Term
| What is the most important requirement of the kidney to maintain under anesthesia? |
|
Definition
PERFUSION
normally receives 25% of cardiac output |
|
|
Term
| T/F: pressure is greater in the afferent arteriol of the glomerulus and lower in the efferent arteriol |
|
Definition
TRUE
high pressure in afferent arteriole drives GFR and is necessary to maintain urine output |
|
|
Term
| T/F: Renal blood flow and GFR are autoregulated to a mean arterial pressure between 60-160 mm hg |
|
Definition
|
|
Term
| What two side effects of most anesthetic drugs result in compromised renal perfusion? |
|
Definition
| systemic hypotension and renal vasoconstriction |
|
|
Term
| Which anesthetic premed causes peripheral vasodilation and blocks dopaminergic transmission |
|
Definition
|
|
Term
| Which premed compromises renal perfusion secondary to bradycardia? |
|
Definition
|
|
Term
| What premedications decrease cardiac output and increase urine output? |
|
Definition
alpha 2 agonists
*increased urine output is secondary to decreased ADH |
|
|
Term
| How do NSAIDS affect renal perfusion? |
|
Definition
| NSAIDS decouple renal blood flow regulation |
|
|
Term
| T/F: Injectable induction drugs have the most minimal impact on renal perfusion of all anesthetic drugs |
|
Definition
TRUE
these drugs tend to preserve cardiovascular function, or have a transient hypotensive effect (propofol) |
|
|
Term
| T/F: ALL inhalant anesthetics cause peripheral vasodilation which results in systemic hypotension |
|
Definition
|
|
Term
| What two inhalant anesthetics are potentially nephrotoxic? |
|
Definition
methoxyflurane
sevoflurane |
|
|
Term
| What should the urine output per hour be (small animals) if the kidneys are being adequately perfused? |
|
Definition
|
|
Term
| what is the minimum database when preparing to anesthetize a patient with compromised renal function? |
|
Definition
blood gas, electrolytes, ECG
assess hydration, HR and rhythm, and mentation with physical exam |
|
|
Term
| T/F: Ketamine is eliminated by the kidneys in its active form in cats |
|
Definition
TRUE
cats eliminate active ketamine in the urine, in all other species ketamine is eliminated in inactive form |
|
|
Term
| How does metabolic acidosis as a complication associated with animals that have urinary blockage affect anesthetic considerations? |
|
Definition
metabolic acidosis causes decreased cardiac contractility and higher plasma concentrations of many active anesthetic drugs
blocked animals may also present with shock or significant dehydration |
|
|
Term
| What three treatments are useful for correcting hyperkalemia associated cardiac arrhythmias? |
|
Definition
insulin and glucose --> intracellular translocation of potassium thereby lowering serum potassium concentration
Bicarbonate --> alkalosis shifts potassium into cells
*calcium can be used to lower action potential threshold of cardiac myocytes and will help control arrythmias, but calcium has NO effect on serum potassium |
|
|
Term
| T/F: urinary disease has the greatest incidence and economic impact in large animals |
|
Definition
FALSE
GI and Respiratory disease have a greater incidence and economic impact than urinary tract disease |
|
|
Term
| What is the major urinary disorder affecting ruminants? |
|
Definition
|
|
Term
| T/F: the kidneys are the most common site of urinary disease in large animals |
|
Definition
FALSE
bladder and urethra are more commonly affected than the kidney |
|
|
Term
| Which kidney is palpable in ruminants? |
|
Definition
left kidney,
it is most caudal, and located on midline, to the right of the rumen |
|
|
Term
| dehydration, endotoxic shock, and hemorrhage are all potential causes of _____ azotemia |
|
Definition
|
|
Term
| absent or reduced urine output with low specific gravity are clinical exam findings consistent with ______ azotemia |
