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Urology > Large Animal > Flashcards

Large Animal Flashcards

1
Q

how to acquire urine on a female ruminant

A

stroke vulva

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2
Q

how to acquire urine from a small ruminant

A

occlude nares

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3
Q

things to look for on a CBC of a large animal

A

anemia –> hemolysis or acute blood loss will cause nephropathy

chronic inflammation or infection –> neutrophilia, hyperfibrinogenemia, increased globulins

glomerulonephritis –> hypoalbuminemia, panhypoproteinemia

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4
Q

things to look for on chemistry of a large animal

A
  • creatinine
  • BUN is a waste of time in large animals bc they can get rid of it in other ways
  • azotemia
  • serum electrolytes in AKI will have decreased Ca and increased P
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5
Q

what is unique about the chemistry lab evaluation in horses with CKD?

A

they will have increased Ca and decreased P –> this is the opposite of all other animals

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6
Q

how do you evaluate a UA for hematuria?

A

spin the urine. if you get a pellet or RBCs at the bottom, its hematuria. if not - its either hemoglobinuria or myoglobinuria.

though if its myoglobinuria, the color of the urine will be brown

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7
Q

when evaluating for hemoglobinuria

A

the urine and serum will be discolored

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8
Q

when evaluating for myoglobinuria

A

the urine will be discolored but the serum will be clear

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9
Q

what are the levels of isosthenuria and what is it indicative of?

A

1.008 - 1.014

tubular disease

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10
Q

what test can you run to evaluate a large animal for tubular disease? and how does it work?

A

fractional clearance.

take urine and serum sample at the same time and test Crt and electrolyte (usually Na).

  • Na clearance helps differentiate from pre-renal and renal azotemia
  • can be altered by fluids, furosemide, and exercise
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11
Q

what is a way to get rid of the dilutional effect when collecting urine?

A

take the urine GGT/Crt ratio: Uggt / Ucrt x 100%

this way you don’t have to collect the entire sample of urine.

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12
Q

what is GGT?

A

GGT is a big protein that cannot cross the glomerulus. so if its in the urine, it got there bc it was released by the proximal tubular brush border indicating tubular damage.

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13
Q

if you get trace protein on a dipstick from a large animal indicating proteinuria, should you panic?

A

no! because large animals normally have alkaline urine which causes false positives on dipsticks.

to avoid this, look at the pH before looking at trace protein!

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14
Q

when evaluating sediment of a urine sample in large animals, what do casts indicate? what is important to remember about casts?

A

tubular damage

they dissolve quickly so look at them within 30min!

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15
Q

if you see crystals in urine sediment evaluation in large animal should you get excited?

A

nope, it just means the urine is supersaturated.

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16
Q

if you see excess WBCs on a urine sediment evaluation in large animal, what does it indicate? what should you do?

A

if you see excess 10/hpf WBC, its an indication of infection or inflammation.

look for bacteria. if you don’t see any, it DOES NOT mean you can rule out a UTI

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17
Q

once a horse is on fluids, how fast should you see a reduction in azotemia?

A

> 50% within 24 hours

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18
Q

horses: what is intrinsic renal azotemia?

A

acute kidney injury. its a syndrome in which there is an abrupt decrease in GFR

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19
Q

horses: what two things cause AKI? which one is most common?

A

acute tubular necrosis (ATN) and acute glomerulonephritis

ATN is most common

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20
Q

horses: what things cause ATN? how?

A
  1. ischemia - “vasomotor nephropathy” - not perfusing kidneys
  2. aminoglycoside toxicity - inhibits phospholipase and causes vasoconstriction
  3. NSAIDs - decreases renal blood flow causing medullary crest necrosis because medulla is not well perfused
  4. pigment nephropathy - causes vasoconstriction, casts and heme particles
  5. leptospira - should jump to top of ddx if hx of uveitis, AKI and infertility on farm
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21
Q

horses: how is lepto diagnosed and treated?

A

dx: urine PCR
tx: amoxicillin, penicillin, ceftiofur

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22
Q

what two drugs are nephrotoxic and may cause aminoglycoside toxicity? what can aminoglycoside toxicity cause?

A

gentamicin > amikacin

aminoglycoside toxicity may cause ATN (acute tubular necrosis)

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23
Q

what antigen causes acute glomerulonephritis in horses? what does acute glomerulonephritis cause?

A

streptococcus equi (strangles) and EIA

causes ATN

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24
Q

horses: what are the clincal signs of AKI? what will you see on chemistry? on UA?

A
  • often non-specific like poor appetite and dull

- oliguric

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25
Q

horses: what clinical sign will tell you its post-renal azotemia

A

if a horse continues to be oliguric 6 - 12 hours after initiation of fluid therapy

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26
Q

horses: how do you treat AKI?

