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198 Cards in this Set

  • Front
  • Back
Bovine have what type of kidneys?
Lobulated
Which bovine kidney can be felt on rectal palpation?
The left kidney (towards the right side)
When palpated rectally, the bovine ureters are what size?
The size of straws
In the llama, the male urethra points in which direction?
Posterior
What structure make catheterization of the male ruminant difficult?
Urethral diverticulum
What stance do female ruminants take when urinating?
Wide legged, tail raised, back arched
Why is stance important?
Abnormal stance can indicate a problem
In general, are renal diseases in ruminants a herd problem or an individual problem?
Individual problem
What are the clinical signs of lower urinary tract dz?
-dysuria
-stranguria
-character of urine
-urinary incontinence
-concretion accumulation
What's a sign of urinary incontinence in female ruminant?
Dried urine of perineum, or legs
What are the clinical signs of upper urinary tract infection?
More systemic signs
-depression
-anorexia
- increased TPR
-dehydration
Hematuria seen at the beginning of urination indicates a problem where in the tract?
lower tract- urethra
Hematuria at the end of urination indicates a problem where?
Bladder
Hematuria throughout urination indicates a problem in what part of the tract?
Renal in origin or entire tract
What are the clinical signs/finding of terminal renal dz?
-hypoproteinemia from renal loss
-ventral edema, ascites, wt loss, renal anemia
Septicemia of what other organ systems can affect the kidney?
-mastitis
-metritis
Which diseases can act as a urinary tract dz, but not actually affect the urinary tract?
-intravascular hemolysis
-tying up/azotemia
-ketosis
-diabetes mellitus
-adrenal or pituitary dysfunction
-stress
The color of urine varies with what 2 factors?
Species and hydration
What is the turbidity of cow urine?
Clear
What is the specific gravity of normal bovine urine?
1.015-1.045
Urine pH of ruminants can vary with what?
-anionic salts
-increase in grain
Under which normal conditions would you expect to see proteinuria?
-parturient animals: due to genital tract contamination
-neonates: colostral proteins
Is a urine dipstick more sensive to albumin or globulins?
Albumin
True or False...a urine sample with hematuria will be clear red?
False, cloudy red
clear red is hemoglobinuria
What are the potential causes of glucosuria?
-IV dextrose
-stress
-steroids
-diabetes mellitus
-renal tubular dz
-C perfringens type D
Ketones are a result of what?
by product of fat degradation, increase when fat stores are used as an energy source
What 2 by products are dependent on GFR for excretion?
-urea
-creatinine
Increased BUN and creatinine are seen ih which conditon?
Pre-renal azotemia, usually higher BUN than creatinine
What does low BUN with increased creatinine indicate?
Hepatic dz
What is the common name for ulcerative posthitis and vulvitis?
Pizzle rot
Describe pizzle rot.
An ulcerative bacterial infection of the mucous membrane surrounding the skin of the prepuce or vulva of small ruminants
What is the causative agent of pizzle rot?
Corynebacterium renale
The presence of what, in the urine, can cause proliferation of C renale?
urea
When is an increase of urea usually seen?
A diet with a content of excess protein
Which breeds of sheep are more susceptible to pizzle rot and why?
Angora and Merino- thick wool
Is pizzle rot contagious?
venereal transmission has been reported
In rams and bucks where does pizzle rot first occur?
As a moist ulcer located at he mucocutaneous junction of the prepuce
What is the appearance of pizzle rot as the disease progresses?
Thin, loose brown-red malodorous scab, focal swelling at the cranial aspect of the prepuce, is very painful
In left intreated, what can happen?
Infection will spread to deeper tissues, adhesion can form between prepuce and penis, urethral process (pizzle) may stricture
Does pizzle rot affect breeding soundness?
Yes
-blood and exudate in semen
-pain will inhibit libido
-scarring or urethral orifice
Where do lesions appear on ewes and does?
Vulva and perineum
What clinical sign might be seen in vulvitis?
Dysuria from involvement of urethral orifice
Whta dietary condition is needed for C renale to proliferate and cause pizzle rot?
Diets high in crude protein or nonprotein nitrogen, increases urinary urea--> ammonium ions liberated, causes ulceration of muscosa
What is the tx for affected animals?
-isolate affected animals
-clip wool from infected areas, apply topical abx
-admin systemic PCN
-reduce dietary protein levels
What is the prognosis of pizzle rot?