|
Definition
|
|
Term
| T/F: electrolyte abnormalities associated with renal azotemia are more pronounced in ruminants than in monogastrics |
|
Definition
FALSE
although we can see less pronounced:
hyponatremia (lost in urine)
hypochloremia (sequestered in GI)
hypokalemia (increased loss in saliava and decreased absorption from the GI) |
|
|
Term
| polyuria and polydipsia, anorexia, weakness are clinical exam findings supportive of _____ azotemia |
|
Definition
|
|
Term
| dysuria, stranguria, pulsating urethra on rectal exam are findings consistent with what urinary disorder? |
|
Definition
| urethral or ureteral obstruction |
|
|
Term
| How frequently and what volume of urine should a normal cow produce each day? |
|
Definition
| 5-8x a day --> 8-12 L/day |
|
|
Term
| what are some morphologic changes to the kidney appreciable on rectal palpation that suggest pyelonephritis or nephrosis? |
|
Definition
| less distinct lobulation of the kidney |
|
|
Term
| What two syndromes are implicated when an enlarged bladder is palpated in a ruminant? |
|
Definition
obstructive urolithiasis
neurogenic bladder (UMN) |
|
|
Term
| T/F: exteriorization of the penis in ruminants often requires sedation +/- local anesthesia (nerve blocks) |
|
Definition
|
|
Term
| Why is a catheter collected urine sample superior to a midstream dipstick in patients with suspected renal disease? |
|
Definition
avoids falsely elevated protein from vaginal discharge contamination
reduces numbers of sloughed epithelial cells
reduces frequency of false positive cultures |
|
|
Term
| T/F: creatinine is a more specific indicator of renal function than BUN |
|
Definition
|
|
Term
| What is the most common eitiology associated with nephrosis? |
|
Definition
| toxins (plants or chemicals) |
|
|
Term
| What region of the kidney is affected in nephrosis and what are the two most characteristic clinical abnormalities? |
|
Definition
nephrosis is associated with degenerative or inflammatory lesions in the renal tubules
commonly seen with azotemia and protinuria --> hypoalbuminemia |
|
|
Term
| What plants can cause nephrosis in ruminants? |
|
Definition
young oak buds and acorns
oxalate containing plants (chronic ingestion) |
|
|
Term
| Which heavy metals can cause nephrosis? |
|
Definition
|
|
Term
| What therapeutic drugs can cause nephrosis? |
|
Definition
Aminoglycosides (accumulate in proximal tubules)
sulfonamides (calves w/ diarrhea)
oxytetracycline (acute tubular necrosis associated with several days of tx at high doses) |
|
|
Term
| T/F: prognosis is poor for cases of nephrosis caused by oxalate and heavy metal poisoning, as well as sepsis |
|
Definition
TRUE
other causes have fair/good prognosis with prompt diagnosis and treatment |
|
|
Term
| What are two organisms commonly implicated in contagious bovine pyelonephritis? |
|
Definition
corynebacterium renale
e. coli
*sporatic ascending infections |
|
|
Term
| What are some factors that predispose individuals to the development of contagious bovine pyelonephritis? |
|
Definition
urine stasis (obstructive outflow due to pregnancy)
*rarely hematogenous spread secondary to endocarditis or septicemia
Physical damage to the lower urinary tract (catheterization, dystocia) |
|
|
Term
| What UA findings are supportive of the diagnosis of contagious bovine pyelonephritis? |
|
Definition
increased RCB, WBC and protein with normal specific gravity
*also inflammatory leukogram |
|
|
Term
| What are two differentials for contagious bovine pyelonephritis? |
|
Definition
cystitis (seldom see systemic illness or enlarged kidneys/ureters)
GI disease |
|
|
Term
| what is the treatment of choice for contagious bovine pyelonephritis due to c. renale? |
|
Definition
Procaine penicillin
*do a culture!
