Urinary System Flashcards
Acute renal failure
Sudden decline in glomerular filtration rate and concurrent development of uremia
What causes ARF
Complete or partial loss of nephrons due to hemodynamic changes
Toxic tubular nephrosis* (aminoglycosides and NSAIDs)
Immunologic disorders
Acute inflammation
Obstruction
ARF pathophysiology
↓ glomerular hydrostatic pressure
↑ Bowman’s capsule pressure
CS of ARF
Early polyuria, then depression and anorexia, later oliguria and dysuria (azotemia)
Dx of ARF
CS
Rectal palpation (enlarged kidneys)
Clin path: azotemia, isothenuria, hyponatremia, hypchloremia, hematuria
Tx for ARF
Treat inciting dz (endotoxemia)
Fluid therapy to correct vol and electrolyte imbalances
Peritoneal dialysis (warm lactated ringers)
How to tx oliguric renal failure
Fluid and electrolyte replacement (mannitol and furosemide, dopamine)
Chronic renal failure
Slower, progressive loss of nephrons
Causes of chronic renal failure
Progressive glomerular dz
Tubular interstitial dz
CS of chr. renal dz
Early polyuria and polydipsia
WL (most common)
Pitting edema due to hypoproteinia from glomerulonephritis
Dx of chr. renal failure
Clin path: Azotemia, ↓ Na, Cl and ↑ K, marked proteinuria without hematuria, isothenuria
Rectal: enlarged painful kidneys with pyelonephritis
Tx for chr. renal failure
Similar tx to ARF
Limit protein
Prog: grave for progressive glomerular dz
Ulcerative Posthitis & vulvitis
Pizzle rot, sheath rot, enzootic balanoposthitis
Small ruminants
Ulcerations on prepuce of males and vulva of females
What causes ulcerative Posthitis & vulvitis
Corneybacterium renale and abnormally high levels of urea in the urine (↑ protein in the diet)
Spread by infective material from lesions
Pathophysiology of UP
C. renale= normal inhabitant of the skin and hydrolyses to form ammonia → accumulates in hair/ wool around prepuce → damage to cells with necrosis and ulceration
CS of external UP
Males: Ulceration around preputial opening, scabs of necrotic material form over ulcers
CS of internal UP
Debilitating,Preputial wall thickened, foul-smelling exudate
Females: blisters under tail → progress to inflame vulva
Tx of UP
Debride ulcerated area, apply ointment with penicillin or bacitracin
Highest incidence of ulcerative Posthitis & vulvitis
Merino and angora weathers due to amount of hair or wool on prepuce
Urolithiasis
Uroliths/ urinary calculi in ruminants: feedlots- (struvite) and grazing cattle (silica)
Obstructive: in males
Who is more susceptible to urolithasis
Castrated males because the diameter of the urethra is smaller
3 main clinical entities of urolithiasis
Urethral obstruction (prox sigmoid flexure)
Rupture of urethra
Rupture of the bladder (dorsal wall of bladder)
Pathophysiology of urolithasis
Calculogenic crystalloids concentrated in urine → precipitate out → form crystal nidus → forms center for calculus formation
Dx urolithiasis
CS
Rectal palpation: distended bladder
Azotemia (↑ BUN, creat, TP and K)
Aspirate ventral abdominal swelling and heat fluid
Abdominocentesis (copious urine
U/S in small ruminants (fluid line)
Tx of urolithiasis
Acidification of urine by adding ammonium chloride to feed
↑ Ca and salt content of feed
Aminopromazine (antispasmodic)
Sx: amputation of urethral process in small rums- cystotomy
Urethral obstruction
Caused by calculi* (Ca carbonate), blood, neoplasia*, smegma, edema or cellulitis
CS of a urethral obstruction
Stranguria, mild abdominal discomfort, occasional discolored urine
Dx a urethra obstruction
CS, rectal palp, catheterization and urethral endoscopy and U/S
Tx for urethral obstruction
Sx: subischial urethrostomy
Medical: correct fluid, electrolyte imbalances, anti-inflamm. drugs, diuretics, hydrotherapy
Ureter/ kidney obstruction
