FA Med, Q1, Renal

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HLW
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197623
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FA Med, Q1, Renal
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2013-02-03 14:20:52
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FA Med Q1 Renal
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FA Med, Q1, Renal
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  1. Which kidney is palpable in the cow? where do you find it on palpation?
    • Left kidney palpable on right side of midline
    • lobulated in bovine
  2. which species has its penis directed posteriorly? what makes catheterization difficult in ruminants?
    • llama/alpaca
    • urethral diverticulum
  3. is it normal in a cow or bull to dribble urine or have repeat short pulsations? what posture does bull/cow have when urinating?
    • bull has short pulsations
    • arched back, lifted tail
  4. where in the urinary tract can you localize the problem if there is blood at the beginning of the urine stream? at the end? throughout?
    • beginning: urethra
    • end: bladder
    • throughout: kidney
  5. Are UTI's usually an individual or herd problem? what signalment is likely to get pyelonephritis?
    • usually NOT herd problem
    • pyelonephritis in stanchioned dairy cattle
  6. what are important clinical signs of Lower UT disease?
    • *dysuria/stranguria*
    • grunting, prolonged stance
    • concretion accumulation on preputial/vulvar hairs indicates stones
  7. what are important signs of Upper UT disease? what are signs the disease is terminal/advanced?
    • more systemic signs (fever, anorexia, dehydration)
    • hematuria
    • terminal dz: hypoproteinemia --> edema; anemia, wt loss
  8. what is normal SG for bovine urine? pH? how does feeding grain affect pH?
    • SG: 1.015 - 1.045
    • pH: 7.0-8.5
    • feeding grain = alkaline
  9. what are some reasons the urine would become acidic?
    • diet with anionic salts, ammonium chloride
    • ketosis, lactic acidosis, paradoxical aciduria
  10. why is it normal to see trace protein on urine dipstick for bovine urine?
    • alkaline urine reacts with the strip (made for humans) to make it look like there is trace protein
    • neonates with colostrum can also react w/protein marker
  11. can the urine dipstick distinguish between hemoglobin and myoglobin? how do you distinguish between hematuria and hemoglobinuria?
    • no, use other signs
    • hematuria has RBCs in sample; hemaglobinuria has none
  12. hematuria or hemaglobinuria: which would you expect with leptospirosis? copper toxicity?
    hemoglobinuria
  13. hematuria or hemaglobinuria: which would you expect with pyelonephritis or urolithiasis?
    hematuria
  14. hematuria or hemaglobinuria: which would you expect with cold water intoxication?
    hemaglobinuria
  15. would Selenium toxicity and cassia toxicity result in myoglobinuria or hemoglobinuria? what would anaplasma do to urine?
    • myoglobinuria
    • anaplasmosis = normal urine
  16. list 3 drugs that can cause false positive for glucosuria?
    penicillin, tetracycline, aspirin
  17. what are some common reasons glucose is found in bovine urine?
    • stress/steroids
    • *enterotoxemia*
    • xylazine (transient hyperglycemia)
    • IV glucose
  18. which ketone does the urine dipstick NOT detect?
    beta-hydroxybutyrate
  19. Is bull or cow more likely to have higher creatinine? Does BUN or creatinine increase faster w/dehydration?
    • bull may have higher creatinine
    • BUN increases faster w/dehydration
  20. What is the formal name for pizzle rot? what is causative agent? what dietary component is the problem?
    • ulcerative posthitis
    • corynebacterium renale
    • high dietary protein (>18% crude protein)
  21. How do you treat ulcerative posthitis (pizzle rot)?
    • *reduce protein*
    • debride necrotic tissue and irrigate sheath; shear thick wool
    • Abs to skin +/- systemic penicillin
    • fresh, clean water available
  22. what are two most common causative agents of urinary tract infection in bovine? what are common presenting signs?
    • corenybacterium and e.coli
    • *dysuria, pollakiuria*
    • swishing tail, tread feet, arched stance after voiding
  23. Is there usually systemic signs associated with bladder infection? pyelonephritis?
    • not with bladder
    • yes with pyelonephritis (fever, *scleral injection*, anorexia)
  24. what is expected CBC with pyelonephritis?
    • neutorphilic leukocytosis
    • hyperfibrinogenemia, incr. globulins
    • decreased albumin (diarrhea)
  25. What is treatment for UTI? How long to you treat for?
    • Penicillin (will NOT cover e.coli) or Ampicillin
    • 2-3 weeks then culture one week after tx finished
    • *remember to adjust WDT*
  26. what is a patent urachus a remnant of? how do you correct a small patent urachus?
    • allantoic remnant
    • medical cauterization w/silver nitrate or strong iodine
    • give Abs to avoid infection from trapped bacteria
  27. where does amyloid deposit? how does this affect the cow?