A
  • correct fluid volume deficits
  • monitor edema
  • tx for hyperK
  • give diuretics if they still will not urinate after fluids started
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27
Q

horses: how do you treat hyperK?

A
  • give fluids without K like 0.9% NaCl, plasmalyte or LRS
  • give 5% dextrose - stimultes endogenous insulin which drives K back into cells
  • give Ca gluconate - restores RMP of cardiac cells
  • Na bicarb - DO NOT give at the same time as Ca gluconate, they will precipitate out
  • insulin
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28
Q

horses: what diuretics are indicated if you give fluids and they still wont urinate?

A
  1. furosemide (lasix) - loop diuretic
  2. Mannitol - increases GFR but also O2 demand
  3. dopamine - increases GFR but also causes hypertension so its basically never used.
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29
Q

horses: what is the most common cause of acquired CKD in horses?

A

tubulointerstitial disease

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30
Q

what are the 3 most important signs of CKD in horses?

A

dental tartar 10:1 = CKD

increased Ca decreased P

31
Q

what are some common signs of CKD in horses?

A

uremia

chronic weight loss

32
Q

horses: what are the most important differences between AKI and CKD in horses?

A

AKI =
BUN: Crt 10:1
HyperCa, HypoP

33
Q

horses: what are common post-renal issues in horses?

A

uroperitoneum and urolithiasis

34
Q

horses: what is uroperitoneum most common in? how is it diagnosed?

A

colts&raquo_space;> fillies

diagnosed via ab tap: if peritoneal Crt > 2x serum = confirms uroperitoneum

35
Q

what lab abnormalities will you have with uroperitoneum?

A

azotemia - BUN and Crt leak from urine back into blood

decreased NaCl

super increased K

36
Q

horses: what are the clinical signs of a cystolith vs a nephrolith or ureterolith?

A

cystolith

37
Q

horses: how are uroliths diagnosed in horses?

A

cystoscopy

38
Q

horses: what does hematuria mean if its
throughout =
beginning =
end =

A 
throughout = kidneys, bladder
beginning = distal urethra
end = proximal urethra
39
Q

what two things can cause renal hematuria/

A
  1. adenocarcinoma

2. idiopathic renal hematuria

40
Q

horses: what is idiopathic renal hematuria? in which breed do we see it the most?

A

sudden onset of life threatening hematuria

> 50% Arabians

41
Q

horses: what is the most common way to get urethra hematuria?

A

summer sores - habronema lesions at the end of the urethra that lead to bleeding

42
Q

horses: when we see urethral tears in geldings, what is it thought to be caused from? how do you treat it?

A

thought that it relates to all the muscle in hindquarters resulting in “blowout” of corpus spongiosum into urethra

tx: by leaving it alone bc it will heal on its own. can also do:
a urethostomy - relieves pressure
buccal mucosal graft - rare

43
Q

horses: what do we need to remember about bacterial cystitis?

A

its rare in horses but occurs most often in mares

and is treated with TMS. TMS is great bc its cheap and concentrates in the urine so its a great 1st line abx

44
Q

horses: what is the 411 on pyelonephritis?

A
  • secondary to ectopic ureters
  • commonly occurs with bacteremia
  • CS: systemic illness + dysuria + hematuria
  • Tx: abx, nephrectomy
45
Q

horses: what 3 things cause urinary incontinence?

A

upper motor neuron disease

lower motor neuron disease

myogenic bladder

46
Q

horses: what is the big deal about upper motor neuron disease?

A

it will cause urinary incontinence but the big deal is its caused from a spinal cord lesion and they wont be able to stand!!

47
Q

horses: whats the 411 on lower motor neuron disease?

A
  • it causes urinary incontinence
  • CS: continuous dribbling, cauda equina syndrome (no anal tone, perineal analgesia, hindlimb weakness, etc.)
  • etiology: if they have fever + dribbling urine = EHV-1 myeloencephalitis!!
48
Q

horses: what does myogenic bladder cause?

A

sabulous cystitis - it stretches out the detrussor

49
Q

how do you treat myogenic bladder?

A
  • culture urine
  • treat cystitis
  • lavage bladder
  • stimulate emptying with bethanechol
50
Q

horses: how do you stimulate bladder emptying?

A

bethanechol

51
Q

horses: if a horse has PU/PD what is their urine output and water intake levels?

A

> 50 ml/kg/day urine output = PU

>100 ml/kg/day water intake = PD

52
Q

horses: what are some causes of PU/PD in horses?

