Urinary Tract: Urinary and Urolithiasis Flashcards
How can the urinary system be examined?
- History- how long/ other sigs
- Frequency/ease of urination
- Urine- smell/appearance
- Rectal ecamination- left kidney/bladder
- Catheterisation
- Prepuce
What is normal urinalysis for large animals?
- Colour
- SG- 1.02- 1.045
- pH- normally alkaline
- Protein- usually trace only
- Glucose- usually teace
What are the clinical signs of urinary disease?
- Abdominal pain
- Dysuria
- Haematuria
- Polyuria
- Anuria
- Oliguria
- Proteinuria
What urinary disease do the following clinical signs show?
1. Abdominal pain
2. Dysuria
3. Polyuria
4. Anuria
5. Oliguria
6. Proteinuria
- pyelonephritis, calculi
- pyelonephritis, calculi, cystitis
- diabetes mellitus, diabetes insipiidus, idiopathic in calves
- obstruction by calculi
- prerenal, renal or post renal
- renal amyloidosis
What diseases can cause haematuria?
- Pyelonephritis +pus
- Cystitis
- Urolithiasis
- Enzootic haematuria
- Acute bracken poisoning
- Toxic nephrosis
- Glomerulonephritis, renal infarction
What diseases may cause haemoglobinuria?
Babesiosis- red water
* port coloured urine
Post-parturient haemoglobinuria
Bacillary haemoglobinuria- clostridium haemoliticum
- What is hypospadia?
- What is a patent urachus?
- Failure of closure of male urethra- usually fatten fine
- Urine from the ummbilicus
- What agents may cause pyelonephritis?
- What can it be secondary to?
- Corynebacterium renale clasically or E.coli- usually sporadic
- Secondary to trauma
Ascending infection usually
What are the clinical signs of pyelonephritis?
- Chronic weight loss
- ± mild pyrexia
- Appetits usually ok
- Dysuria
- Blood and pus in urine
- Examine rectum- painful swollen kidney, bladder, ureter
What do these images show?
Pyelonephritis
How is pyelonephritis treated?
Long course ABs
* penicillins, oxytet
C.renale- sensitive to most ABs
E.coli- may not be
1/3 get better, 1/3 recur, 1/3 never get better
- What is often associated with cystitis?
- What can it be secondary to?
- What is the clinical sign?
- How is it treated?
- Pyelonephritis
- Secondary to dystocia
- Straining more pronounced
- ABs as for pyelonephritis
- What can amyloidosis be secondary too?
- What are the clinical signs
Secondary to other chronic infections
Clinical signs
* off food and ill
* profuse diarrhoea
* generalised sub cut oedema
* PUPD
* proteinuria
* low plasma albumin
* pale swollen kidneys
What can cause enzootic haematuria?
What lesions are found
Associated with long term ingestion of braken
- Haemangiomata in bladder
- ‘teart pastures’ high molybdenum
- Blood clots in urine
- Tumour in guts- squamous cell carcinoma
How does long term ingestion of braken poisoning show?
- Bright blindness- sheep retinal atrophy
- Enzootic haematuria- long term ingestion
- Gut tumours- sheep and cattle- long term
How does acute braken poisoning present?
- Bone marrow toxicity
- Pancytopenia
- Thrombocytopenia
- Petechiae in mouth, conjunctive, vulva
- Subcut bruising
- Blood clots- nose, faeces
- Pyrexia and depression
- Diarrhoea
- Haematuria
- Death
What more commonly causes toxic nephrosis in cattle?
Oak acorn poisoning
Tannins in acorns cause kidney damage
How does toxic nephrosis present?
How can it be treated?
- Anorexia, depression
- Bloat due to ruminal stasis
- Constipation and straining
Death in 4-7 days
Charcoal, rumenotomy can be done
move other animals
- Where in the country is affected by bacillary haemoglobinuria?
- Where is it found in the environment and in the animal?
- What triggers spores?
- What are the clinical signs?
- How is it controlled?
- Wet, high pH pastures- southwest
- In soil, dormant in liver
- Migrating fluke
- Pyrexia, jaundice, anaemia, oedema- fatal
- Vaccinate (black disease), fluke control
Clostridium haemolyticum
- What agentcauses redwater?
- What parasite carries it?
- When are clinical signs seen?
- Babesia divergens
- Tick-borne
- Older non-immune animals- usually moved into the area
What affects epidemiology of redwater?
