Flashcards in Bovine hematuria and hemoglobinuria Deck (116):
How do you differentiate hematuria and hemoglobinuria/myoglobinuria?
spin down the urine
hematuria when centrifuged leaves clear supernatant
What will you find with myoglobinuria that does not occur with hemoglobinuria?
increased CK, AST
Where might blood in the urine arise from?
What are differentials of hematuria?
1. urethra: caluli, trauma, urethritis
2. bladder: bracken fern, cystitis, papilloma, neoplasia, calculi, polyps
3. kidney: pyelonephritis, infarction, trauma, malignant catarrhal fever, endotoxic shock
What are the major calculi in ruminants?
1. struvite--seen in feed lot--phosphatic on grain based diets
3. calcium carbonate--most comon on lush clover pasture
4. calcium oxalate: idiopathic
Who is most likely to get urinary calculi?
When do urinary calculi occur?
when high mineral concentratrions in urine overwhelm crystallization inhibitors
What forms a matrix for calculus formation?
How are calculi diagnosed?
2. colic and straining to urinate
3. enlarged ureter or urethra (rectal exam, urethra pulsing without urination)
4. post renal azotemia
How are calculi diagnosed?
2. salvage if not uremic
3. medical (tranquilizer, NSAID, IV fluids)
4. Walpole's solution (acetic acid)
How are struvite crystals prevented?
1. increase long stem forage in diet (hard to convince in feedlot)
2. 3-5% salt in feedlot diets
3. ammonium chloride (alkalinize the urine) but reduces palatability
How do you prevent silica calculi?
sodium or ammonium chloride
What is urethral trauma commonly associated with?
What is bacterial urethritis sometime sassociated with?
What does bacterial urethritis suually manifest as?
hemospermia. treated by rest from reprod acitvity and antibiotics that concentrate in urine like penicillin
What are the clinical signs of bracken fern poisoning?
bladder wall thickneing, tumors
blood and clots in urine
anemia may be present
what is the cause of enzootic hematuria?
pteridium aquilinum (braken fern)
What are the toxic agents of pteridium aquilinum toxicity?
ptaquiloside, quercetin, A ecdysone
What is the treatmetn for braken fern?
supportive care, removal of braken fern from diet
Who most commonly gets cystitis?
What are the common etiological agents of cystitis?
C. renale, or e. colie
is grosshematuria common with cystitis?
What are common clinical signs of cystitsi?
3. decreased urinary flow rate
4. thickened bladder wall
What is a good treatment for cystitis?
penicillin, actually gets such high levels in urine that can get e. coli
Who does pyelonephritis usually affect?
Are animals systemically ill with cystitis? what about pyelonephritis?
What are the clinical signs of pyelonephritis?
systemic clinical signs
smooth enlarged painful kidney occasionally palpable on rectal
What is the treatment for pyelonephritis?
antibiotics (penicillin) and supporitve care
What is the prognosis for pyelonephritis?
What are the most common causes of renal infarction?
dehydration and/or NSAID treatment
What occurs with renal infarction?
acute tubular necrosis, primarily at loop of henle
What are the clinical signs of renal infarction?
polyuria, anuria, dysuria
renal azotemia on blood work
What is the treatment for renal infarction?
resotration of adequate renal perfusion--fluids
What is hemoglobinuria caused by?
What is the issue of hemoglobin and the kidney?
nephrotoxic and causes renal damage
What are the bacterial causes of hemoglobinuria?
What are the parasitic causes of hemoglobinuria
What are the immune causes of hemoglobinuria?
1. neonatal isoerythrolysis
What are the causes of heinz body (cause of hemoglobinuria)
3. molybdenum deficiency
4. selenium deficiency
What are 3 micellaneous causes of hemoglobinuria?
3. post partum
What causes bacillary hemoglobinuria?
clostridium hemolyticum (C. novyi type D)
Where do spores of clostridium haemolyticum go?
to the kupffer cells of liver
What is clinical disease of bacillary hemoglobinuria exacerbated by?
liver fluke infestation
What are the clinical signs of bacillary hemoglobinuria?
