LA Urinary tract diseases Flashcards
(49 cards)
1
Q
Outline urolithiasis in farm animals
A
- leading cause of obstruction
- v common in small ruminants d/t dietary imbalances
- males and females develop uroliths, generally only males show signs of urinary obstruction
2
Q
Predisposing factors - farm animal urolithiasis
A
> Castrated males • Diet has major influence – high concentrate / low roughage – high phosphate diets/low calcium diet – high magnesium diets – alkaline urine • Dehydration • Urinary tract infection
3
Q
Types of farm animal uroliths
A
DIET DEPENDENT:
- calcium (apatite and carbonate)
- phosphate (calcium and magnesium ammonium = struvite types)
- silicate
- oxalate
4
Q
Site of urolithiasis obstruction - cattle and small ruminants
A
- CATTLE: distal sigmoid flexure
- SMALL RUMINANTS: urethral (vermiform) process in small ruminants > distal sigmoid flexure
5
Q
CS - farm animal urolithiasis
A
• Early clinical signs – haematuria, dysuria, crystals on prepuce – urine dribbling – tail flagging & colic signs • Later clinical signs – anorexia, depression – preputial swelling – abdominal distension – recumbent, seizures and death
6
Q
Dx - farm animal urolithiasis
A
- hx and CS
- axotaemia, hyperkalaemia, hyponatraemia, acidosis
- ultrasound
- radiograph
7
Q
Complications - farm animal urolithiasis
A
• bladder rupture – painful becoming comfortable then sick – abdominal distension and uroperitoneum • urethral rupture – swollen prepuce • hydronephrosis – requires chronic obstruction – diagnosis via ultrasonography
8
Q
Managemetn - farm animal urolithiasis
A
• Medical management – increase diet Ca: P ratio – urinary acidification • Surgical management – urethral process amputation – perineal urethrostomy – tube cystotomy
9
Q
How common is amyloidosis in cattle? what is it associated with>
A
- common in cattle
- assoc with chronic sepsis (metritis, mastitis, pneumonia, pericarditis)
10
Q
Outline amyloidosis in catlle
A
- inflammation drives SAA production –> glomerulopathy
- loss of glomerular function –> PLN
- oedema, wt loss, chronic diarrhoea
- proteinuria, hypoalbuminaemia, azotaemia
- raised serum fibrinogen, SAA, globulins
11
Q
Tx - cattle amyloidosos
A
None
12
Q
Outline enzootic haematuria in cattle
A
- cattle and sheep grazing bracken
- requires chronic (>12 months exposure)
- multiple cases
- contains ptaquiloside carcinogens
- bladder wall neoplasia (haemorrhagic cystitis, haematuria)
- anaemia
- differentiate from haemoglobinuria
13
Q
Ddx - enzootic haematuria
A
haemoglobinuria
14
Q
Proper name for ‘pizzle rot’
A
= ulcerative posthitis/ vulvitis
15
Q
Outline pizzle rot in small ruminants
A
- ulcerative bacterial infection of prepuce and vulva MM (C. renale, high protein diets seem to predispose)
16
Q
CS - pizzle rot
A
- pain
- loss of condition
- decreased fertility/ libido
17
Q
Management - pizzle rot
A
- penicillin
- NSAIDs
- reduce dietary protein
18
Q
Outline pyelonephritis in FA and horses
A
- ascending (usually) infection of urinary tract
- commonest renal dz in cattle
- post-parturition and post service/ covering
- following metritis and urolithiasis
19
Q
Acute PN CS
A
– pyrexia, anorexia, depression, colic signs
– decreased milk yield
– stranguria, polyuria, hematuria, pyuria
20
Q
Chronic PN CS
A
weight loss, colic, decreased milk yield, diarrhoea, polyuria,
anemia, less obvious signs of urinary tract infection
21
Q
Which bacteria cause PN in cattle?
A
- mainly GRAM NEGATIVE (coliforms, Proteus sp, Klebsiella sp, Enterobacter sp)
- also GRAM POSITIVE: (A.pyogenes, rarely C. renale)
22
Q
Dx - bovine PN
A
– clinical signs and rectal palpation
– pyuria, haematuria, proteinuria
– azotaemia
– urine culture?
23
Q
Tx - bovine PN
A
– long term (14-21 days) broad spectrum AB’s
– oxytetracycline or penicillin/aminoglycosides
24
Q
How can infection establish in umbilicus?