- Premunity- infection when young
- ticks- spring/autumn rise
- rented grazing- novel exposure
What are the clinical signs of red water?
- Pyrexia
- Anaemia and haemoglobinuria
- Diarrhoea
Later- constipated, temp falls, anaemic/jaundice
How is babesia diagnosed?
- Blood smear- capillary blood from ear
- Thin smear- look at edges
- Parasites in RBC
- Evidence of anaemia
ELISA- assess herd exposure
How can babesiosis be treated?
- ‘Imzol’- imidocarb- licensed in the UK
- 213 d meat, 21 milk withhold
- Inform DVM
- Easy to overdose
- Supportive therapy- blood transfusion, fluids
What is the aetiology of post parturient haemoglobinuria?
Low phosphorous diet
* lush spring grass and sugar beet pulp
Kale, rape, turnips
What are the clinical signs of haemoglobinuria?
How is it treated?
- Sudden onset
- Collapse, dyspnoea and death
- Haemoglobinuria, pallor, jaundice
Treated
* Phosphorus
* Blood transfusion
Describe a blood transfusion?
One transfusion is safe
* Sodium citrate- anticoagulant
* Choke-rope to raise jugular
* Jugular trochar 10 or 12G
* 5 litres
* Collect into winchester bottle or empty wormer bottle
Describe a blood transfusion?
One transfusion is safe
* Sodium citrate- anticoagulant
* Choke-rope to raise jugular
* Jugular trochar 10 or 12G
* 5 litres
* Collect into winchester bottle or empty wormer bottle
What are the most common presentations of uroliths of ruminants?
- 2-4 month old rams
- Mature goats castrated in first few days of life
- Bull beef calves
Usually Calcium/magnesium ammonium phosphate
What are uroliths in ruminants associated with?
- Ca:P imbalance in diet
- High concentrate
- Water deprivation
- Interactions- forage quality and concentrate intake
- History of diet change in mature animals
- Innapropriate material used in feeds- pig nuts for goats
What are the clinical signs associated with calculi?
- Restlessness- mild to severe
- Abdominal pain (kicking) and straining (hiccups)
- Dysuria or anuria- dry floor
- Preputial crystals
- Progressive till urethra and/or bladder ruptures
- Bladder rupture- initially brighter- high urea and creatinine
What does this image show?
Water belly
Rupture of urethra accumulating
What is the main idiopathic differential for calculi?
- Bloodless castrators- burdizzo
- Rupture urethra
- Water belly
What animals cocks are these?
Horse
Cow
Sheep
Goat
How is urolithiasis diagnosed?
Abdominal palpation
* distended bladder
* free fluid wave
* s/c fluid- piting, colour of skin
Hair on ventral abdomen- sand around prepucial orifice
Examination of penis
Radiography ± contrast
US- S/C tissue, free fluid in abdomen, bladder, kidnet
Abdominocentisis
Palpate urethra per-rectum
Blood sample- urea/creatinine, postassium, PCV, total protein
How is urolithiasis treated?
- Relaxants- buscopan or xylazine
- Always used but little use
- Casualty slaughter- unlikely to pass
How is urolithiasis treated?
- Relaxants- buscopan or xylazine- Always used but little use
- Casualty slaughter- unlikely to pass
Approach if exploring
* Cut vermiform appendage if palpated
* Stabilise i/v fluids
* Exteriorise penis- palpate to feel calculi
* Catheterise urethra?- difficult
Flush with local and walpoles solution (dissolves stones)- valuable rams
* Percutaneous bladder catheterisation- flush as before
* Urethrostomy
Describe the process of a urethrostomy
- Standing and epidural anaesthesia
- Midline incision from 4 inch below anus
- Identify penis and blunt dissect
- Transect penis distally to leave a 4 inch proximal stump
- Suture stump to skin- not through urethra
How is water belly treated?
- Incise skin in multiple sites to produce drainage
- Necrosis, slough off and re-epithelialise
- Bath/spray
- AB?
- Fly?
How is urolithiasis prevented/recurrence prevented?
Urinary acidification
* Ammonium chloride
* Acid sodium phosphate
Check diet
* Mixing diet
* Source of minerals
* Growing rams- not added magnesium
* Calcium chloride or ammonium chloride in lamb creep
* Ca:P ratio 1.2-2: 1
