Urinary System 2 Flashcards
Infection of the urinary tract can come from what two sources?
Hematogenous (descending infection)
Urinary bladder (Ascending infection)
What are the 4 classifications of nephritis, according to location?
Glomerulitis
Glmonerulonephritits
Interstitial nephritis
Pyelonephritis
What type of nephritis has a multifocal suppurative glomerulitis? What is the cause?
Embolic nephritis
Caused by bacteremia
What is a common cause of embolic nephritis in a foal?
Actinobacillus equuli
What is the progression/chronic form of embolic nephritis
Microabscesses -> rupture -> loss of glomerulus
What are the two immune mediated mechanisms that lead to glomerulitis and glomerulonephritis ?
Deposition of Ag-Ab complexes
Autoantibodies directed against the GBM (antibasement membrane disease)
What are the acute changes seen in a glomerulonephritis ?
Subtle changes - kidney appear swollen and pale
Chronic glomerulonephritis appears ???
Kidneys are shrunken and granular
What are the three morphologic types of glomerulonephritis ?
Membranous -> thickening of BM
Proliferative -> increased cellularity
Membrano-proliferative -> glomerular sclerosis
What is glomerulosclerosis
Scar tissue replacing glomerulus
What do you call an inflammatory infiltration in the interstitium that affects tubular function
Interstitial nephritis
Does interstitial nephritis usually have a diffuse or multifocal distribution
Diffuse (pale cortex), except in bovine is multifocal (white spotted kidney)
Off-white foci randomly scattered throughout the renal cortex and medulla of bovine kidney
EDx?
White-spotted kidney
Residual lesions of E.coli bacteremia (common in young cattle)
What is the pathogenesis of bacterial interstitial nephritis?
Bacteremia -> renal interstitial capillaries -> migrate through vascular endothelium -> persist in interstitial space
Causes of interstitial nephritis in dogs?
Leptospirosis
Canine hepatitis virus (recovery phase)
Theileria parva
Causes of intersitial nephritis in cattle?
Ecoli
Leptospirosis
Malignant catarrhal fever
Causes of interstitial nephritis in sheep
Sheeppox
Causes of interstitial nephritis in pigs?
Leptospirosis
Porcine reproductive and respiratory syndrome
PCV-2
Causes of interstitial nephritis in horse?
Equine viral arteritis
Kidney is shrunken, pale and firm
Capsule is firmly adhered to cortex
Histo shows..
interstitial fibrosis
Tubular atrophy and dilation
Aggregate of lymphocytes and plasma cells
Disease?
Chronic interstitial nephritis
What do you call inflammation of the renal pelvis and renal parenchyma?
Pyelonephritis
T/F: pyelonephritis is always bilateral
False
Pyelonephritis results form what type of infection? What species is it commonly seen in?
Ascending infection
Pig, cattle, and dog
What are predisposing factors to pyelonephritis ?
Urinary obstruction -> urine stasis facilitates bacterial growth
Abnormal vesico-urethral reflux (retrograde flow of urine) normally prevented by the oblique insertion of ureters into bladder wall
Cystitis (female>male)
What conditions may interfere with ureteral peristalitc waves and predispose to vesicourethral reflux?
Cystitis and ureteritis
Suppurative exudate in pelvic cavity with partial destruction of medulla, irregular discoloration of cortex.
Disease?
Pyelonephritis
Histology of kidney..
large number of neutrophils and bacteria in lumen of renal tubules. Necrosis of tubular epithelium . Glomerulus still intact
Disease
Acute Pyelonephritis
Ascending infection affecting renal tubules and not glomerulus
White bands of scar tissue Extending from cortex to medulla, interstitial fibrosis and loss of tubules
Disease?
Chronic pyelonephritis
What is a form of chronic nephritis characterized by predominance of machrophages in the inflammatory infiltrate ?
Granulomatous nephritis
In a cat
Multifocal to coalescing off-white raised nodules or cortical and cut surface of the kidney
DDx?
Granulomatous nephritis -> Feline infectious peritonitis
Lymphosarcoma (often more diffuse)
Mycobacterium bovis would result in what type of nephritis?
Granulomatous nephritis
What nematode of horses causes granulomatous nephritis by its migration through the kidney?
Halicephalobus gingivalis
A large nematode of mink and dog that is in the renal pelvis and can sometimes be found free in peritoneal cavity
Diocticophyma renale
Giant kidney worm
In pig
Larvae that migrates from intestine to liver, causing hepatitis and phlebitis, and then crosses the peritoneal cavity to the peri-renal fat and form cysts within the renal pelvis of the kidney
Stephanurus dentatus
Hydatid cyst on surface of kidney of moose
EDx?
