Urinary System Flashcards
What can oak toxicity in cattle cause
renal tubular damage, streaking red-white pattern in the cortex
What does an acute kidney infarct injury look like
Wedge shaped
Red
Swollen
What does a subacute kidney infarct injury look like?
Wedge-shaped
Red-Rim with white/grey/tan center with a surface that is still swollen
What does a chronic kidney infarct injury look like
a wedge shaped
white/grey/tan surface is sunken due to tissue loss and scarring
What kidney pattern does Actinobacillus infection in a foal have
White speckles from small thrombi and bacteria in the bloodstream that have settled in the microvasculature of the glomeruli
What kidney pattern does E coli infection in a calf have
White speckles from small thrombi and bacteria in the bloodstream that have settled in the microvasculature of the glomeruli
What do white, tan, or red cortical dots on the kidney likely indicate
Ekbolic/septic pattern from an infectious process
likely bacterial
What does a pinpoint pattern that is uniform tan or red dots on the cortex of the kidney likely indicate?
Likely Glomerular disease - glomerulonephritis, glomerular amyloid, or glomerulosclerosis
Pyelectasia
distention of the renal pelvis
Hydronephrosis
severe distention of the renal pelvis by fluid (urine)
Implies and obstruction without infection
Pyelitis
inflammation of the renal pelvis, usually suppurative
Pyelonephritis
inflammation, usually, suppurative of the pelvis and renal papilla; may cause pyelectasia (distention of pelvis)
What is a likely cause of pyelonephritis
usually ascending infection from a lower urinary tract infection
Upon necropsy you see distented renal pelvis and distended renal calyces. What is going on
Pyelectasia
You observe pyelectasia what is the likely cause
1) obstruction (stones, stricture, neoplasia, ecotopic ureter)
2) If pus: pyelonephritis from an ascending bacterial infection
What pattern of kidney injury is seen in ethylene glycol toxicosis
corticomedullary injury (streaks in the cortex)
What pattern of kidney injury is seen in rattle snake envenomation
corticomedullary injury (streaks in the cortex)
tubular necrosis
you observe kidney cortical or medullary streaks, what process is likely occurring
tubular necrosis or tubulointerstitial disease
What should you ensure in your postmortem sampling of kidney for histopath
make sure sample has cortex, medulla, and pelvis
sample thickness should be no more than 1cm
Multiple samples are okay if one is abnormal
can submit a whole kidney if needed
What kidney patterns can be seen in a cat with FIP?
1) Few to many variably sized white to yellow nodular to fuzzy masses
sometimes along the vessels
may cause infarcts so wedges can be seen
Lesion is granulomatous (nodular) phlebitis/vasculitis (may track vessels and cause infarcts)
What disease causes kidneys to have variably size white to yellow nodular to fuzzy masses that are sometimes along the vessels and can cause infarcts
Feline infectious peritionitis
Confirm by ensuring also swollen belly, elevated gamma globulins, and viscous yellow fluid
What is a result of glomerular disease
proteinuria (protein losing nephropathy) leading to hypoalbuminemia, immunoglobulins are usually normal
What is the clinical pathology hallmark of glomerular disease
Clin Path: significant proteinuria in dilute urine especially if quiet sediment
An Path: Pinpoint white or red cortical dots
What are the two general causes of glomerulonephritis
1) Primary infection of glomeruli (embolic/septic or systemic disease)
2) Immune-complex deposition (Ig-Ag)- many causes
What bacteria can cause glomerulonephritis
Septic conditions leading to damage of the glomerulus
1) Actinobacillus equuli in foals
2) E Coli (any species)
3) Erysipelothrix (pigs)
often has a classic embolic pattern rather than glomerular pattern
What viruses can cause infectious glomerulonephritis
Porcine Circovirus 2 (Pigs)
*You will see a classic pinpoint glomerular pattern
You necropsy a pig with Porcine Circovirus 2. What pattern do you expect to see in the kidneys
Classic pinpoint glomerular pattern due to damage to the glomerulus
What type of hypersensitivity lead to immune complex deposition in the glomerulus
Type 3
A 10yo FS mutt is brought in for lethargy and coughing. The dog test positive for heartworm. As part of your lab work you run urinalysis that shows proteinuria in dilute urine with quiet sediment. What type of renal pathology do you suspect?
Glomerular disease
What are the causes of Ig-Ag glomerulonephritis in dogs?
-IMHA
-IMPA (immune mediate polyarthritis)
-Chronic Heartworm
-Adenovirus
-Any chronic infection
You have been managing a 12yo MI mix breed dog with chronic intermittent systemic lupus erythematosus. Upon a recheck exam with CBC, chem, UA you notcie significant proteinuria in dilute urine with a quiet sediment. What do you suspect the patient has developed
Glomerulonephritis due to type III hypersensitivity
What are the causes of Ig-Ag glomerulonephritis in cats?
-FIP
-FIV
-FeLV
-Autoimmune disease
-Any chronic inflammatory conditons
What are the causes of Ig-Ag glomerulonephritis in cattle
BVDV
Trypanosomiasis
What are the causes of Ig-Ag glomerulonephritis in pigs?
Hog cholera (Classical Swine Fever; pestivirus)
African Swine Fever (Asfarvirus)
Streptococcal disease
What are the causes of Ig-Ag glomerulonephritis in horses?
Streptococcus- chronic abscesses
EIA- Equine Infectious Anemia
A protein deposit with b-pleated sheet secondary structure that may form out of misfolded proteins or form when excess normal proteins aggregate
difficult to remove once deposited
Amyloid
What is the most common form of amyloidosis in animals?