-tx is good in early stages of dz
-must reduce dietary protein
-breeding soundness is poor if infection has invaded internal tissues
Urolithiasis is a dz occuring almost exclusively in which sex? Why?
Males
female urethra is shorter and wider
Animals with untreated urolithiasis can have azotemia and what other condition?
Progressive renal failure
Since blood work can be unremarkable in urolithiasis, what diagnostics are used?
-Hx
-PE
-U/S
-rads
What CBC results are common with urolithiasis?
-hyperglycemia
-stress luekogram
-in time dehydration, azotemia
In the case of bladder rupture, what changes are expected on the CBC?
-hypnatremia
-hypochloremia
-hyperphosphatemia
-uremia
-hemoconcentration
-inflammatory CBC with fibrinogen (tissue necrosis)
What step do you take in the case of urolithiasis if azotemia or urinary tract rupture has not occurred?
Slaughter
Whae steps in medical tx can you take for urolithiasis?
-IV fluids
-Nsaids
-tranquilizers
What surgical tx are available to tx urolithiasis?
-tube cystotomy
-perineal cystotomy
-urethrotomy
-bladder marsupilization
Post operatively, urine needs to be monitored, how long should abxs be given?
1 week past surgery 3 weeks for UTI
need antimicrobial that will reach high urinary concentrations
What other post op considerations are taken?
Urine acidifying agents
Nsaids
Does the age at which a male is castrated make a difference in the development of urolithiasis?
No
Why do urolithiasis occur more frequently in cold weather or hot, arid summer?
frozen water
stagnant water
What is the pathophysiology of calculi formation?
High urinary concentrations of soluble, ionized material aggregate to form insoluble crystals
What is a prerequisite for urolith development?
Supersaturation of urine with crystalloid minerals
What other factors dictate if crystalloids form into crystals?
-mucoprotiens: act as a template on which calculogenic ions can initiate crystallization
-some plants
-urine pH
Acidic urine promotes the formation of what types of crystals?
Oxalate and xanthine
Alkaline urine favors the formation of which calculi?
calcium
magnesium phosphat
cabonates
triple phosphates
iron carbonates
A deficiency of which vitamin can lead to metaplasia of urinary tract epithelium....a nidus for calculogenesis?
Vitamin A
What is another name for phosphate uroliths?
Struvite
What type of feed promotes struvite formation?
Rations high in phosphorus- grain
Why do pelleted rations increase the risk of urolithiasis?
requires less chewing, saliva is high in phosphorus and doesn't get excreted as much
Silica uroliths are generally found in sheep and cattle grazing where?
Rangeland grasses in western North America
What is the characteristic appearance of calcium carbonate crystals?
Round shape and gold color
True or false, calcium oxalate uroliths are rare in ruminants.
True
To lower the incidence of urolithiasis, the diet should be adjusted to have what ratio of calcium and phosphorus?
2 parts calcium: 1 part phosphorus
What should be fed instead of pelleted diets to stimulate cud formation?
Long stem fibers
Why would you add sodium chloride to the diet?
Increase thirst and water consumption
Why is ammonium chloride added to ruminant feed?
To acidify urine and prevent crystals from precipitating
What are the signs of acute urethral obstruction?
-stranguria
-abdominal pain
-restlessness
-treading of feet
-swishing of tail
-grinding of teeth
-tachypnea
-tachycardia
-mild rumen bloat
(goat's may vocalize)
Continued stranguria can result in what condition?
Rectal prolapse
UA of urethral obstruction by a calculi will show what results?
-increased blood
-proteins
-crystals
What sign of obstruction might be seen on preputial hair?
Mineralized concretions
Where is the common site of urethral obstruction in cattle?
Sigmoid flexure near the retractor penis muscles
Where is the common site of urethral obstruction in small ruminants?
At the urethral process at the tip of the penis
In small ruminants, where would you palpate for a pulsing urethra?
Through the flank (rectally on bovine)
How can urethral obstruction be tx in small ruminants?
Amputate the urethral process
Which drug should not be given to small ruminants for sx of the urethral obstruction?
Xylazine- will increase blood glucose and will increase urine production
What is a common complication of urethral obstruction?
urethral rupture
What effects can result from pressure necrosis causing leakage of urine into the subcu tissues of the perineum and ventral abdomen?
-cellulitis
-penile adhesions
-urethral stricture
Urethral obstruction can lead to what effect in the bladder?
pinpoint perforations or necrosis of large areas of the bladder wall (from prolonged distension)
Where is the most common site of the necrosis?
