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Questions and Answers
What type of setting is depicted in the majority of the images?
What type of setting is depicted in the majority of the images?
Which activity is associated with the images related to horses?
Which activity is associated with the images related to horses?
Which of the following illustrates a social interaction with a horse?
Which of the following illustrates a social interaction with a horse?
What type of imagery is featured more heavily based on the content provided?
What type of imagery is featured more heavily based on the content provided?
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Which demographic appears to be featured in the activities involving horses?
Which demographic appears to be featured in the activities involving horses?
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What is the most common composition of uroliths?
What is the most common composition of uroliths?
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What clinical sign is NOT associated with cystic and urethral calculi?
What clinical sign is NOT associated with cystic and urethral calculi?
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Which method is NOT typically used for diagnosing urolithiasis?
Which method is NOT typically used for diagnosing urolithiasis?
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What may be a cause of nidus formation in nephrolithiasis and ureterolithiasis?
What may be a cause of nidus formation in nephrolithiasis and ureterolithiasis?
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Which of the following is a common clinical sign of chronic renal failure linked to urolithiasis?
Which of the following is a common clinical sign of chronic renal failure linked to urolithiasis?
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What is a potential consequence of having a cystic calculus?
What is a potential consequence of having a cystic calculus?
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What symptom might indicate the presence of a urethral calculus?
What symptom might indicate the presence of a urethral calculus?
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Which statement about the composition of uroliths is correct?
Which statement about the composition of uroliths is correct?
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What is the most common tumor affecting the kidney that is likely to cause haematuria?
What is the most common tumor affecting the kidney that is likely to cause haematuria?
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Which condition is caused by Halicephalobus gingivalis?
Which condition is caused by Halicephalobus gingivalis?
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What can exercise-induced haematuria be primarily attributed to?
What can exercise-induced haematuria be primarily attributed to?
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Which of the following is most likely to result in life-threatening renal hemorrhage?
Which of the following is most likely to result in life-threatening renal hemorrhage?
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What is one of the causes of haematuria in horses that have consumed contaminated alfalfa hay?
What is one of the causes of haematuria in horses that have consumed contaminated alfalfa hay?
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During the diagnosis of urethral rents, when is haemorrhage typically observed?
During the diagnosis of urethral rents, when is haemorrhage typically observed?
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Which condition leads to the formation of cystic structures in the renal tubular system?
Which condition leads to the formation of cystic structures in the renal tubular system?
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What is commonly associated with nephrotoxic drug administration in dehydrated horses?
What is commonly associated with nephrotoxic drug administration in dehydrated horses?
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What is a primary mechanism by which Cushing's disease can lead to polyuria?
What is a primary mechanism by which Cushing's disease can lead to polyuria?
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Which factor is least likely to contribute to polyuria in horses?
Which factor is least likely to contribute to polyuria in horses?
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How does cortisol affect antidiuretic hormone function?
How does cortisol affect antidiuretic hormone function?
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Which treatment approach is NOT applicable for managing nephrogenic diabetes insipidus?
Which treatment approach is NOT applicable for managing nephrogenic diabetes insipidus?
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What kind of polydipsia results from restricting water availability?
What kind of polydipsia results from restricting water availability?
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What is the primary treatment approach for bacterial cystitis?
What is the primary treatment approach for bacterial cystitis?
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Which of the following conditions can lead to a failure of the pancreas to secrete insulin in horses?
Which of the following conditions can lead to a failure of the pancreas to secrete insulin in horses?
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What is a common treatment for Cushing's syndrome?
What is a common treatment for Cushing's syndrome?
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What should be done in cases of nephrolith associated with urolithiasis?
What should be done in cases of nephrolith associated with urolithiasis?
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What condition can result from the pressure of a tumor within the pituitary gland?
What condition can result from the pressure of a tumor within the pituitary gland?
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Which treatment is advised for patients suffering from verminous nephritis?
Which treatment is advised for patients suffering from verminous nephritis?
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What is the expected daily urine production for a healthy horse?
What is the expected daily urine production for a healthy horse?
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What is a common cause of psychological polyuria/polydipsia in horses?
What is a common cause of psychological polyuria/polydipsia in horses?
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In cases of idiopathic renal hemorrhage affecting only one kidney, what is the recommended treatment?
