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Equine Medicine Final > Urinary Tract Disorder IN FOALS > Flashcards

Urinary Tract Disorder IN FOALS Flashcards

1
Q

Signs of Urinary Tract Problems in foals

A
  • Azotemia in the first 24 hours
  • Lack of urination
  • Dribbling urine from the urachus
  • Abnormal posturing
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2
Q

Normal Time for first normal colt urination

A

6-8 hours postpartum

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3
Q

Normal time for first filly urination

A
  • 10-12 hours postpartum
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4
Q

Initial urine concentration

A
  • Dilute or concentrated
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5
Q

Foal urine concentration after 24-48 hours

A
  • Hyposthenuric
  • AKA specific gravity <1.008
  • If it’s not this in a foal, the foal isn’t nursing enough
  • Mare’s milk is mostly water
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6
Q

Azotemia in neonatal foals possible indicators if foal is less than 7 days of age?

A
  • Placental insufficiency

- Pre-renal failure

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7
Q

Other causes of azotemia in foals

A
  • Acute kidney injury (AKI)
  • Obstructive disease
  • Congenital renal disorders
  • Uroperitoneum
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8
Q

Normal umbilical anatomy of the foal

A
  • see the picture on your desktop
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9
Q

What structure does the umbilical vein become?

A
  • Falciform ligament
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10
Q

What structures do the umbilical arteries become?

A
  • Round ligaments of the bladder
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11
Q

Umbilical ultrasound

  • Image type: transverse/longitudinal
  • Where is it located?
A
  • Transverse image
  • Cranial to urinary bladder
  • Caudal to external umbilicus
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12
Q

What would it mean if the urachus was black?

A
  • That means that it’s patent
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13
Q

Urachal diverticulum

- Image type: transverse/longitudinal

A
  • Can be seen on longitudinal view
  • Cranial to left
  • Occasionally occurs
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14
Q

Clinical signs with urachal diverticulum

A
  • Straining to urinate
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15
Q

Patent urachus signs

A
  • Dribbling urine from umbilicus
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16
Q

Patent urachus and umbilical infection

A
  • Can be a preliminary feature of umbilical infection
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17
Q

Treatment for patent urachus

A
  • Surgical or medical
  • Must fix underlying problem, treat urine scald with skin protectants (can pool underneath the skin)
  • Systemic antimicrobials excreted in the urine in high concentrations
  • Surgery to remove umbilicus (sometimes hope that getting up and not laying in urine will close it up without surgery)
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18
Q

Uroperitoneum causes

3, and which is most common?

A
  • Ruptured bladder* (most common)
  • Ureteral rupture
  • Urachal leak
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19
Q

Clinical pathologic abnormalities for uroperitoneum

A
  • Serum sodium: decreased
  • Serum creatinine: increased
  • Serum potassium: increased
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20
Q

Diagnosis of uroperitoneum

A
  • Ultrasound
  • Abdominocentesis
  • Peritoneal fluid creatinine will be 2x serum creatinine
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21
Q

Treatment of uroperitoneum

A
  • Surgical typically

- Can try to treat medically with Foley catheter in place

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22
Q

Uroperitoneum cases

A
  • see the cases in the lecture
  • Not producing urine
  • Abdomen increases in size often
  • Straining to urinate
  • Can be obtunded
  • May not be nursing
  • Often diagnosed with CBC/Chem/ultrasound
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23
Q

What is the emergency with uroperitoneum?

A
  • NOT surgical repair
  • Treating the hyperkalemia is
  • You MUST manage that before going in surgically
24
Q

How to correct hyperkalemia?

A
  • Drainage of peritoneal urine accumulation

- Fluid therapy - LRS or 0.9% NaCl with Dextrose (2.5-5%)

25
Q

Omphalophlebitis structures that can be involved?

A
  • Arteritis
  • Phlebitis
  • Urachitis
  • Combinations
26
Q

Diagnosis of omphalophlebitis

A
  • Ultrasound may help

- Try to accurately assess the internal structures to determine the extent of surgery needed

27
Q

Umbilical abscess locations

A
  1. Umbilical vein
  2. Umbilical abscess
  3. Subcutaneous abscess
  4. Omphaloarteritis
28
Q

Umbilical infection in the umbilical vein challenges

A
  • Can be quite difficult
  • Poor vascular entry of antimicrobials
  • ## Sometimes extends to the liver - difficult to remove surgically
29
Q

Treatment of omphalophlebitis

A
  • Choose antimicrobial with good penetration
  • Thick vascular and abscess walls
  • Thick purulent exudate
  • Culture via swab if possible
  • Antibiotics
  • Can treat medically, but may need to remove the umbilicus too
30
Q

What antibiotics work best for omphalophlebitis initially?