Dorsal aspect
When does the stranguria associated with bladder distension stop?
When the bladder ruptures
What clinical signs are seen as urine accumulates in the abdomen?
depression
-anorexia
-weakness
-dehydration
-shock
What techniques are used to demonstrate urine in the abdomen?
-U/S
-abdominocentesis (large volume of yellow to blood tinged fluid)
What effects can chronic retention of urine have from a partially obstructed urethra?
-hypertrophy of bladder wall
-hydroureter
-hydronephrosis
What are the 2 most common bacteria associated with UTI in ruminants?
E coli
C renale
How is cystitis characterized in cattle?
-dysuria
-pollakiuria
-w/wo gross hematuria
What signs might an affected cow show?
-tread
-tail swishing
-arched stance after voiding
Blood, purulent debris pr crystalline material may occasionally be found were in affected cows?
On the hairs of the ventral commissure of the vulva
What might you find on rectal palpation of a cow with a UTI?
Thickened, painful bladder
Does a cow with an infection limited to the bladder show generalized signs such as depression, fever, anorexia?
No
What signs in the history of an infected cow can point to illness?
Abrupt reduction in food intake and milk production
What are the other signs that can be seen with acute pyelonephritis?
-fever
-depression
-ruminal stasis
-scleral injection
-milk colic
What vague clinical signs might be seen in chronic pyelonephritis?
-weight loss
-poor growth rate
-anorexia
-decreased milk production
What CBC changes would you expect to see in a cow with pyelonephritis?
-neutrophilic leukocytosis
-hyperfibrinogenemia
if the infection is established for several days what changes might you seen in the bloodwork?
Hyperglobuloinemia
What might be the cause of diarrhea in an infected cow?
Proteinuria may cause hypoalbuminemia--> low plasma oncotic pressure-->diarrhea
How does chronic pyelonephritis lead to anemia?
-reduced erythropoietin production
-chronic inflammatory dz
-blood loss through urine
How do subclinical carriers of C renale transmit the organism?
Direct vulvar contact or splashing of urine on the vulvas of susceptible cows
How does iatrogenic transmission occur?
Through contaminated obstetric instruments or urinary catheters
Is adherence of C renale to the renale tract epithelium enhanced by an acidic or alkaline pH?
Enhanced by alkaline pH
How does the C renale organism maintain an an alkaline environment?
Through ureolysis and ammonia production
What is the drug of choice to treat C renale?
PCN
What drug can be used for E coli?
Ampicillin (high doses)
How long should abx tx be continued?
3 weeks
What is the cause of amyloidosis in cattle?
Deposition of insoluble protein fibrils in the kidney, GIT, liver, adrenals
Renal amyloidosis is characterized by what clinical sign?
Sporadic chronic wasting disease
What effect does amyloid have on the kidney?
Disrupts normal glomerular structure, results in PLN
What are the common clinical signs of amyloidosis?
-diarrhea
-weight loss
-poor productivity
-ventral edema from hypoproteinemia
When a cow with amyloidosis urinates, what finding might you seen in the urine?
Develops stable foam after hitting the ground (or shaking in a container) due to high protein content
What clin path findings will you see with amyloidosis?
-proteinuria, hypoalbuminemia
-elevated BUN, creatinie if renal damage is advanced
-hyperfibrinogenemia and hyperglobulinemia may occur
What technique would be need to look for the presence of amyloid protein in the urine?
Electron microscopy
Amyloidosis in cattle is classified as the reactive type (AA) which is associated with what type of dz?
Chronic inflammatory dz
True or false, amyloidosis is easily reversible.
False, cannot be reversed
Active amyloidosis is usually in response to what type of condition?
-concurrent inflammatory dz such as mastitis, hardware dz, pneumonia, metritis
Why does amyloidosis cause diarrhea?
As a result of edema or amyloid deposition in the GIT
What is the cause of glomerulonephritis (rare condition) in ruminants?
Deposition of Ag-Ab complexes in the glomerular basement membrane or binding of Ab to intrinsic or foreign antigens in the glomerulus
Mesangiocapillary glomerulonephritis has been described in which breed of lambs?
Finnish Landrace
What signs might affected lambs show?
-dull
-ataxic
-appear blind
signs start within hours after birth to 3 months of age
-may see fine muscle tremors, colic, convulsions
What is the tx for glomuleronephritis?
