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Flashcards in Urinary tract disease 2 Deck (100)
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List the methods used for the diagnosis of ectopic ureters and give the treatment

- Diagnosis: contrast radiography, urethroscopy, caginoscopy, cystoscopy in large animals
- Treatment


What may develop secondary to ectopic ureters?

- Hyroureter/hydronephrosis
- Urine scald


Give the foetal role and adult structure of the umbilical vein

- Source of oxygentated blood from dam to foetus via liver
- Forms falciform ligament/round ligament of liver


Give the foetal role and adult structure of the umbilical arteries

- Branches of external iliac arteries carrying waste material from foetus to dam
- Forms round ligaments of the bladder


Give the foetal role and adult structure of the urachus

- Connection from foetal bladder to allantoic sac
- Forms scar on apex of bladder


List the differentials for umbilical swellings in the neonate/young animal

- Umbilical hernia
- Umbilical abscess
- Patent urachus


Describe the typical appearance of umbilical hernias

- Soft tissue swelling in ventral abdomen
- Usually present since birth
- May be fluctuant
- Reducible


How are umbilical hernias diagnosed?

Ultrasonography demonstrating intestine, omentum, other abdominal organs


Discuss the prognosis for umbilical hernias

- Small: good prognosis, may spontaneously regress, less likely to contain abdominal contents
- Medium: may contain intestines, more concerning if more than 2-3 fingers wide, risk of strangulation
- Large: least likely to seal up with conservative treatment, but less likely to strangulate (material can get in, can probably get out)
- Simple hernias have no effect on animal except cosmetic appearance


Describe the possible types of umbilical infection

- Omphalophlebitis: sepsis of umbilical veins (tracks to liver)
- Omphaloarteritis: sepsis of umbilical arteries (tracks along round ligaments)
- Urachal sepsis (sepsis of urachus, tracks to bladder)


Outline the signs of umbilical infection

- Heat, pain, oedema, cellulitis
- Other systemic signs e.g. pyrexia, joint infection
- +/- discharge


Describe the ultrasonographic appearance of umbilical infection

Encapsulated soft tissue mass with flocculent fluid (pus) or gas


Outline the treatment of umbilical infection

- Asses and correct underlying cause (e.g. failure of passive transfer, hygiene)
- Medical treatment: systemic antibiotics
- Surgical: where infection has spread (esp. to abdo organs) or not responding to medical treatment. Must excise or marsupialise entire extent of infection


Outline the signs and diagnosis of patent urachus

- Present at birth
- Dribble urine from umbilicus
- Umbilical infection
- Frequent posturing/straining to urinate
- Diagnosis: ultrasound or contrast radiography (in dogs and cats)


Outline the treatment of a patent urachus

- Leave to resolve if very young
- Local treatment if non-infected: clamps, astringents (e.g. 7% iodine, silver nitrate)
- Medical management: broad spec antibiotic treatment/prophylaxis based on C+S
- Surgical: resection of urachus back to bladder, close over apex scar
- Treat scondary problems


List causes of uroperitoneum

- Patent urachus
- Damage to ureters or urethra
- Bladder rupture or perforation


Discuss the occurrence uroperitoneum in neonates

- Bladder rupture most common in large animals, usually dorsal bladder, can be spontaneous or trauma
- Patent urachus discharging into peritoneal cavity
- Urachal infection compromising bladder wall


Discuss the occurrence uroperitoneum in adults

- Bladder rupture secondary to trauma
- Bladder rupture secondary to obstruction


Outline the clinical signs of uroperitoneum

- Fluid distension, fluid thrill
- Unable to palpate bladder
- Peritonitis (abdo pain, ileus)
- Dehydration
- Acid-base and electrolyte abnormalities (cardiac arrhythmias)
- Decreased urination
- Neonate: lethargy, not suckling, collapse, sepsis
- Some animals may still pass small vols of urine and small bladder may be visible on imaging


Outline the diagnosis of uroperitoneum

- Aspiration of fluid
- Ultrasonography/contrast radiogrpahy to confirm peritoneal effusion and defect in bladder
- Biochem: uraemia, dehydration, hyperK, hypoNa, hypoCl


Discuss hyperK associated with bladder rupture

- Reduced/no excretion = hyper K, reabsorbed through peritoneal membrane
- Causes bradycardia
- Must be corrected and stabilised as an emergency, must be dealt with prior to surgery


Outline the treatment of uroperitoneum and bladder rupture

- Correct hydration and electrolyte imbalance
- Calcium gluconate to correct potassium in emergency, dextrose and insulin
- Treat uroperitoneum, drain with care, flush
- Surgical repair of bladder
- Post-op fluids (0.9% saline, bolus admin indicated), NSAIDs and antibiotics


Compare the fluid therapy of a neonate to that in an adult

- Neonate has limited ability to alter renal function
- GFR and RBF reduced in neonate
- Limited ability to respond to changes in ECF or acid base imblances
- Neonate has high body water due to small amounts of fat
- Predisposed to hypovol
- Fluids need to be accurate and regularly monitored


List pathogenic causes of urinary tract disease that may occur in cattle, and indicate other species that may be affected and whether they are shed in the urine

- Leptospirosis (dogs, people, most mammals), shed in urine
- Clostridium perfringens type D
- Clostridium haemolyticum (sheep, rarely in dogs), canbe shed in urine
- Babesia spp. (dogs)
- MCF (pigs, exotics, ruminants, deer, transmitted asymptomatically by sheep)


What disease may be transmitted by rabbit urine? Zoonotic?

- Encephalitozoon cuniculi
- May affect severely immunocompromised people


Compare leptospirosis in cattle and dogs

- Cattle: mainly reproductive disease
- Dogs: AKI, liver disease, acutely ill


Describe the clinical signs of Clostridium perfringens type D in cattle

- Neuro signs, depresson, sudden death
- Pulpy kidney on PM (not pathognomic)


Outline the treatment and prevention of Clostridium perfringens type D in cattle

- Antibiotics not usually effective, toxins causing disease, often fatal
- Vaccinate pregnant dam with general clostridial vaccine
- Prevent animals gorging on lush pasture


Outline the prevention of Clostridium perfringens type D in sheep

- Vaccinate lambs before 2 months old, booster 1 month later
- Care moving lams from milk to concentrate, prevent gorging


Compare the prevalence of Clostridium perfringens type D and Clostridium haemolyticum

- Common in UK
- C. haemolytic ~15% of clostridial disease