A
  • Rifampin + TMS or chloramphenicol

- Chloramphenicol can cause aplastic anemia in people

31
Q

What should you consider when evaluating an umbilical hernia?

A
  • How large?
  • How many fingers? (1 or 2 generally okay; more might be a concern)
  • What do you palpate within the hernia?
  • GI viscera
  • Peritoneal fluid
  • Omentum
32
Q

Evaluating a hernia with ultrasound

A
  • Look for bowel and small intestine
  • Omentum
  • Fluid
  • If entrapped fluid or incarcerated intestine (measure wall thickness; intestinal distension; evaluate peristalsis)
33
Q

Treatment of hernia variables

A
  • Depending on size may mean surgical treatment right away or surgical treatment later
34
Q

Inguinal hernia signalment

A
  • young colts
35
Q

Typical timeline for inguinal hernia

A
  • Present at birth or several days later

- Can be unilateral or bilateral

36
Q

Predisposing factors for inguinal hernias (3 we talked about)

A
  • Large inguinal rings (Tennessee Walking Horse; Standardbred; Draft breeds)
  • Trauma
  • Increased abdominal pressure (straining)
37
Q

Indirect inguinal hernia definition

A
  • Intestines pass through the intact vaginal ring

- Contained within the parietal layer of the vaginal tunic

38
Q

Are indirect inguinal hernias usually reducible or non-reducible?

A
  • Usually reducible
39
Q

Urgency of indirect inguinal hernias

A
  • Not usually life-threatening
40
Q

Treatment of indirect inguinal hernias

A
  • Typically resolve with manual reduction within a few days

- Can even put a diaper on them to try and squish everything back in

41
Q

Direct inguinal hernia definition

A
  • Parietal vaginal tunic or peritoneum in vaginal ring region TEARS
  • Intestines become positioned under the skin
  • See images
42
Q

Direct inguinal hernias reducible/non-reducible

A
  • Typically not reducible

- Large amount of intestine involved

43
Q

Urgency of treating direct inguinal hernias

A
  • SURGICAL EMERGENCY
44
Q

How would you usually identify an inguinal hernia?

A
  • usually noted by observation or palpation
45
Q

Clinical signs of indirect inguinal or umbilical hernia

A
  • No apparent clinical signs
46
Q

Clinical signs of direct inguinal or umbilical hernia

A
  • May notice direct inguinal hernia where intestines appear under skin
  • very painful and colicky
47
Q

When do inguinal hernias need to go to surgery?

A
  • If strangulation occurs
  • Inability to reduce hernia
  • Increase in hernia size
  • Increase in heat, pain, firmness on palpation
  • Development of colic
48
Q

Treatment of indirect inguinal hernias

A
  • Conservative initially
  • Small hernias usually correct without treatment
  • IMPORTANT to instruct owners to monitor size of hernia and reduce frequently
49
Q

What size hernia are unlikely to resolve on their own?

A
  • Umbilical >5 cm in diameter are more prone to complications and less likely to resolve on their own
50
Q

When is elective surgery indicated for hernias?

A
  • > 7-10cm or ones that have not resolved by 7-10 months of age
  • Or if strangulating hernia suspected, a prompt surgical treatment is required
51
Q

Ectopic ureters how common?

A
  • Not at all
52
Q

Normal ureter anatomy

A
  • Ureters start at the renal hilus
  • Penetrate dorsal wall of the bladder at the trigone
  • Trigone is just cranial to the neck of the bladder
53
Q

Internal urethral sphincter

A
  • Segment in proximal portion of urethra where a smooth muscle layer is augmented with fascicles of skeletal muscle
  • forms a functional sphincter
54
Q

Control of internal urethral sphincter

A

Voluntary

55
Q

Ectopic ureters

A
  • One or both ureteral ostia empty into the bladder, urethra, or some point distal to the functional sphincter
  • Sometimes ureters empty into uterus or vaginal tract
56
Q

Diagnosis of ectopic ureters

A
  • Urine dribbling

- Definitive diagnosis made by ultrasound or cystography

57
Q

Treatment of ectopic ureters

A
  • Reconstructive surgery
  • Or if unilateral, a nephrectomy
  • rarely successful

Equine Medicine Final (10 decks)

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