Urology I Flashcards
What is the only antiinflammatory used for urinary obstruction/ rupture in small ruminants?
Flunixin meglumine
What is one of the biggest clinical signs of leptospira infections?
Abortions
What are some abnormal enlargements in the urethral area of males?
Hematomas, ruptured urethra/ “water belly”
What tool can you use to perform a vaginal exam on a cow, ewe, doe, sow/gilt?
A vaginal speculum
For what types of ruminants is a radiograph most useful?
In young or small ruminants
What is normal micturition like in the cow? Bull?
Cows –> urinate after standing up/ eating/ walking/ lying down, arched back, raised tail, straddled legs
Bulls –> arched back, raised tail, dribbling/ short pulsating urine
abnormal posture may indicate problem
How can you make a patient urinate to collect a sample?
Cows - stimulate vulva (“feather”) or catheterize
Bulls/steers - preputial massage (may or may not work), don’t catheter
Ewes - hold nose
Can use Lasix but will dilute urine SG
Which kidney is palpable rectally?
Left kidney
- Found between 3rd-5th vertebra mobile
- Smooth in goats, sheep, and pigs
- Lobulated in cows
How do you palpate the urinary bladder in cattle vs small ruminants?
Rectally in cattle
Abdominally in small ruminants
What is the normal viscosity of ruminant urine? Color? Transparency? Odor?
Viscosity - watery
Color - straw/ amber, no abnormal proteins
Transparency - clear/ transparent, turbid/ cloudy not normal
Odor - ketones or strong ammonia abnormal
What is the normal range of a specific gravity for ruminant urine? pH?
1.020 - 1.040
pH 7.0 - 8.0 (acidic with ketosis, lactic acidosis basic)
What are some causes of red urine?
Hematuria - pyelonephritis, cystitis, urolithiasis, enzootic hematuria, embolic nephritis
Hemoglobinuria - Leptospirosis, bacillary hemoglobinuria, copper toxicity, post-parturient hemoglobinuria, cold water
intoxication
Myoglobinuria - Cassia toxicity, capture myopathy
** anaplasmosis results in normal colored urine**
What is the normal urea and creatinine levels in the cow?
BUN - 10-30 mg/dL
Creatinine - < 2 mg/dL
–> tends to increase faster due to urea reuptake in rumen
What is obstructive urolithiasis?
- Condition in (usually castrated) males where urethra is blocked –> can be life-threatening
What causes Struvite or Calcium Phosphate obstructive urolithiasis?
◦ High concentrate diets ◦ Diets high in calcium, magnesium, and/or phosphorus ◦ Low Ca:P ratio ◦ Pelleted rations ◦ Vitamin A deficiency
What causes calcium carbonate/ oxalate obstructive urolithiasis?
Legumes Oxalates ◦ Apples ◦ Sweet potatoes ◦ Dock ◦ Pigweed
What are some causes of high urine pH?
Herbivorous diet, high protein diets, UTI
What might reduce water ingestion by a ruminant?
Dirty water
Cold weather
Other diseases
What factors can predispose ruminants to obstructive urolithiasis?
Sigmoid process, urethral process in small ruminants (MOST COMMON SITE OF BLOCKAGE), early castration, exogenous estrogens/ growth hormones
What are the most common site of blockage from OU?
Urethral process/ vermiform appendage/ pizzle, followed distal sigmoid flexure
What is another name for Mg NH+ PO4? CaPO4?
Mg NH+ PO4 = STRUVITE
CaPO4 = APATITE
What 3 syndromes can occur from stones lodging at the urethral process or sigmoid flexure? What can prolonge partial obstruction lead to?
- Urethral obstruction
- Urethral rupture
- Bladder rupture
Partial obstruction –> hydroureter, hydronephrosis, bladder wall damage, urethral strictures
What urologic condition can be mistaken for constipation?
Stranguria
What are the clinical signs of urethral obstructions?