AA- amylodosis- derived from serum amyloid-A (SAA)
seen in chronic inflammatory conditions, immune mediated diseases and chronic infections
What form of amyloidosis is rare in animals
AL amyloidosis from monoclonal immunoglobulin light chains
seen in plasma cell neoplasia or proliferations
In dogs, amyloid deposits in the __________
In cats, amyloid deposits in the _____________
Renal glomeruli (dogs)
Renal medulla (cats)
What is the stain used to tell glomerular amyloid
Congo Red
What breed of cat is predisposed to renal amyloidosis
Abyssinian
hardening or scarring of the glomerulus, usually by fibrosis
end stage of glomerular disease
Glomerulosclerosis
What is very suspicious of glomerular disease
proteinuria in dilute urine with a quiet sediment
Name toxins that cause renal tubular necrosis (corticomedullary pattern)
-Ethylene glycol
-grapes
-Lilys (cats)
-oak- cattle
-pigweed-pigs
-Bluegreen algae (with liver failure)
-Vitamin D
-Amanitin (mushroom with liver failure)
-Lead (cattle)
What can help you diagnose ethylene glycol toxicity in a dog
1) Metabolic acidosis
2) Azotemia and isosthenuria renal failure
3) Calcium oxalate monohydrate crystals in urine
4) cortical to medullary streaks, red-white pattern indicating tubulointersitital pathology- tubular necrosis
What causes pigment nephrosis
1) Free hemoglobin from severe hemolysis
2) Free myoglobin from severe rhabdomyolysis
leading to acute kidney injury, renal tubular necrosis
You observe kidneys that are diffusely dark red to blue-black and pigmenturia. What is likely happening
Pigmentary nephrosis due to hemoglobin or myoglobin (hemolysis or rhabdomyolysis)
What are your differentials for Hb pigment nephrosis
Hemolysis
1) Wilted red maple (horses)
2)Isoerthrolysis (horses)
3) incomaptible blood transfusion
4) Copper (sheep)
5) IMHA
6) Onions (dogs)
7) Zinc
8) Acetaminophen
What toxin causes renal tubular necrosis with severe heinz body anemia and methemoglobinemia, hypoxia, icterus, hemoglobinuria, and splenomegaly in horses
Red Maple
Does neonatal isoerythrolysis occur with the first or second pregnant in horses?
Second
During the first the foal inherits RBC antigen from a sire that is foreign to mare. Mare sensitized to RBC antigen during pregnancy. Mare produces antibodies against the RBC antigen. Foal #2 has same foreign RBC antigen so the mare’s antibodies concrentrated in the colostrum causes a type II hypersensitivity reaction and hemolysis
What type of hypersensitivity reaction is neonatal isoerythrolysis in foals?
Type II
Low amounts of the metal_________ can cause copper toxicity in small ruminants
molybdenum
What is the effect of copper on the kidney
Storage of excess Cu in the liver raises release and oxidation of Hb where heinz body anemia occurs with hemoglobinuric acute tubular necrosis; Hb-uria and diffusely dark red/black cortex
What are your differentials besides copper toxicity for HB pigment nephrosis in small ruminants
IMHA
-Erythroparasite
Clostridium perfringens type A
What can cause myoglobin pigment nephrosis
Capture myopathy
Exertional rhabdomyolysis
Compartment syndrome in large animal
Describe the pathogenesis of capture myopathy/exertional myopathy
1) Prolonged sympathetic tone activation and exhaution- relative muscle hypoxia
2) Muscle exertion leading to a production of lactic acid - lactic acidosis
3) Exacerbated by heat/hyperthermia and other stressors
4) Myoglobin is released from daged/dead myofibers (CK and K+ will be elevated)
5) Circulating Mb is toxic to renal tubular epithelium leading to acute tubular necrosis and acute renal failure
What is compartment syndrome
caused by long term recumbency in large animal where the weight of the animal upon the side that is down can cut off the blood supply
Muscle ischemia lead to muscle necrosis, edema
Restriction by fascia casues increased pressure in the compartment and causes more muscle damge to the muscle belly in that fascia plane
What causes renal papillary necrosis
1) NSAID administration (overdose or chronic use) especiallyequines with bute,bamaine- alter renal blood flow and cause ischemia of the renal papilla
2) Can also see with pelvic stones leading to pressure necrosis
3) Can also see with pyelonephritis leading to infection and necrosis
What does papillary necrosis look like? and what are its likely causes
Yellow/green/ or brownish discoloration at the renal pelvis
NSAIDs, pelvic stones, or pyelonephritis
What are the infectious causes of tubulointerstitial disease
-Leptospirosis
-Malignant catarrhal fever (bovines, ungulates)
-Encephalitozoon cuniculi (rabbits)
Spiral bacteria that is shed in the urine by infected animals.
infection via contact with urine or water or soil contaminated with urine
contact with the mucous membrane or breaks in the skin
cause tubulointerstitial disease
Acute renal AND hepatic failure (but serovar dependent)
Leptospirosis
What is the classical canine presentation of Leptospirosis
Acute Renal AND Hepatic Failure
What pattern does malignant catarrhal fever have on the kidney
Systemic disease with vasculitis
Renal lesion is multifocal with intersitital nephritis
Patchy white areas of pallor
What causes Malignant catarrhal fever
Ovine herpesvirus 2 or alcelaphine herpesvirus
Caused by a microsporidian parasite
Most infected rabbits are asymptomatic
Can cause encephalitis, catarct, granulomatous tubulointerstitial nephritis
Potentially zoonotic to immune compromised people
Encephalitozoon cuniculi
What is seen in a kidney of a rabbit with Encephalitozoon cuniculi
-Granulomatous tubulointerstitial nephritis
infected renal tubular epithelial cells
Kidney has pitted surface