Urinary

Question 1

Foal 3 days old
Colt

Depressed, off suck, abdominal distension
mild/ mod colic signs
increased urination with small volumes passed

Biochem and haem:

increased K+
decreased Na and Cl
dehydration
metabolic acidosis

peritoneal fluid: creatine>, clear with low USG

top ddx?

Answer 1

Ruptured Bladder

Question 2

Treatment for ruptured bladder in colt?

Answer 2

stabilise first
correct hyperkalaemia with calcium borogluconate or insulin/ glucose
drain abdomen
ABs and check IgG

surgery: midline laparotomy +/- resection of umbilicus and urachus at same time

Question 3

Stallion 8 years

haematuria
stranguria +/- pollakuria
pyuria or incontinence

ddx?
tx?

Answer 3

urolithiasis

surgical removal

Question 4

which of these is type 1 or type 2 calcium carbonate uroliths affecting the bladder

more common, spiculated yellow/ green, easily fragmented
smooth and grey/white, harder and contain more phosphate
sludge and usually secondary to bladder paralysis

Answer 4

more common, spiculated yellow/ green - type 1
smooth and white - type 2
sludge and usually secondary to bladder paralysis - type 3

geldings» mares

bladder»> kidneys

Question 5

most common neoplasia in bladder?

Answer 5

SCC

Question 6

when can bladder eversion occur?

Answer 6

excessive straining in parturition

Question 7

when can sabulous cystitis occur in horses?

Answer 7

sequalae to incomplete bladder empting

Question 8

when does the umbilicus normally break?

when should the stump have gone by?

Answer 8

straight after parturition

4-6 weeks

Question 9

foal
moisture around umbilicus +/- dripping urine

possible concurrent septicaemia/ septic arthritis or physitis

ddx?
tx?

Answer 9

patent urachus (connecting bladder and umbilicus)

often self resolves

medical: topical cauterising agents= phenol or iodine solution + silver nitrate
surgical: resection of urachus

Question 10

foal depressed and off suck
swollen and painful urachus
US: enlarged umbilical blood vessel

ddx?
tx?

Answer 10

umbilical sepsis

systemic ABs

Question 11

when should you surgically repair an umbilical hernia?

Answer 11

large, persists > 6 months
defect enlarges
asc with colic

can cause strangulation of bowel care,

Question 12

with any urinary condition/ infection

what should all foals be checked for?

Answer 12

concurrent sepsis or septic joints or physitis

Question 13

hypovolaemia
effusions
decreased CO
sepsis and endotoxaemia» inc vascular resistance

primary acute tubular necrosis (2ndry to ischaemia, nephrotoxin exposure),
glomerulonephritis
interstitial nephritis

all causes of what

Answer 13

acute renal failure

Question 14

which antibiotic is most nephrotoxic

Answer 14

neomycin> polymyxin

Question 15

infectious cause of glomerulonephritis?

Answer 15

EIA

Question 16

anorexia depression

uraemia

fluid electrolyte acid base disturbances
hypoatraemia
hypocholraemia
hypocalcaemia and hyperphosphataemia 
metabolic acidosis 

may have hyperkalaemia

ddx?

Answer 16

acute renal failure

Question 17

tx for acute renal failure

Answer 17

fluids, hartmans

discontinue nephrotoxic drugs

Question 18

if horse has acute renal failure + oliguric, what should you do?

Answer 18

furosemide - care

Question 19

why give dopamine to foals with acute renal failure

Answer 19

renal vasodilator

Question 20

chronic weight loss
lethargy
poor coat
pupd
oral ulceration
Gastroenteritis 
excessive tartar and halitosis 
ventral oedema 

persistent isosthenuria (1.008-1.014) + azotaemia
mild anaemia and mild hypoalbuminaemia
hypercalcaemia and hypo phosphateameia, low na,cl, bicarbonate

rare

Answer 20

chronic renal failure

Question 21

how are electrolytes different in horse chronic renal failure than in small animal

Answer 21

hypercalcaemia

horses normally excrete calcium bicarbonate in urine (can see sediment of this usually)

with CKD they cant as much, so calcium increases in blood

Question 22

Normal USG of a horse

Answer 22

1. 008-1.040 in adult horses

1. 001-1.025 in foals

Question 23

normal pH of urine of horse

Answer 23

7. 5-8.5 in adult horses

5. 5-8.0 in foals

Question 24

tx of CKD horse?

Answer 24

palliative

decrease calcium in diet (alfalfa decrease)
water and salt always available

Question 25

tx of CKD horse?

Answer 25

palliative

decrease calcium in diet (alfalfa decrease)
water and salt always available

Question 26

creatine >800U/L prognosis in CKD?

Answer 26

grave pgx

Question 27

3 main ddx for PUPD in horses

Answer 27

renal failure

Equine cushings/ PPID

pyschogenic- behaviour inc water consumption

diabetes insipidus, mellitus, inc salt, alpha 2 agonists, gram negative sepsis or endotoxaemia

Question 28

what is the water deprivation test used to diagnose?

Answer 28

distinguish renal failure vs other causes of PUPD

if urins spG > 1.025 or >12-15% loss of BWT or 12 g/l increase in TPP or azotaemia = renal

if concentrates normally, cushings or psychogenic

Question 29

horse with PUPD

responds to additional ADH

dx?

Answer 29

Diabetes insipidus

Question 30

USG or <1.008

rule out renal disease?

Answer 30

yes,

Question 31

red urine ddx

Answer 31

haematuria: whole red blood cells,
cystitis, pyelonephritis, drug toxicity, urinary tract neoplasia

pigmenturia: myoglobinuria
myopathy, exercise induced, sycamore poisoning (very ill horse)

haemoglobinuria:
IMHA, notifiables: EIA, piroplasmosis

Question 32

older gelding with maloderous sheath and swelling
red discharge on legs

ddx?

Answer 32

urethritis

clean + topical abs, dont overclean

Question 33

urine sediment > 10 leucocytes HPF + >20 organisms / HPF

top urinary ddx

Answer 33

cystitis

Question 34

posturing to urinate, dysuria, haematuria, stranguria, colic, urine scalding, loss of condition

dx by palpation or endoscopy

Answer 34

cystic and urethral calculi