There is none
What causes tubular necrosis?
A variety of toxic, infection or hemodynamic insults to the kidneys
What heavy metals can cause tubular necrosis?
-arsenic
-mercury
-lead
-zinc
-copper
Tubular necrosis in ruminants can be caused by which antimicrobials?
-aminoglycosides
-tetracyclines
-sulfonamides (rare)
(and Nsaids)
Which plants can cause tubular necrosis?
-pigweed
-easter lily
-oak
-ponderosa pine
-cocklebur
-oxalate containing plants
Endogenous causes of tubular necrosis include what?
-hemoglobin
-myoglobin
-calcium oxalate
What other causes of tubular necrosis might you see?
-ethylene glycol
-vit C
-vit D
What are the clinical signs of tubular necrosis?
Often nonspecific
-anuria, oliguria, polyuria
-diarrhea
-poor appetite
-depression
-nasal discharge
-epistaxis
-ileus
-melena
-mild bloat
-muscle weakness
What clin path results could you see with tubular necrosis?
-elevated BUN/Cr, w/ isosthenuria
-protein, hematuria, granular casts on UA
What is the tx for tubular necrosis?
-remove source of toxin
-restore perfusion (IV isotonic, sodium containing fluids, calcium and potassium supp if needed)
-diuretics to stimulate urine production
What effect can leptospira have on the kidney?
Chronic infection of the renal tubules--usually causing little or no dz to the host
How is lepto transmitted?
-direct contact with urine from an infected maintnance host
-through environmental or feed contamination with infected urine
Infection of an incidental host can cause what disease conditions?
-kidney, liver, CNS dz
-abortion and reproductive failure
On of the challenges of tx lepto is its ability to persist in what kind of environment?
can persist for 6 months in a warm, moist environment
Which serovar of lepto is host adapted to cattle?
serovar hardjo
Cattle are the incidental hosts for which 2 serovars?
-pomona
-grippotyphosa
For cattle, an infection with hardjo produces what type of dz?
Most infections are asymptomatic or result in non-specific repro failure or abortion
Infection with a non-host adapted serovar can lead to what dz conditions?
-systemic dz
-hemolytic anemia
-hepatitis
-interstitial nephritis
-tubular nephrosis in calves
What are the clinical signs of non-host adapted lepto infection?
-fever, anorexia, lethargy
-decreased milk production
-petechiation
-hemolytic anemia
-hemoglobinuria
How does lepto gain entry into the host?
Through external mucosal surfaces and scarified macerated skin
During the convalescent phase of infection, where does lepto localize, where it appears to be protected from the immune response?
-mammary gland, kidney, genital tract
Which is the most widely used test to detect lepto?
Microscopi agglutination test (MAT)
(detects Ab to specific serovars)
urine culture is often unrewareding for detecting lepto, if you proceed with a urine culture how should the sample be collected?
Second void urine sample collection after the administration of furosemide
How is lepto tx?
-Oxytetracycline
-supportive care (IV, Nsaids, nutrition)
How can lepto be prevented?
-drain or fence off standing water
-dry, clean environment
-limit exposure to rodents, wild life
-vaccinate
What are the clinical signs of lower urinary tract infection?
-pollakiuria
-dysuria
-stranguria
-periuria
-hematuria

No PU/PD... higher up in kidney or systemic
A PE for lower urinary tract dz must include what components?
-abd palpation
-rectal exam
-UA/UC
If there are signs of systemic illness, what diagnostic should you do?
Bloodwork
What can cause an anatomic urethral obstruction?
-urolithiasis
-neoplasia
-cysts
-mucus plug
What can cause a functional urethral obstruction?
reflex dyssynergy
What steps do you take in tx an urethral obstruction?
-is it a complete obstruction
-blood work (K+)
-correction
-catheterization (retrograde propulsion)
-fluids
-culture
What are uroliths?
Organized crystal aggregates
What factors affect the formation of uroliths?
-pH
-temp
-promoters
-inhibitors
What are the potential sequellae to urolithiasis?
-urinary tract infection
-obstruction
-poly formation
-chronic irritation
What are the potential causes of urolithiasis?
Dogs & Cats:
-absorption or elimination abnormalities
-dietary (calculogenic ingredients)
-genetic abnormalities (metabolism, elimination)
Dogs Only: UTI
True or False, crystalluria is uncommon.
False, it is common
How do stones start to form?
adherence to epithelium-->aggregation-->stone formation
How is urolithiasis dx?
