Disease of the ruminant urinary system including urolithiasis

Question 1

How would you examine the urinary system?

Answer 1

• History - how long /other signs
• Frequency / ease of urination
• Urine - smell / appearance
• Rectal examination - L kidney, bladder, diseased ureters
• Catheterisation
• Prepuce

Question 2

What should ruminant urinalysis be?

Answer 2

• SG = 1.020- 1.045
• pH - alkaline
• Protein - usually trace only
• Glucose - usually trace

Question 3

What are clinical signs of urinary disease?

Answer 3

• Abdominal pain - pyelonephritis, calculi
• Dysuria - pyelonephritis, calculi, cystitis
• Haematuria
• Polyuria - diabetes mellitus (post FMD) diabetes insipidus, idiopathic
• Anuria - obstruction by calculi
• Oliguria - prerenal, renal or post renal
• Proteinuria - renal amyloidosis

Question 4

What causes haematuria?

Answer 4

– Pyelonephritis (+ pus)
– Cystitis
– Urolithiasis
– Enzootic haematuria
– Acute bracken poisoning
– Toxic nephrosis (Acorn)
– Glomerulonephritis, renal infarction

Question 5

What causes haemoglobinuria?

Answer 5

• Babesiosis - redwater
• Post-parturient haemoglobinuria
• Bacilliary haemoglobinuria
  -clostriudum haemoliticum

Question 6

What are congenital abnormalities of urinary tract?

Answer 6

• Hypospadia - failure of closure of male urethra
• Patent urachus - urine from umbilicus

Question 7

What usually cause pyelonephritis?

Answer 7

• Corynebacterium renale
  -more common in sucklers = venereal spread
  -secondary to trauma (dystocia)

Question 8

What are signs of pyelonephritis?

Answer 8

• Chronic weight loss
• +/-mild pyrexia
• Appetite usually OK
• Dysuria
• Blood + pus in urine (check vulval hairs)
• Examine per-rectum - swollen kidney, bladder thickening

Question 9

What is treatment of pyelonephritis?

Answer 9

• Long course of antibiotic - penicillin / oxytet
• C. renale = sensitive to most AB
• E. coli = more resistant = amoxicillin / clavulanic acid

Question 10

What can cause cystitis? CS? Tx?

Answer 10

• Associated with pyelonephritis
• secondary to dystocia - ascending infection
• CS = similar to pyelonephritis - more straining
• Tx = ABs, same as pyelonephritis

Question 11

What are CS of amyloidosis?

Answer 11

• Off food & ill
• Profuse diarrhoea (DDX Johne’s disease)
• Generalised subcutaneous Oedema
• Polydipsia/polyuria
• Proteinuria
• Low plasma albumin
• Pale swollen kidneys

Question 12

What can cause haematuria?

Answer 12

• Enzootic haematuria
• Bracken poisoning
• Toxic nephrosis
• Pyelonephritis (+pus)

Question 13

What can cause enzootic haematuria?

Answer 13

• Benign tumours of blood vessels in bladder (haemangioma)
• Long term ingestion of bracken
• Older cows
• Teart pastures = high molybdenum
• Blood clots in urine
• Tumours in guts - SCC

Question 14

What does bracken poisoning cause?

Answer 14

• Contain thiaminase = toxic in horses
• Bright blindness = sheep retinal atrophy
• Enzootic haematuria = long term ingestion
• ## Gut tumours = sheep + cattle = long term
• Bone marrow toxicity
• Pancytopaenia & thrombocytopaenia
• Petechiae in mouth, conjunctiva, vulva etc
• Subcutaneous bruising
• Blood clots – nose, faeces
• Pyrexia & depression
• Diarrhoea (bloody)
• Haematuria
• Death

Question 15

What causes toxic nephrosis? CS?

Answer 15

• Oak (acorn) poisoning
  -tannins in acorns = kidney damage
  -sudden death
  -anorexia, depression, bloat (ruminal stasis), constipation
  -tarry diarrhoea

Question 16

What causes bacilliary haemoglobinuria? CS? Control?

