Urinary Tract Disorder IN FOALS Flashcards
(57 cards)
1
Q
Signs of Urinary Tract Problems in foals
A
- Azotemia in the first 24 hours
- Lack of urination
- Dribbling urine from the urachus
- Abnormal posturing
2
Q
Normal Time for first normal colt urination
A
6-8 hours postpartum
3
Q
Normal time for first filly urination
A
- 10-12 hours postpartum
4
Q
Initial urine concentration
A
- Dilute or concentrated
5
Q
Foal urine concentration after 24-48 hours
A
- Hyposthenuric
- AKA specific gravity <1.008
- If it’s not this in a foal, the foal isn’t nursing enough
- Mare’s milk is mostly water
6
Q
Azotemia in neonatal foals possible indicators if foal is less than 7 days of age?
A
- Placental insufficiency
- Pre-renal failure
7
Q
Other causes of azotemia in foals
A
- Acute kidney injury (AKI)
- Obstructive disease
- Congenital renal disorders
- Uroperitoneum
8
Q
Normal umbilical anatomy of the foal
A
- see the picture on your desktop
9
Q
What structure does the umbilical vein become?
A
- Falciform ligament
10
Q
What structures do the umbilical arteries become?
A
- Round ligaments of the bladder
11
Q
Umbilical ultrasound
- Image type: transverse/longitudinal
- Where is it located?
A
- Transverse image
- Cranial to urinary bladder
- Caudal to external umbilicus
12
Q
What would it mean if the urachus was black?
A
- That means that it’s patent
13
Q
Urachal diverticulum
- Image type: transverse/longitudinal
A
- Can be seen on longitudinal view
- Cranial to left
- Occasionally occurs
14
Q
Clinical signs with urachal diverticulum
A
- Straining to urinate
15
Q
Patent urachus signs
A
- Dribbling urine from umbilicus
16
Q
Patent urachus and umbilical infection
A
- Can be a preliminary feature of umbilical infection
17
Q
Treatment for patent urachus
A
- Surgical or medical
- Must fix underlying problem, treat urine scald with skin protectants (can pool underneath the skin)
- Systemic antimicrobials excreted in the urine in high concentrations
- Surgery to remove umbilicus (sometimes hope that getting up and not laying in urine will close it up without surgery)
18
Q
Uroperitoneum causes
3, and which is most common?
A
- Ruptured bladder* (most common)
- Ureteral rupture
- Urachal leak
19
Q
Clinical pathologic abnormalities for uroperitoneum
A
- Serum sodium: decreased
- Serum creatinine: increased
- Serum potassium: increased
20
Q
Diagnosis of uroperitoneum
A
- Ultrasound
- Abdominocentesis
- Peritoneal fluid creatinine will be 2x serum creatinine
21
Q
Treatment of uroperitoneum
A
- Surgical typically
- Can try to treat medically with Foley catheter in place
22
Q
Uroperitoneum cases
A
- see the cases in the lecture
- Not producing urine
- Abdomen increases in size often
- Straining to urinate
- Can be obtunded
- May not be nursing
- Often diagnosed with CBC/Chem/ultrasound
23
Q
What is the emergency with uroperitoneum?
A
- NOT surgical repair
- Treating the hyperkalemia is
- You MUST manage that before going in surgically
24
Q
How to correct hyperkalemia?
A
- Drainage of peritoneal urine accumulation
- Fluid therapy - LRS or 0.9% NaCl with Dextrose (2.5-5%)
25
Omphalophlebitis structures that can be involved?
- Arteritis
- Phlebitis
- Urachitis
- Combinations
26
Diagnosis of omphalophlebitis
- Ultrasound may help
| - Try to accurately assess the internal structures to determine the extent of surgery needed
27
Umbilical abscess locations
1. Umbilical vein
2. Umbilical abscess
3. Subcutaneous abscess
4. Omphaloarteritis
28
Umbilical infection in the umbilical vein challenges
- Can be quite difficult
- Poor vascular entry of antimicrobials
- Sometimes extends to the liver - difficult to remove surgically
-
29
Treatment of omphalophlebitis
- Choose antimicrobial with good penetration
- Thick vascular and abscess walls
- Thick purulent exudate
- Culture via swab if possible
- Antibiotics
- Can treat medically, but may need to remove the umbilicus too
30
What antibiotics work best for omphalophlebitis initially?