Hx: stranguria, dysuria, hematuria,stones
complete or partial obstruction
PE: palpation including rectal
What chem results might you see with urolithiasis?
-normal
-obstructed: azotemia, hyperkalemia, hyperphosphatemia
Other dz: hypercalcemia, PSS (urate stones), BUN, albumin, glucose
What are the 4 components of a UA?
-USG
-pH
-sediment
-urine culture
Which type of uroliths can't be seen on radiographs?
cysteine, urate
(I can't C U)
What are the goals of tx for urolithiasis patients?
-stone removal/retrieval (analysis/culture)
-prevention of recurrence
-diet, management, monitoring
What concurrent dz might you encounter with urolithiasis?
-PSS
-persistant urachus, diverticula
What is a common complication of tx urolithiasis?
Hematuria
What factors determine the tx for urolithiasis?
-composition
-size and location
-complicating factors(owner.pt compliance)
Often, what is the best tx for urolithiasis?
Surgery
When performing sx, what is the best method of visualizing the urethra?
pass a catheter
External catheterization can be used for what size of stones?
small and numerous
-in lat recumbency
-sedation/anesthesia
-saline distention of bladder
-vigorous abdominal massage
How is voiding urohydropropulsion performed?
-anesthesia
-vertical positioning
-saline distention
-vigorous massage
-steady slow pressure on bladder
-stones must be small enough to pass thru urethra
Lithotripsy uses what to break up stones?
sound waves
Can stones be medically managed?
-certain minerals can
-diet and drugs
-risk for obstruction
-weeks to months to tx
-monitoring is necessary
-frequent BUN, Cr, UA
How can urolithiasis be prevented?
-increase water consumption
-pH control
-UTI elimination
-tx predisposing conditions
-diet
-pharmaceuticals (Alopurenol)
What is the most common calculi in dogs?
Struvite
(magnesium ammonium phosphate MAP)
What are the causes of sterile struvite calculi?
-hereditary
-diet
-metabolic
How do you dx struvite calculi?
-Hx, PE, clin signs
-large, multiple radiodense calculi
-UTI (staph intermedius)
-pH > 6.2
-struvite crystalluria
-schnauzer, poodle, bichon
What is the sx tx for struvite calculi?
-removal and urethral hydropropulsion
-stone analysis and culture
-abx for 14 days
How can you medically manage struvite calculi?
-S/D diet short term
-urinary acidifiers
-urease inhibitors (lot of side effects)
-recheck monthly, if no response in 2 months...sx
How can you prevent struvite calculi?
- long term UTI prevention
-low ash maintenance diet
Calcium oxalate calculi result from what dietary condition?
-dietary Ca++, oxalate or citrate ions
Do calcium oxalate calculi form in alkaline or acidic urine?
Acidic (hypocitraturia)
Hyperoxaluria can be from the diet or what other source?
Oral vitamin C excess
How do you dx oxalate calculi?
-Hx, PE, clin signs
-male of predisposed breed
-calcium oxalate crystaluria
-dz conditions (hypercalcemia/uria
How can oxalate stones be prevented?
-alleviate hypercalcemia/uria
-avoid calcium, excessive protein & oxalate
-do not restrict phosphorus
-increase water intake
-potassium citrate (alkalinizer)
-Vit B6 (prevents oxalate formation)
-hydrochlorothiazide (reduces hypercalciuria)
Urate calculi are a result of uric acid produced by what?
Purine metabolism
In which breed are urate calculi common?
Dalmations, esp males
What other dz condition can cause urate calculi?
PSS, severe hepatic dysfunction
urine culture in the case of urate calculi shows what?
urease + bacteria
Do urate calculi form in acidic or alkaline urine?
acidic
What are the txs for urate calculi?
-sx removal
-PSS correction
-medical dissolution (Allopurinal)
How can urate calculi be prevented?
-increased water intake
-low purine diet
-potassium citrate (alkinizaiton/normal pH)
-UTI management
-Allopurinol
What is the cause of cystine calculi?
Abnormal renal reabsorption of basic amino acids
Which breeds are most affected in cystine crystals?
-english bulldog, mastiffs, bull mastiffs
What is the appearance of cystine crystals?
Small, spheroid finely granular
Along with sx, what other steps to prevention of cystine calculi can be taken?
-water increase
-potassium citrate (alkalinizing)
-cystine chelators
-diet: low proteins