Bovine hematuria and hemoglobinuria Flashcards Preview

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Flashcards in Bovine hematuria and hemoglobinuria Deck (116):
1

How do you differentiate hematuria and hemoglobinuria/myoglobinuria?

spin down the urine
hematuria when centrifuged leaves clear supernatant

2

What will you find with myoglobinuria that does not occur with hemoglobinuria?

increased CK, AST

3

Where might blood in the urine arise from?

1. urethra
2. bladder
3. kidney

4

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

5

What are the major calculi in ruminants?

1. struvite--seen in feed lot--phosphatic on grain based diets
2. silica--rangeland
3. calcium carbonate--most comon on lush clover pasture
4. calcium oxalate: idiopathic

6

Who is most likely to get urinary calculi?

males

7

When do urinary calculi occur?

when high mineral concentratrions in urine overwhelm crystallization inhibitors

8

What forms a matrix for calculus formation?

mucoproteins

9

How are calculi diagnosed?

1. hematuria
2. colic and straining to urinate
3. enlarged ureter or urethra (rectal exam, urethra pulsing without urination)
4. post renal azotemia
5. endoscopy?

10

How are calculi diagnosed?

1. surgical
2. salvage if not uremic
3. medical (tranquilizer, NSAID, IV fluids)
4. Walpole's solution (acetic acid)

11

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

12

How do you prevent silica calculi?

sodium or ammonium chloride

13

What is urethral trauma commonly associated with?

uroliths

14

What is bacterial urethritis sometime sassociated with?

pseudomonas

15

What does bacterial urethritis suually manifest as?

hemospermia. treated by rest from reprod acitvity and antibiotics that concentrate in urine like penicillin

16

What are the clinical signs of bracken fern poisoning?

bladder wall thickneing, tumors
blood and clots in urine
anemia may be present
usually sporadic

17

what is the cause of enzootic hematuria?

pteridium aquilinum (braken fern)

18

What are the toxic agents of pteridium aquilinum toxicity?

ptaquiloside, quercetin, A ecdysone

19

What is the treatmetn for braken fern?

supportive care, removal of braken fern from diet

20

Who most commonly gets cystitis?

females

21

What are the common etiological agents of cystitis?

C. renale, or e. colie

22

is grosshematuria common with cystitis?

no

23

What are common clinical signs of cystitsi?

1. dysuria,
2. pollalkuria,
3. decreased urinary flow rate
4. thickened bladder wall

24

What is a good treatment for cystitis?

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