A
- umbilicus as portal of entry
- localise following haematogenous spread from GIT, other sites of sepsis or generalised septicaemia
25
What part of umbillicus tends to be most commonly infected?
arteries and urachus > vein
26
Common umbilical pathogens
- E. coli, Actinobacillus equuli, Klebsiella spp, Pseudomonas spp
- Bacillus spp, S. aureus, Strep spp, Enterococcus spp
- Clostridium spp
- mixed infections common
27
CS - umbilical pathogens
- fever, malaise, lethargy
- heat, pain, swelling and discharge from umbilicus
- localising signs aren't present in every case, particularly when there is generalised septicaemia
28
Why is ultrasound useful for diagnosis of umbilical infection?
- enlargement of BVs (normal A and V
29
Tx - umbilical infection
- SURGICAL RESECTION: presents spread to other sites, animals with generalised septicaemia may not be good candidates for anaesthesia
- BS AB Tx: monitor response with ultrasound, if umbilicus continues to enlarge, change AB or consider sx
30
ABs for umbilical infection
- CEFTIOFUR: in foals require 2x adult horse dose
- TRIMETHOPRIM-SULPHONAMIDE: economical and given orally but organisms may not be sensitive
- AMINOGLYCOSDIES: care in v young animals (nephrotoxic), used in conjunction with gram positive cover
- PENICILLINS and other BETA-LACTAMS
- CEPHALOSPORINS
31
Ddx - umbilical infection
umbilical hernia
32
Outline umbilical hernia
- small hernias
33
Differentiate patent and persistent urachus
- PATENT: has been closed then opens d/t infection or prolonged recumbency
- PERSISTENT: open since birth, excessive torsion in parturition? may need cautery or sx resection
34
Outline renal failure in horses
- primary renal failure less common than renal failure secondary to hypovolaemia (i.e. pre-renal failure --> renal failure)
- renal dz without renal failure usually doesn;t cause obvious CS or clinical pathology changes
- renal failure when >70% nephrons lost
35
Causes - primary renal failure
- congenital
- interstitial nephritis
- GN
- PN
- amyloidosis
- neoplasia
36
CS - primary renal failure
* depression, anorexia, weight loss
* polydipsia and polydipsia
* oedema and diarrhoea
* pyrexia and colic signs
* encephalopathy
* oral mucosal ulceration
* excessive tooth tartar
37
Urinalysis - primary renal failure
- proteinuria
- casts
- wbcs and bacteria
- haematuria
- inability to concentrate urine (isossthenuria is SG 1.008 - 1.014)
- increased urine GGT (GGT: creatinine ratio to correct for variations in urine flow)
38
Serum biochem - primary renal failure
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• azotaemia
– increased urea and creatinine
• hyperkalaemia
• hyponatraemia
• hypercalcaemia
• hypophosphataemia
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39
Tx - ARF
– restore circulating volume (0.9% NaCl 40-80
ml/kg/day)
– diuresis (20% mannitol and furosemide IV)
40
Tx - CRF
– no specific treatment
– supportive only
– ad lib salt and water
– high quality diet
41
When do foals bladders tend to rupture?
usually during or soon after parturition - inherent bladder wall weakness?
42
Ddx - ruptured bladder
- tenesmus
- straining to defaecate (e.g. retained meconium)
- note the caudal position of the HL in foals straining to urinate
43
Outline bladder rupture in foals
- no sex predisposition
- previosuly thought more common in colts (narrow pelvis and long urethra)
- tears on dorsal aspect of bladder
44
CS - ruptured bladder in foal
- within first 2-3 days of life
- dysuria: frequent attempts to urinate with only small amounts voided
- progressive depression and abdominal distension
- ventral and preputial oedema
45
Outline urinary tract rupture secondary to infection
- urachus, bladder or ureters
- birth to 2 months old
- hx of other illness
- easy to miss because deterioration in clinical status can be mistakenly attributed to pre-existing dz
46
Dx - ruptured bladder
- peritoneal fluid: serum creatinine ratio >2.1
| - ultrasound
47
Aid-base and electrolyte derangements in ruptured bladders
- azotaemia (failure to excrete)
- hyperkalaemia (failure to excrete, leads to cardiac arrhythmias)
- hyponatraemia (loss of renal regulation, continued intake of water)
- metabolic acidosis (loss of renal regulation, third spacing causes hypovolaemia and poor perfusion)
- respiratory acidosis (compression of diaphragm)
48
Management - ruptured bladder
• Emergency surgery is usually not required
– manage medically first and stabilise before
surgery
– IV fluids
– peritoneal drainage
• Good outcome (>80%) with surgery if
performed on a stabilised foal
49
Pre-operative stabilisation for ruptured bladder
```
• Restore circulating volume
– 0.9% NaCl
– Hartmann’s solution
• Dextrose and insulin to promote
intracellular movement of potassium
– if not successful - calcium or bicarbonate
• Drain abdomen and peritoneal lavage
• Intranasal oxygen
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