unilateral nephrectomy is an option but you MUST ensure function of remaining kidney first |
|
|
Term
| T/F: gomerular nephritis is uncommon in large animals, definitive diagnosis requires biopsy |
|
Definition
| TRUE characterized by persistent protinuria, usually immune mediated secondary to infectious disease |
|
|
Term
| What could be a cause of persistent protinuria in older cows other than glomerular nephritis? |
|
Definition
amyloidosis
associated with chronic antigenic stimulation, GI may also be affected (so always check urine protein in cows with persistent diarrhea) |
|
|
Term
| T/F: amyloidosis is very responsive to early therapy |
|
Definition
FALSE
no tx --> progressive wasting and anorexia, SQ edema due to chronic hypoprotinemia |
|
|
Term
| What organisms are commonly implicated in cases of embolic nephritis as a complication to septicemia in cows? |
|
Definition
| C. pyogenes, E. coli, Salmonella |
|
|
Term
| What disease can develop in calves with colisepticemia, especially caused by leptospirosis |
|
Definition
| Interstitial nephritis (ie. inflammation of the interstitial tissues of the kidney) |
|
|
Term
| What is the most common disease of the urinary tract associated with post-parturient dairy cows? |
|
Definition
|
|
Term
| What organisms are most common in large animal cystitis? |
|
Definition
C. renale, E. coli, Proteus vulgaris
often mixed infections |
|
|
Term
| T/F: isolation of C. renale from urine culture increases the likelyhood of renal involvement complicating cystitis |
|
Definition
TRUE
*can also distinguish cystitis from pyelonephritis by palpating the left kidney (kidneys are enlarged w/ pyelonephritis) |
|
|
Term
| T/F: most effective treatment of cystitis in ruminants is direct infusion of antibiotics into the bladder |
|
Definition
FALSE
give parentral antibiotics based on culture and sensitivity (good initial choices are penicillin/ampicillin) with minimum 10 day treatment |
|
|
Term
| Chronic non-infectious disease of cattle associated with neoplastic transformation of the bladder wall with intermittent hematuria and anemia |
|
Definition
| Bovine Enzootic Hematuria |
|
|
Term
| What is the suspected etiology of bovine enzootic hematuria? |
|
Definition
| Chronic ingestion of bracken fern |
|
|
Term
| What lesions seen on necropsy are consistent with bovine enzootic hematuria? |
|
Definition
| raised pedunculated tumors on the bladder mucosa |
|
|
Term
| T/F: Obstructive urolithiasis in ruminants is most common in castrated males, also more common in feedlot animals |
|
Definition
TRUE
*hormonal implants and high concentrate diet fed to feedlot animals increases mucoprotein content of urine --> mucus forms a matrix framework for mineralization and stone formation |
|
|
Term
| What is the most common composition of urinary calculi recovered from ruminants? |
|
Definition
|
|
Term
| T/F: increasing NaCl in feedlot animal diets significantly reduces the incidence of obstructive urolithiasis |
|
Definition
TRUE
high urine Cl inhibits stone formation |
|
|
Term
| T/F: the composition of ruminant calculi often reflects dietary or urine concentration of minerals |
|
Definition
TRUE
*consistent with urine supersaturation hypothesis of stone formation |
|
|
Term
| Aside from diet and sex what other factors will predispose a cow to the development of obstructive urolithiasis? |
|
Definition
-alkaline urine
-water deprivation
-early castration (decreases urethral diameter)
-ulceration or bladder mucosal abnormalities (act as a nidus for stone formation) |
|
|
Term
| What are the two most common sites of stone entrapment in ruminants? |
|
Definition
Sigmoid flexure (sheep, goats, steers)
urethral process (sheep and goats) |
|
|
Term
| What are two etiologies of renal ischemia induces ARF in horses? |
|
Definition
vasomotor nephropathy
endotoxemia |
|
|
Term
| In what area of the bladder and urethra is the major vascular and nerve supply located? |
|
Definition
| Dorsal surface, near the trigone of the bladder |
|
|
Term
| T/F: urinary tissue heals much faster than other tissues |
|
Definition
TRUE
regains 100% prewound strength within 14-21 days |
|
|
Term
| What are the most common causes of intra-luminal lower urinary tract obstruction in our domestic species? |
