterium spp in cattle
pilosum
renale
cystitidis
Corynebacterium in cattle:
1. T or F: Corynebacterium is present in the normal microbiota
2. causes what disease in cows? what age?
3. how does pyelonephritis from this genus occur?
4. is this bacteria a problem in cattle?
5. what disposes cows to infection from Corynebacterium?
- true
- UTI, older
- ascending infection through vagina
- sporadic but widespread problem. low herd incidence, but 25-30% of cases are fatal
- dystocia (wounds and lesions)
What are the major risk factors that predispose cows to contracting UTIs from Corynebacterium?
- shortness of female uretha (and other anatomic anomalies)
- stress of parturition and peak-lactation
- high protein diet = increase pH
- physical damage and obstruction of urinary tract
Virulent strains of Corynebacterium have ____ which mediate binding to urethral epithelium and colonize
fimbriae
Corynebacterium is urease +. what does this mean for the cow?
production of ammonia –> mucosal inflammation and increase in pH
Tell me the pathway of Corynebacterium through a cow
vagina –> urethra –> bladder –> ureter –> kidney –> spreads through body chronically and relentlessly
Tell me the clinical signs of Corynebacterium UTI in cows in the following conditions:
1. first clinical sign
2. cystitis
3. only pyelonephritis
4. chronic cases
- blood-stained urine in healthy cow
- frequent urination attempts, hematuria, proteinuria, pain when urinating, colic with restlessness, slight fever, abnormal posture
- emaciation, anorexia, low milk production (vague symptoms)
- colic, diarrhea, PU/PD, anemia
As Corynebacterium disease in cows progresses, what happens to the organs?
bladder & ureters thicken, dilate with purulent exudate
kidney lesions –> blood and exudate drainage in bladder –> terminal hematuria and pyuria
You suspect a cow of having a UTI and do a rectal palpation. You feel the L kidney. What do you expect to feel if the cow has a UTI? Do you expect the R kidney to exhibit these signs?
enlargement, lack of lobulation, pain
typically only 1 kidney affected
How do you diagnose Corynebacterium infections?
urinalysis: presence of blood, protein, and leukocytes & clinical signs
urine culture and isolation
What is the treatment for Corynebacterium infections in cattle?
antibiotics only useful in acute stage of infection and prolonged treatment ‘
later more difficult to reach bacteria in pus
chronic stages –> kidneys are irreversibly damaged
Most cases of repro tract infections are caused by _____ bacteria.
opportunistic
True or false: repro tract infections have a distinct pathogen-clinical manifestation relationship
true
tell me the difference between reproductive infections and venereal infections.
reproductive infections: primary or significant effect on fertility
venereal: primarily transmitted through sexy time
What phase of the estrous cycle is associated with pyometra in dogs? What hormone is involved?
Luteal phase, Progesterone (P4)
1-3 months after completion of estrus
What about progesterone primes the canine uterus for bacterial infection?
accumulating uterine secretions, prominent endometrial gland crypts, immunosuppression
What are the clinical signs of pyometra in dogs? what about when there’s a closed cervix?
fever, lethargy, depression, anorexia, vomiting, diarrhea, PU/PD, toxaemia
closed cervix = more seriously ill (septicemia, endotoxemia, septic peritonitis)
How do you diagnose pyometra in dogs?
± vaginal discharge, ultrasound, radiographs, blood work
how do you treat pyometra in dogs?
antibiotics and addressing underlying problems (high P4?) [high-relapse rates]
surgery
how do you prevent pyometra in doggies?
spay! OHE :)
pregnancy too I guess lol
Metritis in cattle is a common ______ disease often seen _____. This is because after parturition, there are compromised physical barriers, like the ____, ____, and ____. This can facilitate an imbalance in the uterine _____.
polymicrobial
postpartum
cervix, vagina, vulva
microbiome
Which 3 species are associated with metritis in cattle?