Stranguria - (often mistaken for constipation)
Urethral pulsations without urination
Anorexia, mild bloat, lethargy
Treading, stretching, kicking @ abdomen
Tail switching
Vocalization (especially goats)
Palpable bladder distention
◦ Abdominal palpation in small ruminants
◦ Rectal palpation in large ruminants
Azotemia
What clin path abnormalities would you see with a urethral obstruction?
+ Elevated creatinine
+ Hyponatremia
+ Hypochloremia
± Hyperkalemia
BUN normal until late
Creatinine of abdominal or SQ fluid 1.5-2 times serum
What clinical signs would you see with a ruptured urethra?
Ventral and preputial edema
Aspirated fluid smells like urine when heated
Signs of uremia
In chronic cases, skin and SQ tissues begin to slough
Preputial adhesions
What clinical signs would you see with a ruptured bladder?
Pain may subside
Gradual abdominal distension
Depression and anorexia
Signs of uremia
Large amounts of abdominal fluid with abdominal ultrasonography
Clear fluid on abdominal tap
How can you medically treat urethral obstructions?
- Phenothiazine, fluids (give dextrose if hyperkalemic), slowly drain uroperitoneum with trochar in ruptured BLADDER, make paramedian skin incision to drain ruptured URETHRA
Antibiotics
Urinary acidifiers
Need flunixin meglumine and meloxicam
How can you surgically manage urethral obstructions?
- Amputation of the urethral process (small ruminants)
- Urethral catheterization / retrograde flushing
- Perineal urethrostomy
- Tube cystotomy
- Ischial urethrostomy
- Cystostomy
–> can give Acepromazine (antispasmodic) to control urethral swelling
How should you prepare giving a urinary catheter to treat obstructive urolithiasis?
- Give 1 part 2% lidocaine to 3 parts water for pain
- Bladder catheterization difficult due to suburethral diverticulum
How can you lavage a urinary bladder?
- Walpol’s solution (glacial acetic acid)
- Under anesthesia, titrate until bladder contents are acidic
What surgical procedures would you use on an animal going to slaughter?
- Urethrostomy, penile amputation, urethrotomy at site of obstruction
What surgical procedures would you use on an animal used for breeding or a pet?
Tube cystostomy or bladder marsupialization
How do you treat urethral rupture?
Urethrostomy, penile amputation, tube cystostomy,
–> need skin incisions for urine drainage
How do you treat ruptured bladder?
Tube cystostomy for breeding animals/ pets
Urethrostomy with catheter for food animal, can also do perineal or ischial urethrostomy
How can you prevent stone formation?
Delay castration as long as possible
Recommend females for pets
Give more water, avoid grain or have low grain diet
Keep Ca:P ratio at 1.5-2.1
Give proper Ca, P, Mg and avoid excess protein
Give urinary acidifier –> ammonium chloride with syrup
What are the clinical signs of UTI/ Pyelonephritis?
Ill thrift
Fever
Vague colic signs
Stranguria
Purulent or blood in urine
What generally are good options for treating UTIs/ Pyelonephritis?
Penicillin and B lactams (cephalasporins)
Diuresis also necessary
What is the causative agent of Contagious Bovine Pyelonephritis?
Corynebacteria renale
Occurs via ascending urinary infection
CS include
• Hematuria, pollakiuria, pyuria
• Thickened bladder wall, enlarged ureters, painful kidney
Treatment: High doses of penicillin for 2 weeks, nephrectomy if only one kidney involved
Prognosis = poor
What causes ulcerative posthitis and vulvitis?
C. renale converts urea to ammonia in high protein diets resulting in skin irritation, swelling, stenosis, phimosis in males, vulvar commisure distortion in females
angora and merino sheep most affected
How do you treat ulcerative posthitis and vulvitis?
Debride, dry site/ environment, give penicillin, reduce protein consumption
- Can give Petercillin –> lanolin, scarlet oil, oxytetracycline
What is necrotic posthitis?