|
Definition
| urolithiasis, feline lower urinary tract disease (FLUTD), primary neoplasia |
|
|
Term
| What is the most common cause of extra-luminal lower urinary tract obstruction in our domestic species? |
|
Definition
| secondary neoplasia impinging on the urinary tract |
|
|
Term
| Where should you make your incision on the bladder for routine cystotomy? why? |
|
Definition
| Make a stab incision into the ventral surface of the bladder to avoid vasculatur and innervation |
|
|
Term
| What is the difference between urethrostomy and urethrotomy? |
|
Definition
Urethrostomy is a permanent opening through which urine will flow (with or without a tube)
Urethrotomy describes an incision into the bladder which is then sutured or allowed to close by second intention |
|
|
Term
| What are two indications for prescrotal or scrotal urethrostomy in male dogs? |
|
Definition
| neoplasia, urolithiasis that cannot be dislodged |
|
|
Term
| What is the most common source of post-op hemorrhage from a prescrotal urethrostomy in a male dog? |
|
Definition
| off-midline incision with poor epithelial apposition |
|
|
Term
| What two techniques can be employed to prevent pot-op stricture formation following prescrotal urethrostomy in male dogs? |
|
Definition
1. create a large opening
2. gentle tissue handling |
|
|
Term
| What are the two major indications for perineal urethrostomy in male cats? |
|
Definition
Prevention of urethral obstruction in cats that are repeatedly obstructed
distal urethral obstruction that cannot be relieved with catheterization |
|
|
Term
| What complications can be associated with perineal urethrostomy in male cats? |
|
Definition
| urethral stricture, hemorrhage, urinary incontinence, recurrent bacterial infection |
|
|
Term
| What laboratory finding would confirm uroabdomen? |
|
Definition
| abdominocentesis fluid with a higher concentration of creatinine than the serum creatinine level (>2:1) |
|
|
Term
| Injury to what location would result in urine leakage without uroabdomen? |
|
Definition
| injury involving the distal urethra could result in leakage of urine without development of uroabdomen |
|
|
Term
| T/F: upon diagnosis of uroperitoneum patients should be sent to surgery as soon as they are stabilized |
|
Definition
TRUE
correct post-renal azotemia, fluid, and electrolyte balances 1st |
|
|
Term
| What is the treatment of choice in cases of partial urethral tear with slow leakage of urine? |
|
Definition
| small tears may heal without suture closure, divert the urine flow with retrograde urethral catheter and tube cystotomy for 7-10 days |
|
|
Term
| What is the treatment of choice for large tears or ruptures in the urethra and uroabdomen? |
|
Definition
| Collect samples of tissue for culture and histopathology, copious lavage of abdomen to remove all urine, debride damaged tissue --> anastomose ends with minimal tension --> omentalize facilitate healing (omentum has great blood supply) |
|
|
Term
| neoplasia, severe trauma with uncontrolled hemorrhage or urine leakage into the abdomen, refractory pyelonephritis, and congenital deffects in the ureters are all indications for what surgical procedure? |
|
Definition
|
|
Term
| How can you surgically treat nephrolithiasis? |
|
Definition
|
|
Term
| What are some differentials for a calf presenting with an umbilical swelling? |
|
Definition
| hernia (guts, omentum, fat), seroma, abcess, hematoma |
|
|
Term
| What structures comprise the umbilical cord? |
|
Definition
2 arteries (remove waste products from the fetus, extend caudally on both sides of the bladder)
1 vein (carries blood from placenta to the fetus, extents cranially from the umbilicus to the liver)
urachus (connects fetal bladder to allantoic sac extending from the umbilicus to the bladder, should close at birth) |
|
|
Term
| If you're attempting surgery involving the umbilical stalk where should you make your stab incision into the abdomen (ie. relative to the stalk)? Why? |
|
Definition
Your incision should be lateral to the urachal stalk in order to avoid umbilical structures (2 arteries-caudal on either side of the bladder, 1 vein-cranial to the liver, urachus-should be closed, if open connects bladder to umbilicus).
