Urolithiasis Flashcards

1
Q

Who does urolithiasis occur in?

A

occasionally in feedlot steers
more common in small ruminants
especially common in pet animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are complications of urolithasis?

A

bladder rupture

urethral rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are risk factors for urolithasis?

A
male
castrated--urethra is smaller
diet (high grain--high phosphorus)
small ruminants 
breed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common urolithiasis stone?

A

struvite

calcium phsophorus magnesium mix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why are pet animals at risk of urolithiasis?

A

grain + grass

often don’t think about correct calcium phos ratio etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What animals are the worse for urolithiasis?

A

pet pygmy goats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a second common stone of urolithiasis?

A

silicate but specific areas like in some areas of california

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the clinical signs of urolithiasis?

A
  1. dysuria
  2. stranguria
  3. dribbling urine
  4. vocalization
  5. tail flagging
  6. abdominal straining
  7. colic
  8. abdominal distension–bladder rupture, pendulous symmetric abdomen?
  9. preputial edema–urethra ruptured-osmotically active!! draws fluid in!!! can be hot–severe inflam
  10. bruxism
  11. anorexia, weakness, depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you diagnose urolithaiss?

A

examination of penis–not uncommon to see hairs covered in crystals
rectal: bladder, urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What might you feel of the urethra with palpation?

A

spasming of urethra trying to urinate, fluid filled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why does urinary catheterization not work with ruminants?

A
  1. sigmoid flexure

2. dorsal diverticulum (a blinded ended sac just before reaches bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the chemistry seen with urolithiasis?

A
  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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why should you smell cattle breath with urolithiasis?

A

smells like urea!!!! really gross toilet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are two ways can confirm diagnosis by getting at fluid?

A
  1. belly tap

2. FNA of ventral body wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should you use to confirm identity of fluid you get back from belly tap/FNA of ventral blood walls?

A

BUN strips to measure blood BUN (uremia) AND compare to body fluids (is body fluid more uremic than blood?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the toughest urolithiasis cases to dx?

A

those that have not ruptured

17
Q

What are the treatments for urolithiasis?

A
  1. medical
  2. surgical
  3. euthanasia
18
Q

What are the treatments for urolithiasis in small ruminants?

A
  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

19
Q

What is walpole’s solution used for?

A

it is an acidifier that is injected directly into the bladder
some success in goats
(research)
but would take a while for stone to dissolve

20
Q

what are surgical methods of correcting urolithiasis?

A
  1. tube cystotomy (gold standard).

2. perineal urethrostommy

21
Q

What are the features of tube cystotomy?

A

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

22
Q

What is post op care for tube cystotomy?

A
  1. fluids
  2. antimicrobials
  3. urinary acidifiers
  4. smooth muscle relaxants
  5. analgesics
    wait about 10 days then clamp off the foley (do NOT pull out right away)
23
Q

What are the features of perineal urethrostomy?

A
  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
    2cut penis
  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
24
Q

What should you do with bladder rupture?

A

drain urine from bladder slowly

repair (usuallly ruptured dorsally)

25
Q

What do you do with urethral rupture? (the prepucial edema)

A

flay open skin to facilitate drainage but fly strike can be a big issue

26
Q

how do you prevent urolithiasis?

A

adequate water access
ensure balanced minerals in diet
avoid high grain low forage diets
(or balance calcium, phosphorus)