A
  1. diabetes inspidus
  2. cushings - pituitary pars intermedia dysfunction
  3. renal failure - sepsis
53
Q

ruminants: what are the 6 causes of AKI?

A
  1. acute tubular necrosis
  2. hemoglobinuria
  3. myoglobinuria
  4. oak poisoning
  5. pigweed toxicity
  6. leptospira
54
Q

ruminants: what is the most common cause of ATN? vasomotor

A

nephropathy = septic mastitis

55
Q

ruminants: what are some of the most common causes of hemoglobinuria?

A
  • post-parturition = low P
  • Cu toxicity in sheep
  • bacillary hemoglobinuria
  • water intoxication
  • salt poisoning
  • Se deficiency = Fl is Se deficient
56
Q

ruminants: what are some causes of myoglobinuria?

A

white muscle disease (vit E, Se deficient)

cassia occidentalis (wild coffee)

57
Q

ruminants: what is so impt about oak poisoning?

A

oak poisoning is specific to cattle in the Spring and Fall
CS: melena, azotemia, proteinuria and glucosuria
tx: supportive

sheep and goats are ok bc they have tanninase in their rumen

58
Q

ruminants: what is impt about pigweed toxicity?

A
  • affects cattle and swine
  • CS: weakness, tremors, ataxia, azotemia, proteinuria, Increased K
  • 75 - 100% mortality once signs appear
59
Q

ruminants: what is the 411 on leptospira?

A
  • affects young animals exposed to stagnant water
  • CS: fever, abortion, mastitis, meningitis
  • Dx: urine PCR
  • Tx: tetracycline, penicillin, ampicillin
60
Q

ruminants: clinical signs of AKI - regardless of etiology

A 
oliguria
poluria
anorexia
diarrhea, bloat
muscle weakness
epistaxis
ammonia breath
61
Q

ruminants: what is the clin path of ruminants with AKI? how is it treated?

A

azotemia
decreased NaCl
decreased Ca, increased P
isosthenuria

tx - fluids

62
Q

ruminants: how does amyloidosis occur and what does it lead to?

A

inflammatory disease –> serum Amyloid A –> deposits in kidney, GI –> disrupts glomerulus or GI –> PLN or PLE

63
Q

ruminants: what causes pyelonephritis? what are the CS?

A

cornebacterium renale (cattle specific) - contagious, causes herd outbreaks!

CS: colic, arched back, fever, decreased milk yield, blood/pus/crystals on vulva

64
Q

ruminants: how do you treat pyelonephritis?

A

gram + = penicillin
gram - = ceftiofur
for > 3 weeks!

quarantine affected animals - report drug used and adhere to withdrawal times

65
Q

ruminants: in what kind of animals do we see urolithiasis and why?

A

young, castrated males like pet goats and feedlot cattle

its a disease of management- from being fed a high concentrate, pelleted diet

66
Q

ruminants: why does crystallization occur?

A

from decreased water consumption and a basic pH

67
Q

ruminants: what type of stone is most common in small ruminants? why?

A

struvites (Mg ammonium Phosphate)

  • they occur in alkaline pH
  • pelleted diets due to Ca:P
68
Q

ruminants: what are the most common sites of obstruction?

A

small rumiannts = urethral process

cattle = sigmoid flexure

69
Q

ruminants: what is the clin path of a ruminant with a urethral obstruction?

A 
azotemia
hemoconcentration
decreased NaCl
increased K, increased Mg, increased P
ab tap: peritoneal Crt: serum Crt > 2:1
70
Q

ruminants: how do you treat urethral obstructions?

A
  1. medical: correct fluid, walpoles’ solution
  2. amputate urethral process
  3. surgical options: perineal/ischial urethrostomy (salvage procedure for feedlot cattle) , tube cystotomy (best option for breeding animals)
71
Q

ruminants: how do you prevent urethral obstructions?

A

Ca:P > 2:1

Mg

72
Q

ruminants: what is the 411 on enzootic hematuria? what does chronic ingestion cause? what does acute toxicity cause?

A
  • caused by bracken fern
  • chronic ingestion causes hematuria and bladder neoplasms
  • acute toxicity causes bone marrow suppression
73
Q

ruminants: what is ulcerative posthitis and vulvitis? what is it caused by? what are the clinical signs? how is it treated?

A

“pizzle rot” !

  • caused by cornebacterium renale. it proliferates with a high protein diet, hydrolyzes urea to ammonia and causes ulcers. its contagious!
  • CS: moist ulcers on external genitalia, dysuria, weight loss, vocalization
  • Tx: isolate those affected, decrease protein, give systemic and topical abx like penicillin and oxytet powder
74
Q

how to acquire urine froma male ruminant

A

brush hairs on prepuce

Urology (10 decks)

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