This will prevent contamination of your surgical site if any of the umbilical structures are infected. |
|
|
Term
| T/F: if the urachus is infected the best treatment is removal of urachal remnants being careful not to transect the bladder |
|
Definition
FALSE
It is important to remove all infected/compromised tissues, transecting the end of the bladder may be necessary to ensure clean margins |
|
|
Term
| Why would you choose to marsupialize infected umbilical structures? |
|
Definition
| if you cannot effectively remove infected structures marsupialization may be indicated --> create openings that allow the infected structures to drain outside of the body |
|
|
Term
| What clinical chemistry abnormalities are consistent with obstructive urolithiasis in a goat? |
|
Definition
| azotemia, hyperkalemia, hypochloremia, hyponatremia |
|
|
Term
| T/F: obstructive urolithiasis is a surgical emergency |
|
Definition
TRUE
stabilize, correct electrolyte abnormalities (esp. hyperkalemia) prior to induction and surgery |
|
|
Term
| What is the maximum level of serum potassium acceptable in patients that need to be anesthetized? |
|
Definition
|
|
Term
| What type of fluids would be best for patients with obstructive urolithiasis? |
|
Definition
NO potassium (b/c already hyperkalemic)
supplemented with NaCl (tx hypochloremia and hyponatremia)and insulin/dextrose (facilitate intracellular translocation of potassium) |
|
|
Term
| What is the goal of tube cystotomy as a treatment for obstructive urolithiasis? |
|
Definition
| allows the bladder to empty despite distal blockage to urine flow --> relaxation of urethral muscles allowing the stone to pass |
|
|
Term
| T/F: the best way to close the urinary bladder is with non-absorbable suture, making sure to penetrate the full thickness of the urinary mucosa |
|
Definition
FALSE
non-absorbable suture acts as a nidus for stone formation when present in the lumen of the urinary bladder. Additionally urinary tissue regains 100% prewound strength quickly so non-absorbable suture isn't necessary
use absorbable (vicryl, PDS) and a cushing suture pattern (inverts mucosal layers to provide a tight seal and prevent urine leakage) |
|
|
Term
| What is the benefit of penile amputation over urethral process transection as a treatment for obstructive urolithiasis? |
|
Definition
| penile amputation delays stricture formatino |
|
|
Term
| What is the most common composition of equine uroliths? |
|
Definition
| calcium carbonate, often occur as single large stones |
|
|
Term
| What are some methods of preventing urolithiasis in horses? |
|
Definition
-acidify the diet (vit C and potassium magnesium aspartate)
-increase water consumption --> increased urine output |
|
|
Term
| Although calcium carbonate stones are the most common form of urolithiasis in horses what would be a good management practice to prevent stone formation in horses with triple phosphate crystals? |
|
Definition
| feed less grain and less alfalfa |
|
|
Term
| T/F: you must always surgically correct patent urachus in foals |
|
Definition
FALSE
antibiotics and benign neglect is usually fine, if severe or if abscess forms surgical repair with 1-2 days of antibiotic treatment is indicated |
|
|
Term
| T/F: you should always surgically repair patent urachus in a calf |
|
Definition
TRUE
calves are more likely to develop infections than foals, remove urachal remnants via midline celiotomy |
|
|
Term
| Why does abdominocentesis fluid from a patient with uroabdomen not reliably show elevated BUN? |
|
Definition
| BUN is reabsorbed and equilibrates, while creatinine is trapped in the abdominal fluid due to its size and concentration gradient |
|
|
Term
| What are four potential complications following surgical repair of a ruptured bladder? |
|
Definition
1. dehisence with recurrence of uroabdomen
2. peritonitis
3. adhesions
4. incisional infections |
|
|
Term
| What are clinical signs associated with extopic ureters and what is the treatment of choice? |
|
Definition
urinary incontinence since birth, urine scald, UTI
Tx with urethonephrectomy |
|
|
Term
| What are two differentials for clinical signs associated with ectopic ureters (ie. incontinence, urine scald, UTI)? |
|
Definition
| LMN bladder, urolithiasis |
|
|
Term
| What is the pathogenesis of aminoglycoside induced acute tubular necrosis in horses? |