Trueperella pyogenes
Fusobacterium necrophorum
Prevotella melaninogenica
What are the clinical signs of metritis in cattle? What are the predisposing factors?
signs: enlarged uterus and purulent uterine discharge w/i 21 days post-calving
PF: NEB, dystocia, fetal membrane retention, hypocalcemia, etc
Endometritis in cattle is cause by ______ (same/different) bacteria as metritis. Clinical endometritis is seen _____ (before/after) clinical metritis.
same
after (>21 days postpartum)
Where is Strep equi zooepidemicus a commensal?
mucosal commensal of upper resp tract and caudal repro tract of horses
Strep equi zooepidemicus causes repro tract virus after what predisposing factors? what diseases does it cause?
virus infection, heat stress, tissue injury
endometritis, placentitis
How do you prevent strep equi zooepidemicus?
difficult since it’s an opportunistic pathogen
decrease stress and treating predisposing factors
immunization possible, but difficult b/c there’s lots o’ strains + opportunistic
Strep equi zooepidemicus causes different diseases in males vs females (horse). what are they?
females: endometritis, placentitis
males: epididymitis
Taylorella equigenitalis:
1) aerobe vs anaerobe?
2) motile? non-motile?
3) gram + or gram -?
4) shape?
5) slow or fast grower?
6) obligate/facultative pathogen/symbiont?
1) micro-aerophilic
2) non-motile
3) gram -
4) coccobacillus or pleomorphic
5) slow grower
6) obligate symbiote and facultative pathogen
what disease does Taylorella equigenitalis cause and in what species? what is the difference in sexes in this species in terms of disease?
contagious equine metritis (CEM) in horses
males have no clinical signs but can transmit it
females have CEM
(males don’t have no ute utes)
True or false: Taylorella equigenitalis is a reportable disease.
TRUE!
Tell me about Taylorella equigenitalis in mares, including incubation period, clinical signs, and results of disease.
incubation period = 2-13 days
c/s: endometritis, cervicitis, vaginitis, copious odourless greyish-white purulent vulvular discharge – intense neutrophilic endometritis
results: infertility during acute infection, abortion or production of carrier foals if preggers. most mares recover spontaneously, but a small number become chronic carriers
Tell me about Taylorella equigenitalis in stallions including clinical signs, immunity, where the bacteria is carried.
c/s: none
no immunity
carried on external genitalia
How do you diagnose and treat CEM?
diagnosis: bacteriological isolation (gold standard), PCR (sensitive)
treatment: flushing & scrubbing genital surfaces and sinuses with antiseptic solutions/ointments (ex. nitrofurazone*) – not always effective
topical antibiotic treatment sometimes combined with systemic antibiotic therapy
Campylobacter:
1. shape?
2. gram?
3. species we need to know?
4. obligate/facultative pathogen/symbiote?
5. what disease does it cause and in what species?
6. how is it transmitted?
- curved, spiral, slender rods (bacillus), flagella at 1 or both sides
- gram -
- C. fetus venerealis & C. fetus fetus
- obligate pathogen
- enzootic sterility in cows
- from carrier bulls to cows
What clinical signs/diseases does Campylobacter spp. cause in cows?
vaginitis (replication in vagina), ascending infection leads to chronic endometritis, early abortus, temporary infertility or early embryonic death
How do you prevent Campylobacter spp?
immunization = heifers 3-4 weeks before and mid-breeding season; bulls & cows yearly
there is increasing incidence of this bacteria with age, and heifers are more susceptible
Brucella:
1. shape?
2. capsule? motility? flagella?
3. obligate/facultative symbiote/pathogen?
4. where replication?
- cocci, coccobacilli, or short bacilli
- no capsule, non-motile, no flagella
- obligate symbiote, obligate pathogen
- macrophages
Is brucella a reportable disease? is it zoonotic?
YES and YES!!!!
Tell me about the epidemiology of Brucellosis.
transmission b/t infected wildlife and domestic animals
world’s most widespread zoonosis !
What species is the predominant cause of brucellosis in cattle?
Brucella abortus
Tell me about the transmission of Brucella spp.
direct contact with aborted fetus and/or fluids, contaminated feed or water, colostrum/milk
B. canis infects dogs by penetration of mucous membranes
what species causes brucellosis in dogs?
Brucella canis (also Brucella abortus, but less so)
Describe the pathogenesis of Brucella spp.