Ureteral calculi (Ca carbonate or phosphate) and nephroliths are most common in both
CS of a ureter/ kidney obstruction
CRF
WL or poor performance
Azotemia and isothenuria
Dx a ureter/ kidney obstruction
CS, rectal palpation, US to examine retroperitoneal area and detect dilated ureters, dilated renal pelvis, nephroliths and fibrosis in kidney
Calculus formation in the ureter/ kidney
May be due to accumulation around nidus, or abnormal Ca solubility factors (diet, NSAIDs)
Stone in distal ureter rostral to pelvis brim
Tx for ureter/ kidney obstruction
Sx if dx before azotemia (ureterostomy or nephrostomy)
Medical: dissolve by acidifying urine (ammonium chloride)
Bladder obstruction
Ca carbonate or phosphate
Singular large and smooth or small and rough
Predisposed by UTI
CS of bladder obstruction
Pollakiruia, stranguria or dysuria
Dx bladder obstruction
CS, rectal palpation (hand and wrist in rectum), transrectal U/S
Tx for a bladder obstruction
Sx: cystotomy, urethroscopy
Medical: acidifying urine, parasympathomimetics (bethanechol)
Most common tumors of the kidney in bovine
Secondary lymphosarcomas
Primary tumors (rare): carcinomas
Most common tumors of the kidney in small ruminants
Sheep get multicentric lymphosarcoma
CS of urinary system neoplasias
Hematuria, WL, dysruria/stranguria, urethral obstruction, anemia
Dx of urinary system neoplasias
Rectal exam: mass in bladder or kidney
UA: hematuria, proteinuria, occasional neoplastic cells
Endoscopy and bx
U/S
Tx of urinary system neoplasias
Sx: bladder tumor removal, nephrectomy
Urinary incontinence
Caused by neuro, bladder, urethral dz, hormonal causes or ectopic ureter
Main categories of neuron dz
UMN: innervates lining of the bladder (not easily expressed
LMN: easily expressed (most common)
Urinary incontinence may be one of the CS seen in_________
Rabies
CS of urinary incontinence
Dysuria/ stranguria, urine scalding of perineum (female), urine dribbling from penis (male)
Dx of urinary incontinence
No voluntary mictuirition
Rectal palp: enlarged baldder, urine difficult to express (UMN) or easily expressed (LMN)
Sphincter tone: ↓ (LMN)
Tx of urinary incontinence
Neuro dz: phenoxybenzamine + bethanechol
Bladder/ urethral- sx
Hormonal: estradiol
Glomerulonephritis
Immunologic disorder with deposition of Ag-Ab complexes in the glomerular BM or attachment of the anti-glomerular BM ab to the capillary walls
T/F: glomerulonephritis is common in small ruminants
FALSE: uncommon
Mainly see spontaneous proliferative glomerunephritis and glomerunephritis of pregnancy toxemia
CS for glomerunephritis with bovine
WL, chr. diarrhea, generalized
Proteinuria, hypoalbuminemia, anemia, ↑BUN and creat
CS for glomerunephritis with small ruminants
Asymptomatic
Neuro signs +/- proteinuria, ketouria, azotemia
Dx of glomerulonephritis
CS and clin path
Renal bx
Acute tubular necrosis
Due to hypotension/ ischemia (mastitis, salmonella, heavy metals, amaranthus/ pigweed, etc.)
CS of acute tubular necrosis
Depression, edema, oliguria then polyuria due to inadequate tubular resorption
DX of acute tubular necrosis
Electrolyte imbalances
USG <1.02
Hematuria, granular casts and proteinuria
Rectal palpation (renal edema)
Tx of acute tubular necrosis
IV fluids 0.9% NaCl
Oliguric renal failure: mannitol (or dopamine) + furosemide
Enzootic Hematuria
Bovine >4y
Usually found in elevated regions where bracken fern (Pteridium aqulinum) grows
Chr. bracken fern ingestion
Leads to formation of bladder tumors → hemorrhage → intermittent hematuria → death from hemorrhagic anemia
CS of enzootic hematuria
Intermittent hematuria, anemia
Dx of enzootic hematuria
Hx and presence of bracken fern
Hematuria
CBC- hemorrhagic anemia
U/S- tumors in the bladder
