Urinary2- Equine Renal
Card Set Information
Urinary2- Equine Renal
What crystals are normal in equine urine?
How can a GI problem lead to a kidney problem?
diarrhea--> dehydration--> hypotension--> decreased renal perfusion
Endotoxemia causes... (2)
What suggests that azotemia is primarily pre-renal?
50% decrease in serum creatinine after 24 hr of fluid therapy
Horses with __(2)__ are at high risk for acute kidney injury.
large volume blood loss or myonecrosis
Why does myonecrosis and hemorrhage cause kidney injury?
myoglobin and hemoglobin are toxic to the tubules, causing acute tubular necrosis; pigment nephropathy
Mechanisms for pigment nephropathy. (4)
iron is toxic, tubular obstruction, hemoglobin is vasoconstrictive (removes nitric oxide, which is vasodilatory), tubular necrosis
Bug that causes acute tubular necrosis/acute kidney injury.
Typical findings in a horse with CKD. (4)
weight loss, azotemia, hypercalcemia (unique to horses), anemia
2-3 day old foal with mild colic, abdominal distention, bradycardia, cold, depressed, normal IgG. Top differential?
What is an abnormality in adult horse biochem panel that is normal in foals?
increased serum phosphorous is normal in foals
What fluids do you give to an animal with hyperkalemia?
saline (not LRS, which has K+)
Treatment of hyperkalemia. (4)
bicarbonate, calcium, dextrose, insulin (small animals)
What is the sympathetic innervation to the kidney?
aortico-renal and celiaco-mesenteric ganglia
What is the parasympathetic innervation to the kidney?
Renal innervation is primarily ___________.
Adrenergic stimulation of the kidney increases __(2)__; as evidenced by administration of __(2)__ [drugs].
RBF and diruesis; xylazine and detomidine
Autonomic sympathetic innervation to the bladder.
Autonomic parasympathetic innervation to the bladder.
Somatic innervation to the bladder.
What is important to know about bladder contraction that that you can appropriately manage urinary incontinence? (2)
bladder contraction is primarily a cholinergic process; complete denervation is unlikely because they are nerve fibers within the equine bladder wall
Describe the innervation process that leads to urination.
stimulation of pelvic nerve--> contraction of detrusor m. and relaxation of internal urethral smoother muscle sphincter--> urination
Differentials for diseases of the equine bladder. (4)
uroabdomen, urinary incontinence, lithiasis, cystitis
Common biochem findings with uroabdomen in a foal.
hyponatremia, hypochloremia, hyperkalemia, hyperphosphatemia, azotemia
What will you find on an abdominal tap from a foal with uroabdomen?
fluid with biochemical properties similar to the plasma of the animal
Describe the treatment of a foal with uroabdomen.
correct electrolyte imbalances before surgery; prognosis is good
With urinary incontinence in horses, ________ exceeds __________.
intravesical pressure; urethral pressure
3 types of micturition problems in horses.
reflex or UMN bladder (spastic), LMN bladder (paralytic), myogenic bladder (non-neurogenic)
What are clinical signs of bladder dysfunction? (2)
dribbling of urine, scalding and depilation of the perineum in mares/ventral abdomen and limbs in both sexes
You perform a rectal palpation of a horse with bladder dysfunction and feel a firm, full bladder; what is this suggestive of?
UMN bladder- spacity and loss of inhibitory function
UMN bladder is associated with ___________; thus, horses may be _________.
spinal cord trauma/lesions; recumbant
Conditions that may play a role in UMN bladder dysfunction. (3)
EPM, trauma, compression
Describe LMN bladder dysfunction and how it affects the bladder.
still have inhibition from UMN but lose excitatory influence from LMN- flaccid, atonic bladder, relaxed urethra, dribbling bladder from overflow
Clinical signs of LMN bladder dysfunction. (5)
loss of anal tone, tail paralysis, hypoalgesia, atrophy of muscles, distended/atonic bladder
Conditions that may cause LMN bladder dysfunction. (6)
trauma, equine herpes virus 1, sudan grass, tumors, infections, injections
In general, myogenic incontinence occurs with ___________.
sabulous urolithiasis (can also be a consequence of cystitis leading to urine accumulation)
When does myogenic incontinence become clinically evident?
when the cranial aspect of the bladder protrudes over the edge of the pubis (due to urolithiasis)--> stretches beyond capacity to contract--> urine retention
Describe the treatment of urinary incontinence. (4)
antimicrobials, cholinergic agents, anti-adrenergic agents, relaxants
What horses are predisposed to urolithiasis? (2)
10 years and older, geldings
Calculi composition in equids is mostly _________; to a lesser extend, __(2)__.
calcium carbonate; struvite and calcium oxalate
Often, uroliths are positive for ________ in males and ________ in females.
E.coli; Streptococcus [ie. ALWAYS CULTURE URINE FROM HORSES WITH LITHS OR SUSPECTED LITHS]
2 components of equine urine that are abnormal in other species?
calcium carbone, mucus
Clinical signs of urolithiasis. (4)
dysuria, straining to urinate, hematuria, and urine scalding
Clinical signs associated with nephroliths, but not uroliths. (2)
colic, weight loss
________ may contribute to urolithiasis because...
NSAIDs (ESP BUTE); cause medullary necrosis (nephrotoxic)
Describe the treatment of urolithiasis. (4)
antimicrobials, analgesics, urine acidifiers, surgery (cystotomy, urethrotomy, lithotripsy)
Causes of cystitis. (5)
alterations in urine flow from anatomic defects, urolithiasis, neoplasia, paralysis, iatrogenic (catheters)
Cystitis can lead to... (4)
pollakiuria, stranguria, pyuria, and incontinence
What is necessary for diagnosis of cystitis?
culture of urine sample MUST be quantified to be significant; endoscopy often helpful to assess extent of damage
Organisms associated with cystitis in horses? (8)
E. coli, Proteus, Klebsiella, Enterobacter, Streptococcus, Staphylococcus, Pseudomonas, Corynebacterium renale
Describe the treatment of cystitis in horses.
antimicrobials, NSAIDs, access to pasture, salt to increase water intake, [if necessary] correct anatomical defect or urolithiasis