1. sudden death
4. blood in feces
5. red urine
6. blood is usually thin, water and slow to coagulate
How is diagnosis made for bacillary hemoglobinuria?
1. necropsy--gram stain of liver impression
2. FAT on liver
How is bacillary hemoglobinuria treated?
rarely attempte because acute/fatal. could try penicillin
What should you do with bacillary hemoglobinuria carcus?
What provide protection against bacillary hemoglobinuria?
most 8 ways vaccines
Is leptospirosis a zoonosis?
Is leptospirosis common in western canada?
What are the three leptospira species that cause renal disease?
1. L hardjo
2. L pomona
3. L gripptophyosa
What are the clinical signs of leptospirosis?
1. repro failure
4. occasionally hemoglobinuria
HOw is diagnosis of lepto mde?
How is lepto traeted?
penicillin, oxytetracylcine but careful using oxy in animal with impaired renal function
What is prevention of lepto?
1. avoid stnading water
2. screen animals before enter herd
3. control rodents
4. vaccine is good
Who is more susceptible to copper intoxiciation?
What is the pathogenesis of copper intoxication?
liver copper accumulates, once a certain level there is a massive release of copper.
What is the most common history of copper intoxication?
small ruminant fed a cattle mineral
What is treatment for copper intoxication?
supportive care (blood transfusion)
chelation therapy with D-penicillamine or ammonium tetrathimoybdate if available
What can exacerbate copper intoxication?
When does heinz body anemia occur?
exposure to oxidizing agents such as phenothiazines, methylene blue, onions, brassicas or molybdenum or selenium deficiency
What are clinical signs of heinz body anemia?
How is heinz body anemia diagnosed?
ID heinz bodies in blood smears stained with methylene blue, wrights or crystal violet
Why should you not ix blood smears with methanol?
will inhibit stain uptake
What are hemoparasites in cattle?
eperythrozoon (e. weyoni, e. ovis)
What is neonatal isoerythrolysis associated with in ruminants?
vaccines of blood origin (babesia, anaplasma) (there ar eno blood based vaccines currently available in canada)
What is post-parturient hemoglobinuria?
a sporadic syndrome characterized by intravascular hemolysis, hemoglobinuria, anemia which occurs in first month post partum
related to hypophoshpatemia
treatment consists of supportive care and phosphate supplementation
(phosphite does nothing to phosphate concentrations)
What is water intoxication?
large amounts of water will cause RBCs to become osmotically fragile resulting in haemolysis
exacerbated by cold water
clinical signs: associated with large scale haemolysis--neuro signs, hemolysis
How can you classify hemorrhage?
1. acute: internal/external
2. chronic: bleeding GI lesion, renal
What can cause acute externa hemorrhage?
1. surgery: e.g. dehorning and castration
2. trauma: external laceration
What is the treatment for acute external hemorrhagg?
1. surgery to close vessel
2. wund management
3. supportive care (blood transfusion, fluid and electrolyte therapy)
What are the clinical signs of anthrax?
1. sudden death
2. clinical signs may include hematuria and/or bloody diarrhea
What should you do with a suspected anthrax case?
1. blood smear
2. do not open carcass
3. saskatchewan anthrax response plan
4. call provincial chief vet officer
What can cause internal hemorrhage?
1. splenic rupture (trauma)
2. middle uterine artery rupture (spontaneous, sporadic, usually following uterine prolapse)
3. blood vessel erosion
What can cause blood vessel erosions
1. abscess, neoplasia, mycotic
2. caval syndrome following rumen acidosis
How is internal hemorrhage diagnosed?
1. anemia by hypoproteinemia
3. abdominocentesis--not very rewarding in cattle
What is the treatment for internal hemorrhage?
1. may have to attempt surgery
2. anesthetic risk
3. treat shock
4. blood transfusion
What are causes of bleeding GI lesions?