|
Definition
| inhibition of sodium potassium ATPase + decreased renal perfusion ---> tubular epithelial cell death and sloughing --> formation of casts (appreciable before azotemia) and obstruction to urine flow |
|
|
Term
| T/F: neomycin is the most nephrotoxic aminoglycoside |
|
Definition
TRUE
Neomycin > gentamicin + amikacin > streptomycin
*usually associated with chronic unmonitored treatment + dehydration (nephrotoxic effect is cumulative) |
|
|
Term
| What two endogenous pigments can cause pigment nephropathy? |
|
Definition
myoglobin (severe rhabdomyolysis)
hemoglobin (intravascular hemolysis) |
|
|
Term
| T/F: normally colored urine rules out pigment nephropathy |
|
Definition
|
|
Term
| What region of the kidney is most susceptible to NSAID toxicity in horses? |
|
Definition
necrosis of the renal medullary crest
associated with longer term high dose therapy --> usually subclinical but can present with gross hematuria |
|
|
Term
| T/F: vitamin K3 is a common cause of acute tubular nephritis and renal failure horses |
|
Definition
TRUE
pathophysiology unknown, withdrawn from market |
|
|
Term
| T/F: Pyrrolizidine alkaloids, vitamin D, and blister beetles can all cause acute renal failure in horses |
|
Definition
|
|
Term
| What is the pathophysiology of vasomotor nephropathy in horses? |
|
Definition
| hypovolemic shock or endotoxemia --> marked hypotension and vasoconstriction --> decreased renal perfusion and ischemia --> acute tubular necrosis |
|
|
Term
| T/F: a serum creatinine >6mg/dl in neonatal foals in consistent with abnormal renal function |
|
Definition
|
|
Term
| If azotemia if pre-renal how quickly should fluid therapy resolve elevated creatinine? |
|
Definition
| azotemia should resolve within 36 hours of initiating fluid therapy |
|
|
Term
| T/F: large amounts of mucin and calcium carbonate crystals are normal in equine urine |
|
Definition
|
|
Term
| T/F: blood, hemoglobin, and myoglobin can all cause the dipstick to be positive for blood |
|
Definition
|
|
Term
| What should the fractional excretion of sodium be in a horse with healthy kidneys? |
|
Definition
| <1% (remember, sodium is normally reabsorbed by the tubules) |
|
|
Term
| T/F: abdominal or per rectal ultrasound is very informative in the diagnosis of ARF in large animals |
|
Definition
FALSE
minimal abnormalities are associated with ARF, however ultrasound can facilitate guided biopsy |
|
|
Term
| T/F: the renal cortex is more echogenic than the renal medulla |
|
Definition
TRUE
medulla < cortex < liver < spleen |
|
|
Term
| What is the daily water requirement for horses? |
|
Definition
25-70 ml/kg
majority is consumed closely following eating, much lower water requirement for animals on fresh pasture (ie. vs. hay) |
|
|
Term
| What is the normal daily urine output for a horse? |
|
Definition
15-30 ml/kg/day ---> 5-15 liters/day
*note* foals have a limited ability to concentrate urine within the first 6-8 weeks of life --> 148 ml/kg/day |
|
|
Term
| What is the pathogenesis of nephrogenic diabetes insipidis in thoroughbreds? |
|
Definition
| usually secondary to underlying metabolic, endocrine, or renal disease --> reduced response of renal tubules to ADH --> extreme polydipsia with no response to water deprivation (ie. no concentration of urine) or exogenous ADH |
|
|
Term
| What is the pathogenesis of central diabetes insipidis in horses? |
|
Definition
| secondary to intracranial neoplasia or inflammatory disease, can be idiopathic --> failure of ADH production or release and decreased tubular sensitivity to ADH secondary to elevated plasma cortisol --> profound PU/PD --> urine concentration in response to water deprivation and exogenous ADH |
|
|
Term
| Other than PU/PD what physical exam and history abnormalities are consistent with Pituitary Pars Intermedia dysfunction |
|
Definition
hirstuism
history of chronic infections
laminitis |
|
|
Term
| hyperglycemia, mild neutrophilia, lymphopenia, glucosuria and elevated ACTH levels are all consistent with _______ |
|
Definition
|
|
Term
| azotemia + isosthenuria, hypercalcemia, hypophosphatemia is consistent with ______ |
|
Definition
|
|
Term
| What is the purpose of water deprivation test? |
|
Definition
to differentiate Diabetes insipidis from psychogenic polydipsia
