Urolithiasis in Ruminants and Camelids (Carman) Flashcards
(T/F) Ruminant urine is normally alkaline, due to their hay-based diet
True
___________ urine is a predisposing factor for precipitation of many different crystal types
Alkaline
Ruminants or camelids on high grain diet will have a urinary pH _______ than those on hay-only diets
Lower
(T/F) Since ruminants have an alkaline urine pH, trace or 1+ protein is considered to be positive using urine dipsticks
False, False positive
What are some of the drugs that can cause glucosuria un ruminants?
Alpha-2 agonists such as xylazine
List predisposing factors for the development of clinical urolithiasis in ruminants/camelids:
- Male
- Inappropriate Ca:P
- should be 2:1
- High phosphorus diet -> Grain
- High calcium diet -> Alfalfa - Poor water management/ Weather
What helps male ruminants develop wider urethral diameter?
Testosterone influence (age)
What age range of animals is less likely to develop Ca carbonate type stone?
Young ruminants
(T/F) Female>Males ruminants have longer, narrower urethra
False
(T/F) Silicate & oxalate stones are common in Ohio
False
(T/F) In both males and females, they have a urethral diverticulum
True
In males, what are the two most common places where stones will get lodged and cause a problem?
- Urethral Process
- Distal Sigmoid flexure
What is the following describing?
- Blind Pouch
- Ischial arch
- Retrograde passage of the urinary catheter
- <50% success
- Ball-valve effect
Urethral diverticulum
What is the following describing?
- Extension of the urethra at the distal tip of the penis
- Narrowed diameter
- Young animals may adhere to the prepuce
- Amputation of process
- Often first step in tx
- no effect on breeding
Urethral process
What is the following describing?
- Site for retractor penis mm. insertion
- Tight turn, decreased diameter
Distal Sigmoid flexure
What are the two stones most commonly seen in Ohio?
- Struvite
- Calcium Carbonate
What is the following describing?
- Magnesium ammonium phosphate
- Conditions
- Diets high in P, low in Ca (low Ca:P)
- Alkaline urine
- “coffin lid” crystals
- gritty white-tan sand
- NOT radiopaque
Struvite
What is the following describing?
- Formed preferentially with high calcium ingestion
- spherical
- RADIODENSE
- Survey radiographs help w/ tx plan
- CaCO3
Calcium Carbonate
What is commonly mistaken for struvites?
- Can be problematic for treatment/prevention recommendation
Amorphous magnesium calcium phosphate (AMCP)
In relation to bloodwork diagnostics, what is going to give you the most information?
A chemistry
- +/- dehydration
- Azotemia
- Abnormal K
- decreased P
- decreased Na
- decreased Cl
What are some values that you would most likely see in a Urobdomen?
- increased PCV/TP
- increased BUN & creatinine
- increased K
(T/F) Hyperkalemia is not an emergency
False
Treatment of hyperkalemia:
- NO direct effect on K+, but it is cardioprotective
- Calcium can counteract the bradycardia by shifting the membrane potential to be less negative, making it more excitable and easier to contract
Calcium gluconate
Treatment of hyperkalemia:
- Will encourage the pancreas to produce insulin in response to extra glucose
- Insulin will drive potassium into the cell through the action of the Na+/K+ ATPase pump
IV dextrose
Treatment of hyperkalemia:
- Can be given, directly stimulating the action of the Na+/K+ ATPase pump and pumping K+ ions
Insulin
Treatment of hyperkalemia:
- Can affect K+ in two ways:
- increases blood pH, K+ moves into the cell via the H+/K+ exchanger so that pH neutrality can be maintained by adding an acid molecule to the system
- Increased blood pH facilitates K+ excretion in the urine
Sodium bicarbonate
Treatment of hyperkalemia:
- Will encourage renal potassium excretion in small amounts
- Dilution is the solution to pollution!
Diuresis
Diagnostic - imaging
- about 85% of cases
- Assessment of bladder size, rupture
Ultrasound
Diagnostic - imaging
- about 60% of cases
- Radio-opaque vs radiolucent stones
Plain radiography
What are the treatment goals?
- Stabilize
- Allow for decompression of the bladder
- Diuresis/ waste removal
- Restore functionality to the urinary tract
Regarding treatment options, what do we do in every case?
Urethral process amputation
What treatment option will you consider for the following:
- Intact urethra, complete obstruction
- Tube cystostomy
- PU = perineal urethrostomy (inappropriate for breeding males)
- Urethrotomy
What treatment option will you consider for the following:
- Intact urethra, partial obstruction
- Medical management
- Tube cystostomy
- PU
What treatment option will you consider for the following:
- Urethral rupture
- Tube cystostomy
- PU
Medical management
- Only works for dissolvable stones
- Ammonium chloride (can be a risk)
Urine Acidification
Medical management
- Acepromazine
- Midazolam
Urethral relaxation
(T/F) 80%-90% of these animals are still “blocked” after a urethral process amputation
True
A ruminant on a high-grain diet will be predisposed to forming this type of stone
Struvite
A ruminant on a diet of primarily alfalfa will be predisposed to this type of stone
Calcium carbonate
This type of stone can easily be confused for struvite on a macroscopic level
Amorphous magnesium calcium phosphate
