Bovine hematuria and hemoglobinuria Flashcards
(116 cards)
1
Q
How do you differentiate hematuria and hemoglobinuria/myoglobinuria?
A
spin down the urine
hematuria when centrifuged leaves clear supernatant
2
Q
What will you find with myoglobinuria that does not occur with hemoglobinuria?
A
increased CK, AST
3
Q
Where might blood in the urine arise from?
A
- urethra
- bladder
- kidney
4
Q
What are differentials of hematuria?
A
- urethra: caluli, trauma, urethritis
- bladder: bracken fern, cystitis, papilloma, neoplasia, calculi, polyps
- kidney: pyelonephritis, infarction, trauma, malignant catarrhal fever, endotoxic shock
5
Q
What are the major calculi in ruminants?
A
- struvite–seen in feed lot–phosphatic on grain based diets
- silica–rangeland
- calcium carbonate–most comon on lush clover pasture
- calcium oxalate: idiopathic
6
Q
Who is most likely to get urinary calculi?
A
males
7
Q
When do urinary calculi occur?
A
when high mineral concentratrions in urine overwhelm crystallization inhibitors
8
Q
What forms a matrix for calculus formation?
A
mucoproteins
9
Q
How are calculi diagnosed?
A
- hematuria
- colic and straining to urinate
- enlarged ureter or urethra (rectal exam, urethra pulsing without urination)
- post renal azotemia
- endoscopy?
10
Q
How are calculi diagnosed?
A
- surgical
- salvage if not uremic
- medical (tranquilizer, NSAID, IV fluids)
- Walpole’s solution (acetic acid)
11
Q
How are struvite crystals prevented?
A
- increase long stem forage in diet (hard to convince in feedlot)
- 3-5% salt in feedlot diets
- ammonium chloride (alkalinize the urine) but reduces palatability
12
Q
How do you prevent silica calculi?
A
sodium or ammonium chloride
13
Q
What is urethral trauma commonly associated with?
A
uroliths
14
Q
What is bacterial urethritis sometime sassociated with?
A
pseudomonas
15
Q
What does bacterial urethritis suually manifest as?
A
hemospermia. treated by rest from reprod acitvity and antibiotics that concentrate in urine like penicillin
16
Q
What are the clinical signs of bracken fern poisoning?
A
bladder wall thickneing, tumors
blood and clots in urine
anemia may be present
usually sporadic
17
Q
what is the cause of enzootic hematuria?
A
pteridium aquilinum (braken fern)
18
Q
What are the toxic agents of pteridium aquilinum toxicity?
A
ptaquiloside, quercetin, A ecdysone
19
Q
What is the treatmetn for braken fern?
A
supportive care, removal of braken fern from diet
20
Q
Who most commonly gets cystitis?
A
females
21
Q
What are the common etiological agents of cystitis?
A
C. renale, or e. colie
22
Q
is grosshematuria common with cystitis?
A
no
23
Q
What are common clinical signs of cystitsi?
A
- dysuria,
- pollalkuria,
- decreased urinary flow rate
- thickened bladder wall
24
Q
What is a good treatment for cystitis?
A
penicillin, actually gets such high levels in urine that can get e. coli
25
Who does pyelonephritis usually affect?
females
26
Are animals systemically ill with cystitis? what about pyelonephritis?
1. no
| 2. yes
27
What are the clinical signs of pyelonephritis?
systemic clinical signs
| smooth enlarged painful kidney occasionally palpable on rectal
28
What is the treatment for pyelonephritis?
antibiotics (penicillin) and supporitve care
29
What is the prognosis for pyelonephritis?
guarded
30
What are the most common causes of renal infarction?
dehydration and/or NSAID treatment
31
What occurs with renal infarction?
acute tubular necrosis, primarily at loop of henle
32
What are the clinical signs of renal infarction?
polyuria, anuria, dysuria
| renal azotemia on blood work
33
What is the treatment for renal infarction?
resotration of adequate renal perfusion--fluids
34
What is hemoglobinuria caused by?
severe haemolysis
35
What is the issue of hemoglobin and the kidney?
nephrotoxic and causes renal damage
36
What are the bacterial causes of hemoglobinuria?