- Rifampin + TMS or chloramphenicol
| - Chloramphenicol can cause aplastic anemia in people
31
What should you consider when evaluating an umbilical hernia?
- How large?
- How many fingers? (1 or 2 generally okay; more might be a concern)
- What do you palpate within the hernia?
- GI viscera
- Peritoneal fluid
- Omentum
32
Evaluating a hernia with ultrasound
- Look for bowel and small intestine
- Omentum
- Fluid
- If entrapped fluid or incarcerated intestine (measure wall thickness; intestinal distension; evaluate peristalsis)
33
Treatment of hernia variables
- Depending on size may mean surgical treatment right away or surgical treatment later
34
Inguinal hernia signalment
- young colts
35
Typical timeline for inguinal hernia
- Present at birth or several days later
| - Can be unilateral or bilateral
36
Predisposing factors for inguinal hernias (3 we talked about)
- Large inguinal rings (Tennessee Walking Horse; Standardbred; Draft breeds)
- Trauma
- Increased abdominal pressure (straining)
37
Indirect inguinal hernia definition
- Intestines pass through the intact vaginal ring
| - Contained within the parietal layer of the vaginal tunic
38
Are indirect inguinal hernias usually reducible or non-reducible?
- Usually reducible
39
Urgency of indirect inguinal hernias
- Not usually life-threatening
40
Treatment of indirect inguinal hernias
- Typically resolve with manual reduction within a few days
| - Can even put a diaper on them to try and squish everything back in
41
Direct inguinal hernia definition
- Parietal vaginal tunic or peritoneum in vaginal ring region TEARS
- Intestines become positioned under the skin
- See images
42
Direct inguinal hernias reducible/non-reducible
- Typically not reducible
| - Large amount of intestine involved
43
Urgency of treating direct inguinal hernias
- SURGICAL EMERGENCY
44
How would you usually identify an inguinal hernia?
- usually noted by observation or palpation
45
Clinical signs of indirect inguinal or umbilical hernia
- No apparent clinical signs
46
Clinical signs of direct inguinal or umbilical hernia
- May notice direct inguinal hernia where intestines appear under skin
- very painful and colicky
47
When do inguinal hernias need to go to surgery?
- If strangulation occurs
- Inability to reduce hernia
- Increase in hernia size
- Increase in heat, pain, firmness on palpation
- Development of colic
48
Treatment of indirect inguinal hernias
- Conservative initially
- Small hernias usually correct without treatment
- IMPORTANT to instruct owners to monitor size of hernia and reduce frequently
49
What size hernia are unlikely to resolve on their own?
- Umbilical >5 cm in diameter are more prone to complications and less likely to resolve on their own
50
When is elective surgery indicated for hernias?
- >7-10cm or ones that have not resolved by 7-10 months of age
- Or if strangulating hernia suspected, a prompt surgical treatment is required
51
Ectopic ureters how common?
- Not at all
52
Normal ureter anatomy
- Ureters start at the renal hilus
- Penetrate dorsal wall of the bladder at the trigone
- Trigone is just cranial to the neck of the bladder
53
Internal urethral sphincter
- Segment in proximal portion of urethra where a smooth muscle layer is augmented with fascicles of skeletal muscle
- forms a functional sphincter
54
Control of internal urethral sphincter
Voluntary
55
Ectopic ureters
- One or both ureteral ostia empty into the bladder, urethra, or some point distal to the functional sphincter
- Sometimes ureters empty into uterus or vaginal tract
56
Diagnosis of ectopic ureters
- Urine dribbling
| - Definitive diagnosis made by ultrasound or cystography
57
Treatment of ectopic ureters
- Reconstructive surgery
- Or if unilateral, a nephrectomy
- rarely successful
