urinary tract and umbilicus disorders

Question 1

evaluating ureters with endoscopy

Answer 1

urine outflow every 20-45 seconds under xylazine sedation

Question 2

ruptured bladder

Answer 2

foals 1-5 days old
more common in colts
usually during parturition but clinical sings take time to develop
-depression
-off suck
-progressive abdominal distension
-mild/mod colic
-increased frequency of urination and small urination volume, or no urination

Question 3

diagnosing ruptured bladder
biochem and haem

Answer 3

hyper K
hypo Na, CL-
dehydration
metabolic acidosis

Question 4

diagnosing ruptured bladder
peritoneal fluid analysis

Answer 4

peritoneal creatinine more than double serum creatinine

Question 5

stabilise ruptured bladder prior to ga?

Answer 5

hyper K can cause fatal arrythmias
K+ must be <5.5meq/l before induction of anaesthesia

Question 6

urolithiasis

Answer 6

relatively uncommon
more common in males(can block urethra)
less common in females(can remain in bladder and cause mild haemorrhage)

calcium carbonate
type 1–>more common, spiculated, yellow/green
type 2–>smooth and white

Question 7

diagnosing urolithis

Answer 7

haematuria
stranguria
+/-pollakiuria, pyuria or incontinence
rectal exam, external palpation
us
endoscopy

Question 8

treating urolithiasis

Answer 8

surgical removal:laparotomy, laparoscopy, incision directly over urolith if in urethra

electrohydraulic/laser lithotripsy

if horse cannot urinate due to distal urethral obstruction, a temporary perineal urethrotomy may be needed

Question 9

sabulous cystitis

Answer 9

2ndry problem, consequent to bladder paralysis or other physical or neuro disorders interfering with complete bladder emptying

Question 9

bladder eversion

Answer 9

due to excessive straining eg foaling

Question 10

umbilicus

Answer 10

should dry up and disappear over 4-6 weeks
investigate if mositness>24hr, swelling/pain on palpation or if foal is febrile

Question 11

patent urachus

Answer 11

remnant of channel between bladder and umbilicus where urine drains in foetus
-urachus fails to close spontaneously or can reopen if sepsis
-moisture around umbilicus+/-dripping urine
-check for concurrent septicaemia/septic arthritis/physitis
-assess IgG status

Question 12

treating patent urachus

Answer 12

antibiotics
topical agents

Question 13

umbilical sepsis

Answer 13

usually 1st/2nd week old

Question 14

diagnosing umbilival sepsis

Answer 14

us enlarged structures of umbilicus

Question 15

treating umbilical sepsis

Answer 15

assess igg, concurrent septicaemia, septic arthritis/physitis
-systemic abs
surgical resection if no response to treatment

Question 16

umbilical hernia

Answer 16

common congenital defect
surgery if: non reducible as may cause strangulation of gut
large defect >3-5cm
defect>6 months
defect enlarges
associated with colic