1. clostridia
| 2. leptospira
37
What are the parasitic causes of hemoglobinuria
1. babesia
2. eperythrozoon
3. theileria
4. trypanosoma
38
What are the immune causes of hemoglobinuria?
1. neonatal isoerythrolysis
| 2. autoimmune
39
What are the causes of heinz body (cause of hemoglobinuria)
1. drug
2. plants
3. molybdenum deficiency
4. selenium deficiency
40
What are 3 micellaneous causes of hemoglobinuria?
1. water
2. copper
3. post partum
41
What causes bacillary hemoglobinuria?
clostridium hemolyticum (C. novyi type D)
42
Where do spores of clostridium haemolyticum go?
to the kupffer cells of liver
43
What is clinical disease of bacillary hemoglobinuria exacerbated by?
liver fluke infestation
44
What are the clinical signs of bacillary hemoglobinuria?
1. sudden death
2. fever
3. anorexia
4. blood in feces
5. red urine
6. blood is usually thin, water and slow to coagulate
45
How is diagnosis made for bacillary hemoglobinuria?
1. necropsy--gram stain of liver impression
| 2. FAT on liver
46
How is bacillary hemoglobinuria treated?
rarely attempte because acute/fatal. could try penicillin
47
What should you do with bacillary hemoglobinuria carcus?
deep burial/burned
48
What provide protection against bacillary hemoglobinuria?
most 8 ways vaccines
49
Is leptospirosis a zoonosis?
yes
50
Is leptospirosis common in western canada?
no
51
What are the three leptospira species that cause renal disease?
1. L hardjo
2. L pomona
3. L gripptophyosa
52
What are the clinical signs of leptospirosis?
1. repro failure
2. agalactia
3. mastitis
4. occasionally hemoglobinuria
53
HOw is diagnosis of lepto mde?
PCR
| others possible
54
How is lepto traeted?
penicillin, oxytetracylcine but careful using oxy in animal with impaired renal function
55
What is prevention of lepto?
1. avoid stnading water
2. screen animals before enter herd
3. control rodents
4. vaccine is good
56
Who is more susceptible to copper intoxiciation?
small ruminants
57
What is the pathogenesis of copper intoxication?
liver copper accumulates, once a certain level there is a massive release of copper.
58
What is the most common history of copper intoxication?
small ruminant fed a cattle mineral
59
What is treatment for copper intoxication?
```
supportive care (blood transfusion)
chelation therapy with D-penicillamine or ammonium tetrathimoybdate if available
```
60
What can exacerbate copper intoxication?
molybdenum
61
When does heinz body anemia occur?
exposure to oxidizing agents such as phenothiazines, methylene blue, onions, brassicas or molybdenum or selenium deficiency
62
What are clinical signs of heinz body anemia?
1. weakness
2. depression
3. anemia
63
How is heinz body anemia diagnosed?
ID heinz bodies in blood smears stained with methylene blue, wrights or crystal violet
64
Why should you not ix blood smears with methanol?
will inhibit stain uptake
65
What are hemoparasites in cattle?
babesia
eperythrozoon (e. weyoni, e. ovis)
thelia
trypanosomes
66
What is neonatal isoerythrolysis associated with in ruminants?
vaccines of blood origin (babesia, anaplasma) (there ar eno blood based vaccines currently available in canada)
67
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)
68
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
69
How can you classify hemorrhage?
1. acute: internal/external
| 2. chronic: bleeding GI lesion, renal
70
What can cause acute externa hemorrhage?
1. surgery: e.g. dehorning and castration
| 2. trauma: external laceration
71
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)
72
What are the clinical signs of anthrax?
1. sudden death
| 2. clinical signs may include hematuria and/or bloody diarrhea
73
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
74
What can cause internal hemorrhage?
1. splenic rupture (trauma)
2. middle uterine artery rupture (spontaneous, sporadic, usually following uterine prolapse)
3. blood vessel erosion
75
What can cause blood vessel erosions
1. abscess, neoplasia, mycotic
| 2. caval syndrome following rumen acidosis
76
How is internal hemorrhage diagnosed?