    • kidney (disrupts glomerular structure - PLN)
    • also GI, liver, and adrenal glands
    • chronic wasting
  28. does amyloidosis make kidney larger or smaller? what is the appearance of urine?
    • larger from extra deposits
    • foamy urine from the protein content
  29. where does amyloid get synthesized and what triggers it to form?
    • precursors made in liver
    • concurrent inflammation cause precursors to activate --> body can't break them down so they accumulate in tissues
  30. how do you treat amyloidosis and what is prognosis?
    no treatment, poor prognosis for long term survival
  31. what is the host adapted form of lepto in cattle?
    L. hardjo (a serovar of the bacterium L. interrogans)
  32. both L.pomona and L.icterohemorrhagica are host adapted to sheep and goat. What other serovar is adapted to sheep? goat?
    • sheep: L. hardjo
    • goat: L. grippotyphosa
  33. is host adapted or non-host adapted serovar going to cause more clinical disease? which serovars are cows incidental hosts for?
    non-host adapted causes illness (cow is incidental host for pomona and grippo
  34. What serovar causes abortion but generally no other symptoms in the cow?
    • hardjo
    • chronic form, infected animal can shed for life
  35. how do cattle get the acute form of lepto? what signs are common in calves?
    • exposure to non-host adapted serovars (so anything thats not hardjo)
    • calves: more severe than cow; fever, hemolytic anemia, death
  36. how does lepto affect the milk?
    yellow and thick but no inflammation or hardness to udder
  37. where in the kidney does lepto hang out? how is the kidney affected by this disease?
    • renal tubules --> vascular endothelium damaged and tissue hypoxia
    • IV hemolysis releases hemoglobin which is nephrotoxic
  38. how long does bacteremia phase last with lepto? what happens after this phase? how does immune system respond?
    • bacteremia for 4-7days then disseminates to all tissues
    • humoral antibodies detected at end of bacteremic phase
    • then in convalescent phase tissue protect lepto from exposure to immune system so antibodies may not show up positive with titers despite persistent infection
  39. what are ways to diagnose lepto?
    • *4fold increase in titer* between acute and convalescent phase is most important
    • dark field microscopy on urine, culture
    • necropsy/histopath on aborted fetus
  40. what is treatment for lepto?
    oxytetracycline and supportive care
  41. is urolithiasis more common in males or females? why are stones more common in pet and show ruminants?
    • males (females have short/wide urethra)
    • more grain in diet which predisposes
  42. what are 4 common sites of obstruction for calculi?
    • urethral process
    • sigmoid flexure
    • neck of bladder
    • urethra at ischial arch of pelvis
  43. which vitamin deficiency can cause precipitation of crystals?
    vitamin A
  44. What role do estrogenic substances have in the formation of calculi?
    increase mucoproteins
  45. how does diet affect formation of crystals?
    excess grain or phosphorous promotes crystal formation
  46. how does pH affect stone formation?
    more alkaline = more risk of stone formation
  47. how can you treat urolithiasis? what drug do you specifically want to avoid if you need to sedate these patients?
    • remove urethral process
    • attempt to flush urethra
    • surgery
    • no xylazine (transient hyperglycemia leads to diuresis = bad for blocked pt!)
  48. what are your surgical options for urolithiasis? which is best to do if you want the animal to continue to breed in the future?
    • tube cystotomy - ok for breeding animals
    • perineal urethrostomy
    • urethrotomy (not best option, risk of stricture)
    • bladder marsupialization (last resort)
  49. what type of calculi forms due to grain based and pelleted diets? Are these stones forming in alkaline or acidic urine? how can you adjust diet to decrease risk of these?
    • phosphatic (struvites)
    • alkaline urine
    • also form in diets low in Ca; want Ca:P of 2:1
    • increase long stem fiber levels to increase saliva
  50. What type of calculi forms due to diets low in copper and zinc and on native rangeland grasses?
    silica
  51. what type of calculi form due to pt eating lush alfalfa? do these form in alkaline or acidic urine? what dietary recommendations should you make?
    • calcium carbonate
    • alkaline
    • restrict aflalfa, feed grass hay, ammonium chloride + salt
  52. what calculi form in acidic urine?
    calcium oxalates (these are rare)
  53. why should sodium chloride be fed as dietary management of calculi? What is purpose of ammonium chloride?
    • salt promotes water intake
    • ammonium chloride can be added up to 1% of dry matter to lower urine pH (unpalatable!)
  54. the farmer wants to know if his goat is going to block again now that you removed the urethral process and he plans to make the recommended dietary changes. what will you tell him?
    • recurrence is common and this will be a lifelong issue
    • keeping plenty of water available and proper mineral balance with low grain/alfalfa intake is important!

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