1. abomasal lymphosarcoma
3. parasitism (type II dz, post hemonchus treatment--not most common treatment of hemonchus)
How are bleeding GI lesions diagnosed?
1. melena may not always be present
2. fecal occult blood
3. perform fecal occult blood test BEFORE rectal exam
What are features of abomasal lymphosarcoma?
1. may cause bleeding into abomasum
3. intenral iliac LN may be enlarged on rectal
4. large tumor may be palpable on rectal
5. abdominal exploratory surgery may help
6. seropositive does not equal tumour
Type 2 abomasal ulcers associated with what?
significant blood loss
What are clinical signs of abomasal ucleration
What is treatment for abomasal ulceration?
1. supportive care
2. surgery? antacids?
What is type II disease?
hypobiotic larvae excyst and may cause severe disease with hemorrhage into abomasum and melena
What are renal causes of bleeding?
1. bracken fern
2. rare causes include: neoplasia, renal vascular anomalies
What are signs of renal cause of bleeding
blood observed in urine
What are inherited hemostatic dysfunction disorders?
1. factor VIII (hemphilia, sex linnked, recessive)--holstein, hereford
2. factor XI (autosomal, recessive)
simmental hereditary thrombopathy: autosomal recessive primary platelet disorder
Why are inherited hemostatic dysfunctions not common in dairy cattle?
lots of genetic testing esp of bulls
What measures intrinsic pathway?
What are causes of aquired hemostatic dysfunction
4. warfarin toxicosis
5. moudly sweet clover
What are causes of vasculitis?
secondary to some septicemias--malignant catarrhal fever, blue tongue
What are clinical signs of vasculitis
petechiae, ecchymoses, hmoerrhages may occur anywehere
other signs: edema, skin infarction, lameness, colic, dyspnea, ataxia
How is vasculitis definitively diagnosed
How is vasculitis treated?
treat primary cause
What are the mechanisms of thrombocytopenia?
1. decreased production
(IMPORTANT TO KNOW)
What are clinical signs of thrombocytopenia
petichiae and ecchymoses
prolonged buccal mucosal bleeding time
spontaneous GI or renal bleeding
tendancy to bleed with minor trauma, venipuncture
ischemic organ damage
What are the two most common causes of thrombocytopenia?
1. bovine viral diarrhea
2. bovine leucosis virus
What does DIC usually follow?
usually following sepsis
What does DIC require?
a thrombotic stimulus:
increased pro-coagulant activity
-->increased and unregulated procoagulant acitvity
What occurs due to DIC?
Dysregulated thrombotic stimulus
Formation of multiple thrombi
Ischaemic damage and consption of prothrombotic factors
Production of FDPs
ischaemic organ damage
HOw do you diagnose DIC?
numerous hemostatic tests will be abnormal
What is treatment of DIC?
(maybe flunixin meglumine, treat sock, plasma/heparin therapy? avoid glucocorticoids?)
How does warfarin toxicosis occur?
1. usually ingested rodenticide
2. competitive inhibitor of vit K
3. vit K dependent clotting factors II, VII, IX, X affected
4. half life VII is shortest so PT increased
HOw does warfarin toxicosis manifest?
increased or spontaneous bleeding
What is the treatment of warfarin toxicosis?
vit K supplementation
Where is mouldy sweet clover usualyl found?
hay or silage
What is the toxic agent of mouldy sweet clover?
What does dicoumarol do?
interfere with synthesis of vit K synthesis
What are signs of mouldy sweet clover poisoning?
increased bleeding, may develop hematomas
What are the indications for blood transfuions in ruminants?
Is cross-matching for blood transfusion practical?
not in field
first transufions usually otlerated well
HOw do you collect blood from donor for blood transfusion?
1. ACD (acid citrate dextrose) or sodium citrate
How much blood should you replace with blood trasnfusion?
20-40% of blood loss
HOw do you administer blood transfusion?
through in line filter
evaluate vitals before transfusion
give 0.1mL/kg over 5-10min
What are transfusion reactions?
1. changes in respiration, behavior, muscle fasciculations