1. anemia by hypoproteinemia
2. ultrasound
3. abdominocentesis--not very rewarding in cattle
77
What is the treatment for internal hemorrhage?
1. may have to attempt surgery
2. anesthetic risk
3. treat shock
4. blood transfusion
78
What are causes of bleeding GI lesions?
1. abomasal lymphosarcoma
2. ulceration
3. parasitism (type II dz, post hemonchus treatment--not most common treatment of hemonchus)
79
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
80
What are features of abomasal lymphosarcoma?
1. may cause bleeding into abomasum
2. melena
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
81
Type 2 abomasal ulcers associated with what?
significant blood loss
82
What are clinical signs of abomasal ucleration
```
sudden death
bruxism
abdominal pain
melena
anaemia
```
83
What is treatment for abomasal ulceration?
1. supportive care
| 2. surgery? antacids?
84
What is type II disease?
hypobiotic larvae excyst and may cause severe disease with hemorrhage into abomasum and melena
85
What are renal causes of bleeding?
1. bracken fern
| 2. rare causes include: neoplasia, renal vascular anomalies
86
What are signs of renal cause of bleeding
blood observed in urine
87
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
88
Why are inherited hemostatic dysfunctions not common in dairy cattle?
lots of genetic testing esp of bulls
89
What measures intrinsic pathway?
PTT
90
What are causes of aquired hemostatic dysfunction
1. vasculitis
2. thromobocytopeina
3. DIC
4. warfarin toxicosis
5. moudly sweet clover
91
What are causes of vasculitis?
secondary to some septicemias--malignant catarrhal fever, blue tongue
92
What are clinical signs of vasculitis
petechiae, ecchymoses, hmoerrhages may occur anywehere
| other signs: edema, skin infarction, lameness, colic, dyspnea, ataxia
93
How is vasculitis definitively diagnosed
biopsy
94
How is vasculitis treated?
treat primary cause
| supportive care
95
What are the mechanisms of thrombocytopenia?
1. decreased production
2. sequestration
3. consumption/destruction
(IMPORTANT TO KNOW)
96
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
```
97
What are the two most common causes of thrombocytopenia?
1. bovine viral diarrhea
| 2. bovine leucosis virus
98
What does DIC usually follow?
usually following sepsis
99
What does DIC require?
a thrombotic stimulus:
increased pro-coagulant activity
abnormal surface
-->increased and unregulated procoagulant acitvity
100
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
```
101
HOw do you diagnose DIC?
numerous hemostatic tests will be abnormal
102
What is treatment of DIC?
rarely practical--euthanasia
| maybe flunixin meglumine, treat sock, plasma/heparin therapy? avoid glucocorticoids?
103
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
104
HOw does warfarin toxicosis manifest?
increased or spontaneous bleeding
105
What is the treatment of warfarin toxicosis?
vit K supplementation
106
Where is mouldy sweet clover usualyl found?
hay or silage
107
What is the toxic agent of mouldy sweet clover?
dicoumarol
108
What does dicoumarol do?
interfere with synthesis of vit K synthesis
109
What are signs of mouldy sweet clover poisoning?
increased bleeding, may develop hematomas
110
What are the indications for blood transfuions in ruminants?
acute PCV
111
Is cross-matching for blood transfusion practical?
not in field
| first transufions usually otlerated well
112
HOw do you collect blood from donor for blood transfusion?
1. ACD (acid citrate dextrose) or sodium citrate
113
How much blood should you replace with blood trasnfusion?
20-40% of blood loss
114
HOw do you administer blood transfusion?
```
through in line filter
evaluate vitals before transfusion
give 0.1mL/kg over 5-10min
re-evaluate vitals
give 20ml/kg/hr
```
115
What are transfusion reactions?
1. changes in respiration, behavior, muscle fasciculations
116
What is the treatment for transfusion reactions?
1. shut off transfusion
2. epinephrine
3. corticosteroids