*CONTRAINDICATED in azotemic and dehydrated patients |
|
|
Term
| What are grounds for terminating a water deprivation test? |
|
Definition
urine specific gravity >1.025 w/in 24 hrs
5% decrease in body weight
development of dehydration or azotemia |
|
|
Term
| T/F: horses with chronic psychogenic PD should achieve urine SG > 1.020 within 24 hours following a water deprivation test |
|
Definition
| FALSE may not see adequate concentration with abrupt water deprivation test, can restrict water intake to 40ml/kg/day for a couple of days and should result in SG >1.025 |
|
|
Term
| What are two medications that can be used to treat PPID in horses? |
|
Definition
pergolide (dopamine agonist)
trilostane (competitive inhibitor of 3-beta hydroxysteroid dehydrogenase) |
|
|
Term
| How much nephron mass must be lost before clinical signs associated with chronic renal failure emerge? |
|
Definition
| 75% of nephron mass must be lost |
|
|
Term
| What clinical signs characterize uremic syndrome in horses? |
|
Definition
weight loss
anorexia
lethargy
oral ulcers
melena
dental tartar |
|
|
Term
| What organisms are commonly implicated in adult equine cases of cystitis and pyelonephritis? |
|
Definition
usually gram negative:
E. coli, Proteus, Klebsiella, Pseudomonas, Strep, Staph |
|
|
Term
| What organism is most commonly identified in foals with septic embolic nephritis? |
|
Definition
|
|
Term
| What organism is most commonly associated with cystitis in recumbent foals on antibiotic therapy? |
|
Definition
|
|
Term
| T/F: cystitis in horses is usually secondary to trauma (catheterization, calculi), or neurologic disease with bladder paralysis (EHV-1) |
|
Definition
|
|
Term
| What are some antibiotics that achieve high urine concentrations and are ideal for the treatment of cystitis (10 day min) or pyelonephritis (2-4 wk min)? |
|
Definition
Trimethoprim sulfa
ceftiofur
penicillin |
|
|
Term
| T/F: hematuria following exercise is a common presentation for horses with cystic calculi |
|
Definition
|
|
Term
| T/F: recurrence of equine cystic calculi is common following surgical removal |
|
Definition
FALSE
recurrence is uncommon as long as all fragments are removed. Surgical removal is tx of choice, can be combined with antibiotics, urinary acidifiers (ammonium chloride- not effective alone) and bethanechol |
|
|
Term
| What are some differentials for neurogenic urinary incontinence in horses? |
|
Definition
herpes virus myelitis
sorghum toxicity
cauda equine neuritis
equine protozoal myelitis
fracture, abscess, neoplasia |
|
|
Term
| What medical therapy can be employed to treat UMN bladder in horses? |
|
Definition
phenoxybenzamine (relaxes the urethral sphincter)
bethenachol (improves detrusor tone) |
|
|
Term
| What medical therapy can be used to treat LMN bladder in horses? |
|
Definition
phenylpropanolamine +/- bethanechol
can try estradiol in older mares |
|
|
Term
| What predisposes horses to the development of sabulous urolithiasis? How can this be treated? |
|
Definition
neurologic injuries with urine stasis--> accumulation of sediment in the bladder
tx: indwelling catheter with intermittent bladder lavage to clear debris and prevent stasis |
|
|
Term
| T/F: horses with neurologic bladder disorders secondary to herpes myelitis have a poor prognosis |
|
Definition
FALSE
return to normal function 3-6 wks following treatment |
|
|
Term
| T/F: mares more commonly present with urethral hemorrhage than geldings or stallions, aggressive therapy is necessary |
|
Definition
FALSE
stallions and geldings more commonly, conservative tx +/- Ab, NSAIDS
dx: urethral endoscopy to identify any urethral lesions and rule out kidneys and bladder as source of hemorrhage |
|
|
Term
| T/F: ectopic ureters are more common in female foals |
|
Definition
TRUE
90% female, generally present as incontinent from birth although may have bouts of normal voiding |
|
|
Term
| What are the two most common primary renal neoplasias in horses? |
|
Definition
renal carcinoma
nephroblastoma |
|
|
Term
| What is the most common metastatic neoplasia in horse kidneys? |
|
Definition
|
|
Term
| What breed is overrepresented in equine idiopathic renal hematuria? |
|
Definition
| Arabians clots in renal pelvis (ultrasound) r/o other causes of renal hematuria |
|
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