Flashcards in Urolithiasis Deck (26)
Who does urolithiasis occur in?
occasionally in feedlot steers
more common in small ruminants
especially common in pet animals
What are complications of urolithasis?
What are risk factors for urolithasis?
castrated--urethra is smaller
diet (high grain--high phosphorus)
What is the most common urolithiasis stone?
calcium phsophorus magnesium mix
Why are pet animals at risk of urolithiasis?
grain + grass
often don't think about correct calcium phos ratio etc
What animals are the worse for urolithiasis?
pet pygmy goats
What is a second common stone of urolithiasis?
silicate but specific areas like in some areas of california
What are the clinical signs of urolithiasis?
3. dribbling urine
5. tail flagging
6. abdominal straining
8. abdominal distension--bladder rupture, pendulous symmetric abdomen?
9. preputial edema--urethra ruptured-osmotically active!! draws fluid in!!! can be hot--severe inflam
11. anorexia, weakness, depression
How do you diagnose urolithaiss?
examination of penis--not uncommon to see hairs covered in crystals
rectal: bladder, urethra
What might you feel of the urethra with palpation?
spasming of urethra trying to urinate, fluid filled
Why does urinary catheterization not work with ruminants?
1. sigmoid flexure
2. dorsal diverticulum (a blinded ended sac just before reaches bladder)
What is the chemistry seen with urolithiasis?
1. post renal uremia for cattle
ruminants less severely affected
ruminants and small ruminants have salivary glands to take out urea and potassium from blood and dump into mouth and goes to rumen and it is metabolized into protein by bacteria so get way less uremic, can also sequester a lot of potassium in GI tract
Why should you smell cattle breath with urolithiasis?
smells like urea!!!! really gross toilet
What are two ways can confirm diagnosis by getting at fluid?
1. belly tap
2. FNA of ventral body wall
What should you use to confirm identity of fluid you get back from belly tap/FNA of ventral blood walls?
BUN strips to measure blood BUN (uremia) AND compare to body fluids (is body fluid more uremic than blood?)
What are the toughest urolithiasis cases to dx?
those that have not ruptured
What are the treatments for urolithiasis?
What are the treatments for urolithiasis in small ruminants?
1. most blockages are in the urethra process soooo SIMPLY REMOVE!--cut the urethral process
debate about importance of reducing ram fertility but noone has figured this out
What is walpole's solution used for?
it is an acidifier that is injected directly into the bladder
some success in goats
but would take a while for stone to dissolve
what are surgical methods of correcting urolithiasis?
1. tube cystotomy (gold standard).
2. perineal urethrostommy
What are the features of tube cystotomy?
gold standard, maintains fertility
1. percutaneous catheter into bladder--could punch through body wall if bladder really large
allows urine to drain and allow inflam to decrease in urethra and hopefully stone passes on own
What is post op care for tube cystotomy?
3. urinary acidifiers
4. smooth muscle relaxants
wait about 10 days then clamp off the foley (do NOT pull out right away)
What are the features of perineal urethrostomy?
1. surgically prepare area below rectum
2. incise over penis and dissect around bend penis at ventral aspect of sigmoid flexure and pull to get a lot of penis! need a stump 2-3inches long
3. reflect caudally
4. ligate dorsal artery and vein
5. transect retractor penis muscle proximally
6. suture penile stump to skin
7. avoid any pressure dosrally (where urethra now lies!--want to avoid the urethra because don't want swelling to put pressure on urethra)
8. close the incision ventrally
SALVAGE--get them out of uremic state and get the mto slaugther
need to have a big stump because contracts as it dries--need 2 inches sticking out
What should you do with bladder rupture?
drain urine from bladder slowly
repair (usuallly ruptured dorsally)
What do you do with urethral rupture? (the prepucial edema)
flay open skin to facilitate drainage but fly strike can be a big issue