Acute necrosis of prepuce in bulls and steers, usually in wet feedlots resulting in F. necrophorum infection
How do you treat necrotic posthitis?
Debride and give AB ointment, penicillin, keep environment dry
Prognosis is good if caught early, strictures occur if disease progresses
What is the causative agent of “thin sow syndrome”?
Corynebacterium suis
- Causes cystitis, pyelonephritis
- Transmitted venerally from boar –> treat with penicillin
What are the clinical signs of Leptospira pomona and grippotyphosa?
Severe hemolytic disease
Interstitial nephritis (may persist)
Tubular necrosis in calves
How do you diagnose Lepto?
Microscopic agglutination test (MAT) not good for L hardjo
• Phase contrast microscopy, dark-field microscopy,
immunoflourescent
antibody test, & PCR can be performed on renal tissue, urine, or urine sediment.
• Culture is difficult and vaccine titers may alter result
How do you treat lepto?
- Tetracyclines/ penicillins/ long-term oxytetracyclines for herd health
Prevention: Vaccination is good, avoiding standing water, remove rodents/ wildlife, zoonotic
How does embolic nephritis occur?
- Secondary to bacteremia or septicemia –> bacteria cause infarcts in kidneys
- Can be incidental –> need large lesions for clinical signs
- Treat with antibiotics
What metals are nephrotoxic?
Arsenic Mercury Lead Zinc Copper
What antimicrobials are nephrotoxic?
Aminoglycosides Tetracyclines Sulfonamides Ionophores NSAIDs
What plants are nephrotoxic?
Amaranthus retroflexus (pigweed)
Lilium (Earth lily)
Quercus (Oak)
Xanthium spp (Cocklebur)
What other substances can cause nephrotoxicity?
Ethylene glycol
Vitamin C overdose
Vitamin D overdose
Mycotoxin (ochratoxin)
What clinical signs pigweed cause?
Perirenal edema/ kidney pathology
Unknown toxic principle
Death occurs because of hypokalemia
No treatment, just avoid exposure
What causes bovine enzootic hematuria?
- Bracken fern
- Can lead to intermittent hematuria and bladder neoplasia (TCC)
- No treatment, avoid if possible
What part of the oak tree are toxic?
- Oak buds and acorns –> toxins are tannins or gallotanins
- Hepato/nephrotoxic, gastroenteritis, hemorrhage, edema, renal lesion
What is renal amyloidosis and what causes it?
- Amyloid deposition into tissues due to chronic antigenic stimulation
- CS include hypoproteinemia, proteinuria, edema, diarrhea (resembles Johne’s disease)
- No treatment
What is patent urachus?
Congenital condition following C-section or (more rarely) as a primary defect or infected umbilical remnants
What is a urachal abscess?
A congenital defect that:
• Usually located at proximal end of urachus
• A. pyogenes, E. coli, Streptococcus spp, Staphylococcus spp
• Often requires surgical resection.
• Develops within first 1-2 weeks of life
What is polycystic kidney?
A congenital defect where:
• Usually unilateral. Other kidney compensates masking clinical signs
• If bilateral, calves are usually stillborn or die shortly after birth
• Commonly found on necropsy. Kidney is enlarged with a few large cysts or
several small cysts
What is renal oxalosis?
Congenital condition where:
• Cows exposed to excess oxalate levels deposits in fetal glomeruli, tubules, &
collecting ducts
• These neonates also usually have cardiac and/or musculoskeletal defects as
well
What are urachal vestiges? Clinical signs? Treatment?
• Persistent or infected urachus
• Signs include dysuria, pollakiuria,
stranguria
• Treatment by surgical removal
What are some neoplasia of the urinary tract and where do you find them?
External genitalia
• Fibropapilloma
• Squamous cell carcinoma
Kidney
• Lymphosarcoma
• Adenoma
• Nephroblastoma
Bladder
•Transitional cell carcinoma
