Uroliths/Umbilicus/Bladder - Bauck

Question 1

Urachus carries

Answer 1

Urine from bladder to allantois

Question 2

Urachus normally closes

Answer 2

after birth

Question 3

In foals with patent urachus, may or may not have

Answer 3

omphalophlebitis

Question 4

patent urachus medical tx

Answer 4

Silver nitrate cautery

Question 5

patent urachus sx

Answer 5

cystoplasty

-umbilical resection

Question 6

cystoplasty indications

Answer 6

(umbilical resection for urachus)

1. Recommended if no decr urine leakage 5-7 days of medical therapy
2. U/S reveals abnormality multiple structures in umbilicus

Question 7

Omphalophlebitis

Answer 7

infected umbilical remnants

• ush from patent urachus, even if it has closed by presentation
• tx is cystoplasty

Question 8

Co-morbidities omphalophlebitis

Answer 8

1. Septicemia
2. Fever
3. Swollen (septic) joints

Question 9

Omphalophlebitis DX

Answer 9

1. U/S
2. Bloodwork
3. CS

Question 10

Hepatic vein becomes

Answer 10

falciform ligament

Question 11

Umbilical arteries become

Answer 11

round ligaments of the bladder

Question 12

If infection in umbilicus extends to liver

Answer 12

• can’t remove it entirely

- have to marsupialize the vein

Question 13

Uroperitoneum

Answer 13

1. Usually from ruptured bladder at parturition
   - more common males
2. tears on dorsal aspect of bladder usually

Question 14

Uroperitoneum CS

Answer 14

1. Foal does well for 24-48 hours

2. CS develop, colic, arrythmias, neuro defects, abnormal urination

Question 15

Uroperitoneum DX

Answer 15

1. U/S
2. Abdominocentesis
3. Electrolyte abnormalities

Question 16

Uroperitoneum bloodwork

Answer 16

1. hyponatremia
2. hypochloremia
3. hyperkalemia
4. azotemia

Question 17

Uroperitoneum creatinine

Answer 17

Peritoneal fluid : serum = > 2

Question 18

Two common DDX neonate with colic

Answer 18

1. Meconium impaction

2. Ruptured bladder

Question 19

Preop consid uroperitoneum

Answer 19

1. Correct hyperkalemia (goal K+ conc < 5.5 mEq/L

2. Drain abdomen

Question 20

Correcting hyperkalemia

Answer 20

1. Calcium gluconate IV
   - antagonized adverse myocardial effects of hyperK
2. Potassium free fluids
   - 0.9% NaCl
3. 5-10% IV dextrose
   - stimulates release insulin=> drives K+ back into cells

Question 21

Uroabdomen tx

Answer 21

1. Repair bladder if defect
2. Remove Umbilicus
   * Urachus may also be ruptured
   * May have to do some debriding

Question 22

Urolithiasis types

Answer 22

I. Calcium Carbonate - rough

II. Smooth

Question 23

Role of UTIs in development of urolithiasis in horses

Answer 23

unclear

Question 24

Stones more common in

Answer 24

males

-Usually at neck of bladder

Question 25

Urolithiasis DX

Answer 25

1. CS - stranguria, pollakiuria, pyuria, incontinence, recurrent colic, stilted hindquarter gate 2. Rectal palpation 3. CYSTOSCOPY - gold standard

Question 26

Stranguria

Answer 26

Slow, painful, urination

Question 27

Pollakiuria

Answer 27

Frequent urination small amounts

Question 28

Polyuria

Answer 28

Large amounts urination

Question 29

Tx of uroliths

Answer 29

1. Cystotomy (caudal midline or parainguinal approach) 2. Laparocystotomy 3. Perineal urethrotomy (PU) + lithotripsy

Question 30

Dietary management in horses

Answer 30

Not very successful

Question 31

Lithotripsy methods

Answer 31

1. Long regular slotted screwdriver-readily available 2. Lithotrite-not available 3. Laser-too time consuming, rarely done

Question 32

After lithotripsy with screwdriver

Answer 32

removal large frags with sponge forceps, lavage

Question 33

Ureteral calculus

Answer 33

Renal/ureteral calculi rare - not usually diagnosed until CKD - Can attempt nephrotomy or ureterotomy for removal