Echinococcus granulosus
What is an abnormal and permanent dilation of the renal pelvis and calyces with progressive atrophy of renal parenchyma ?
Hydronephrosis
What are causes of hydronephrosis ?
Increased pressure due to obstruction of urine outflow
- congenital malformation
- calculi (uroliths)
- iatrogenic
- chronic inflammation
- neoplasia
- torsion
What is the pathogenesis of hydronephrosis ?
Urine filtrate diffuses into renal interstitum -> absorbed by lymphatic -> pressure shuts down blood vessels -> papillary necrosis and atrophy of renal parenchyma
What is the kidneys response to injury?
Tubular regeneration
Fibrosis (if BM is damaged)
Nephrosclerosis is fibrosis is severe
What is an end-stage kidney?
Kidney severely affected by chronic inflammation and fibrosis -> pale, shrunken, and firm
-not possible to determine initial injury
What is the difference between renal disease and renal failure?
Renal disease- any deviation from normal renal structure or function
Renal failure- inability of the kidney to maintain normal function (loss of at least 70% of kidney function)
Clinical syndrome of toxemia due to intravascular accumulation of endogenous toxic waste substances like urea, creatinine, uric acid, phenolic acid, ect..
Uremia
Clinical signs of uremia?
Vomiting Dehydration and anascara Polydipsia, anuria, oliguria, poliuria Ammonical breath Malaise
What are the non-renal lesions of uremia?
Uremic stomatitis/glossitis Hemorrhagic ulcerative gastritis and colitis Endocarditis/mucoarteritis Tissue mineralization Pulmonary edema
What is the pathogenesis of hemorrhagic ulcerative gastritis due to uremia?
Arteriolar necrosis and mucosal infarction
Mineralization of the gastric glands
What is the pathogenesis of mucoarteritis/endocarditis due to uremia?
Deposition of glycosaminioglycans -> fibrinoid degeneration of the subendocardial CT
Most common in left atria and proximal aorta
What is the pathogenesis of pulmonary edema resulting for uremia?
Damage to the air-blood barrier and plasma fluid leaks into alveoli
Often the cause of death in uremic animals
T/F: abnormal renal function can result in excessive retention of phosphorus
True
What is secondary renal hyperparathyroidism?
Phosphorus levels increased due to decreased renal excretion
-> parathyroid stimulated to increase PTH -> increase Ca
(Maintain ratio between Ca and Phos)
What type of tumors can be present in the kidney?
Renal adenoma
Renal adenocarcinoma
Renal cystadenocarcinoma
A primary urinary tumor common in pigs, rats, and chickens that grows to very large sizes and is composed of immature renal parenchyma
Nephroblastoma
What is the formation of solid or semisolid concretions in the urinary collecting system?
Urolithiasis (calculi)
What are predisposing factors to urolithaiaiss?
Increased concentration (supersaturation)
Low urine volume (dehydration/low water consumption)
Urine pH
UTI
High phosphate diet in sheep
High silica levels
Struvites
Clinical signs of ureathral obstruction by uroliths?
Dysuria
Stranguria
Pollakiuria
Heamturia
“Water belly” is due to?
Ruptured bladder due to urethral obstruction
What are causes of cystitis?
Bacterial infections
Accumulation of uroliths
Toxins (eg blister beetle-cantharidin)
In cattle what causes a chronic enzootic hemturia ?
Bracken fern
-> toxic and carcinogenic compounds leads to cystitis, adenocarcinomas, and papilloma
In bladder..
Mucosal hemorrhage and ulceration
Production of exudate (hemorrhagic and fibrinopurulent)
MDx?
Acute cystitis
In bladder..
Multifocal lymphoid hyperplasia (follicular cystitis)
Polyploid cystitis
MDx?
Chronic cystitis
__________ cystitis can develop in some dogs and cats with diabetes mellitus
Emphysematous
A common condition in male cats characterized by urethral obstruction by a plug composed of protein and cellular debris
Feline lower urinary tract disease
What are predisposing factors to feline lower urinary tract disease?
Diet high in Mg and phosphate
Alkaline urine pH
Decreased fluid consumption
What types of tumors can be seen in the bladder?
Transitional cell carcinoma
Leiomyoma/leiomyosarcoma
Fibromatous/fibrosarcoma
Hemangioma/hemangiosarcoma
Multifocal raised noduels or focal thickening (plaques) of the urinary bladder, commonly in trigone region of bladder
What type of neoplasm is this?
Transitional cell carcinoma