- invades through oral mucosa
- directs vacuole to fuse with endoplasmic reticulum
- ER-associated vacuole formed, allowing intracellular replication
- multiplication incudes inflammatory cell infiltration
- in pregnant ute ute, results in trophoblastic necrosis and vasculitis –> decreased maternal-fetal exchange = abortion or still birth
“true virulence is Brucella’s ability to invade host cells including professional phagocytes and then survive and replicate within them”
True or false. One a cow is infected with Brucella, the bacteria leaves forever and never ever comes back
false. infected animals can remain carriers
tell me about treatment and eradication programs of brucellosis
no treatment in any species, but cats may be resistant (???)
testing is key (serology, remember the latent carrier stage may be seri-negative)
eradication program in Canada, last case was in sask in 1989
vaccination not permitted in Canada, but there are vaccines (but they interfere with diagnostic tests, pathogenic for humans, and can cause abortion in preggo mares)
what are the clinical findings of Brucella canis in dogs?
adult dogs rarely get seriously ill, so infection is routinely missed
bitches abort, but also could have normal litters with subsequent or intermittent repro failures
male dogs have orchitis and epididymitis
there are clinical lab findings too (hyperglobulinemia with hypoalbuminemia, lymphoid hyperplasia, CSF pleocystosis)
how do you diagnose Brucella canis in dogs?
bacterial culture (gold standard)
serologic testing (most common) - many false positives
Leptospira:
1. morphology?
2. gram?
3. how to stain for them?
4. what species do we have to know?
5. host specificity?
- long, thin, spiral shaped, hooked ends
- gram -
- silver stain better than gram stain
- L. biflexa, L. interrogans
- not very host specific, but for every server there is usually 1 host that acts as a reservoir (sub clinically infected)
tell me about reservoir host replication with Leptospira spp
kidney tubuli, shedding, mild infection, occasionally intra-uterine infections, abortion
Is Leptospira zoonotic?
YES!
how is Leptospira transmitted?
direct (urine, venereal and placental transfer, bite wounds, ingestion of tissues, uterine discharge, milk)
indirect (contaminated water, soil, food, bedding)
Tell me about the pathogenesis of Leptospira, including incubation period.
incubation = 7 days
- penetrates intact mucosa or abraded/scratched skin, water-softened skin
- LPS stimulates neutrophil and platelet activation –> inflammation and coagulation abnormalities
- dissemination and replication in kidneys, liver, spleen, CNS, eyes, genital tract
- bacteria persist in kidney after infection done, shed in urine for weeks
what are the virulence factors that Leptospira uses? what are the consequences?
sphingomyelinaeses and hemolysins and porins = severe endothelial damage and vasculitis
what 3 broad categories of clinical manifestations are seen with Leptospirosis?
acute renal failure, hepatic dysfunction, repro tract infection
What are the 3 types/phases of leptospirosis and broad clinical signs of each? this is in dogs btw
- peracute phase: leptospiraemia, sudden death
- acute leptospirosis: hepatic and renal failure don’t have time to develop
- subacute leptospirosis: intrahepatic cholestasis and necrosis of liver may result in echoic feces. renal failure. chronic hepatitis may develop causing hepatic encephalopathy, weight loss, icterus
Think about Ruby last summer at Fish
Tell me about Leptospirosis in horses
lower susceptibility, but acute/severe disease, short duration of shedding
cause of abortion
tell me about leptospirosis in cattle.
host specific L. hardjo = sporadic abortions and infertility
L. pomona specific hemolytic toxin
How do you diagnose Leptospirosis?
direct methods: dark field microscopy in urine, immunofluorescence, culture (gold standard)
indirect methods: serology [ELISA] (most common), titre
how do you prevent leptospirosis?
limit exposure to stagnant water and potential carriers
isolate infected animals & clean/disinfect contaminated areas
dispose of abortions adequately
vaccination! common in most species (although in dogs it doesn’t protect against subclinical infection/carrier, just clinical disease)
Tell me about the most important serotypes of canine leptospirosis and what they cause in dogs.
Canicola, bratislava, grippotyphosa = renal dysfunction
Icterohaemorrhagiae, pomona = hepatic disease
Listeria:
1) morphology?
2) temp tolerancE?
3) what is the species we have to know? facultative/obligate symbiote/pathogen?
4) where multiply?
5) Facultative/obligate intra/extra cellular?
6) host specificity?
1) short rod with peritrichous flagella
2) 3C - 45C (psychrotolerant)
3) L. monocytogenes - facultative symbiote
4) silage with too high pH
5) facultative intracellular
6) not host specific
tell me about what diseases Listeria causes
disease of CNS: cattle, sheep, goats, rodents, humans
abortus in 2nd half of pregnancy in most mammals
Tell me about the pathogenesis of Listeria monocytogenes
- ingestion
- invasion of intestinal mucosa
- circulation
4.1. clearance by macrophages (if not pregnant)
4.2. if pregnant, damages placental barred and/or passes through to infect fetus - fetus delivered with infection, CNS deficits OR abortion/stillbirth
