Basics of Uroperitoneum Flashcards Preview

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Flashcards in Basics of Uroperitoneum Deck (18):
1

causes of uroperitoneum

bladder rupture
leaky urachus (secondary to infections)
congenitcal urinary defects
traumatic defects

2

Bladder rupture happens most commonly in

males
foals between 1-3 days old

3

Clinical signs of Bladder rupture

depressed
distended abdomen
developing colic after 1-3 days of rupture
stranguria
ballottement of abdomen

4

how is Bladder rupture different to impactions?

concave back in Bladder rupture
convex in impactions

5

Typical lab findings with Bladder rupture (and then with older foals)

hyperkalemia
hyponatremia
hypochloremia
azotemia
Increased PCV/TP, stress leukogram
older - DH and metabolic acidosis

6

Pathogenesis of Bladder rupture

milk is high in K and low in NaCl --> kidneys conserve Na/Cl --> urine is highK and low Na/Cl.
rupture - into abdomen --> Na/Cl from plasma goes into peritoneum, K from peritoneum goes into plasma

This causes the lab results

7

Diagnostic tests for Bladder rupture and what we look for...

Abdominocentesis --> periton creatinine:plasma creatinine ratio is 2:1 or higher

NMB test - catheter this stuff, then do the abdominocentesis

rads - fluid and positive contrast
U/S - free fluid
Exploratory

8

Treatment for Bladder rupture

SURGERY. but before, stabilize.

9

when can we go for surgery for Bladder rupture and how much will that be?

after K is

10

Pre-surgery tx for Bladder rupture

saline, 5% dextrose, sodium bicarb
Pen IV, Gent or amikacin
Slow drainage with drain (foley or chest tube)

11

Sx technique for Bladder rupture

traction on bladder and umbilicus
stay sutures
debride edges
simple continuous
cushing or lambert
lavage with warm saline
no. 1 and 2 absorbable for ventral midline
3-0 absorbable SQ
2- non-absorbale for skin

12

Factors affecting Prognosis

if arrhythmia from electrolytes or anes.
re-occurence if suture doesn't hold
Levels of IgG from mother

13

causes of urachal leakeage

septic
premature
hypoxic-ischemic ECopathy

14

When and why do we see uracahl leakage

prolonged recumbency and bladder distention
5-7 days of treatment

15

Clinical signs of urachal leakage

similar but maybe not lab findings to Bladder rupture

16

Why do male foals get Bladder rupture more

narrow and long urethra
pressure urachus

17

What are the muscle layers of the equine bladder?

Everywhere - IC, OL (like the gut)
Dorsal - inner long, outer circular

18

What about Bladder rupture animals makes them bad for surgery?

1. HyperK - arrythmias, AV conduction dist.
2. HypoNa - potentiates the HyperK effects
3. electrolyte, uremia - cardiotoxic