Answer 16

• Wet, High pH land in Southwest UK
• Cl. haemolyticum - in soil + dormant in liver
• migrating fluke = trigger spores (blacks disease)
• CS = pyrexia, jaundice, anaemia, oedema, Hburia
• Control = Vaccinate (blacks disease), fluke control

Question 17

What causes babesiosis? What animals are effected?

Answer 17

• Babesia divergens - tick borne
• CS in older non-immune animals
  -premunity in young - from early infection

Question 18

What are clinical signs of babesia?

Answer 18

• Pyrexia
• Anaemia + Hb-uria (port-wine urine)
• Diarrhoea (pipe stem faeces)
• Later =
  -constipated
  -temperature drop
  -anaemic / jaundice

Question 19

Dx of babesia? Tx?

Answer 19

• Dx =
  -Blood smear - capillary blood from ear
  -Thin smear
  -Parasites in RBC
  -Evidence of anaemia
• Tx = Imidocarb

Question 20

What causes post-partum haemoglobinuria?

Answer 20

• Low phosphorus diet = lush spring grass + sugar beet pulp
• Kale, rape, turnips

Question 21

CS + Tx of post=partum haemoglobinuria?

Answer 21

• CS =
  -sudden onset
  -haemoglobinuria, pallor, jaundice
  -collapse, dyspnoea + death
• Tx = Phosphorus + Blood transfusion
  -One transfusion is safe
  -use Sodium citrate as anti-coagulant
  -raise jugular + collect 5L into empty + cleaned drench bottle

Question 22

What ruminants tend to get urolithiasis?

Answer 22

• 2-4 month old ram lambs
• Mature goats that were castrated in first few days of life
• Bull beef calves on high concentrate diet

Question 23

What are urolithiasis associated with?

Answer 23

• Ca:P imbalance in diet
• High concentrate diet
• Water deprivation
• Interactions e.g. forage quality and concentrate intake
• History of diet change in mature animals
• Inappropriate material used in feeds

Question 24

What are signs associated with calculi?

Answer 24

• Restlessness – mild to severe
• Abdominal pain (kicking) & straining (hiccups)
• Dysuria or anuria – dry floor - management
• Preputial crystals/sand
• Progressive till urethra and/or bladder ruptures.
• Is swelling in abdomen or under skin ?
• Bladder rupture – initially brighter!
  -high urea & creatinine in plasma/abdominal fluid

Question 25

Where are calculi likely to be?

Answer 25

• Sigmoid flexure
• Vermiform appendage
• Pelvic urethra

Question 26

How do you diagnose urolithiasis?

Answer 26

• Abdominal palpation
  -distended bladder, free fluid wave, SC fluid pitting
• Hair of ventral abdomen - ‘sand’ around preputial orifice
• Examination of penis - exteriorise
• Radiography +/- contrast - replaced by US
• US - SC tissue, free fluid, bladder, kidney
• Abdominocentesis
• Palpate urethra per rectum
• Blood sample = urea/creatinine, potassium, PCV, TP

Question 27

What is treatment of urolithiasis?

Answer 27

• Relaxants = buscopan / xylazine
• Casualty slaughter
• DO NOT send home + ignore

Question 28

What should be done if bladder rupture or cannot be catheterized?

Answer 28

• GA, laparotomy + repair bladder
• Can also flush stone from bladder out of urethra

Question 29

How would you perform urethostomy?

Answer 29

• Standing & epidural anaesthesia.
• Mid-line incision from 4” below anus in cattle.
• Identify penis & blunt dissect.
• Transect penis distally to leave a 4” proximal stump.
• Suture stump to skin – not through urethra.
• Leave indwelling catheter for a few days.
• Do NOT allow to scab over

Question 30

If waterbelly / SC oedema, what should be done?

Answer 30

• incise skin in multiple sites to produce drainage.
• Necrosis, slough off and re-epithelialize.
• Worse if a lot of s/c fat.
• Bath/spray with salt water regularly

Question 31

How do you prevent reoccurence of uroliths?

Answer 31

• Urinary acidification = ammonium chloride / acid sodium phosphate
• Check diet - might be on wrong mix (lambs on ewe nuts)