In cases of idiopathic renal hemorrhage affecting only one kidney, what is the recommended treatment?
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What is the defining factor for diagnosing polyuria in horses?
What is the defining factor for diagnosing polyuria in horses?
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For renal neoplasia, what is a common expected outcome when treatment is attempted?
For renal neoplasia, what is a common expected outcome when treatment is attempted?
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What should be done if a foal has a patent urachus and shows a lack of response to conservative therapy?
What should be done if a foal has a patent urachus and shows a lack of response to conservative therapy?
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What is a prominent feature when distinguishing haematuria from haemoglobinuria or myoglobinuria?
What is a prominent feature when distinguishing haematuria from haemoglobinuria or myoglobinuria?
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What is the primary cause of bacterial cystitis in horses?
What is the primary cause of bacterial cystitis in horses?
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What treatment is recommended for uncomplicated patent urachus?
What treatment is recommended for uncomplicated patent urachus?
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Which of the following is likely misunderstood as a cause of haematuria in male horses?
Which of the following is likely misunderstood as a cause of haematuria in male horses?
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If a horse's urine is only blood-tinged, what is a possible confusion with other conditions?
If a horse's urine is only blood-tinged, what is a possible confusion with other conditions?
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What is a common clinical sign indicating a potential infection in umbilical remnants?
What is a common clinical sign indicating a potential infection in umbilical remnants?
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What can lead to haematuria in geldings specifically?
What can lead to haematuria in geldings specifically?
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Study Notes
Equine Urinary System Diseases
- Urinary System Diseases are a significant concern in equine medicine.
- A table of contents outlines the diseases discussed: Urolithiasis, Uroperitoneum, Patent and Persistent Urachus, Haematuria, Polyuria/Polydipsia (PU/PD).
- This focus is on the key aspects and diagnosis of diseases of the equine urinary system.
Urolithiasis
- Uroliths (calculi) can form in the kidney (nephrolithiasis), ureters (ureterolithiasis), bladder (cystic urolithiasis), or urethra.
- If small, uroliths may be voided or cause urethral obstruction.
- Most uroliths are calcium carbonate and spiculated.
- Some fragment easily; others containing phosphate are smooth, hard, and uncommon.
- Aetiology: Mineralization of a nidus (renal disease), renal disease can initiate nephro- and ureterolithiasis.
- Aetiology: NSAID-induced nephropathy might cause nidus formation in horses.
- Aetiology: Diseases of the upper urinary tract (e.g., pyelonephritis) could also be a factor in urolithiasis in horses.
- Clinical Signs of nephrolithiasis and ureterolithiasis: Chronic renal failure signs (cachexia, anorexia, depression, dental tartar, oral ulcers). Can be the cause or result of renal disease itself.
- Clinical Signs of cystic or urethral calculi: Urine dribbling, pollakiuria (frequent urination), dysuria (painful urination), penile protrusion, haematuria (blood in urine), especially post-exercise, and a stilted hindlimb gait.
- Clinicopathological Examination: Renal failure occurs in many horses afflicted with nephrolithiasis.
- Clinicopathological Examination: Increased WBCs/RBCs, and high bacteria counts indicate cystitis.
- Diagnosis Examination per rectum easily reveals cystic calculi.
- Diagnosis Palpation reveals ureteroliths in some cases.
- Diagnosis Ultrasonography, cystoscopy, and inability to pass a urinary catheter can also aid the diagnosis..
- Treatment Surgical removal of calculi (celiotomy, cystotomy, parectal cystotomy, urethral sphincterotomy in mares, ischial urethrotomy in males).
- Treatment Urethrostomy for urethral calculi removal.
- Treatment: Electrohydraulic/laser lithotripsy via ischial urethrotomy.
- Treatment Antimicrobial therapy for concurrent bacterial infections. Renal function assessment before surgery (nephrectomy/nephrotomy) is crucial as bilateral renal failure can occur.
- Treatment for preventing recurrence: Low calcium/phosphorus diet.
- Treatment for preventing recurrence: Urinary acidification (using ammonium chloride, ascorbic acid, or ammonium sulfate) as applicable.
- Treatment: Providing 1% salt may also be recommended in some cases.
Uroperitoneum
- Aetiology (Adults): Bladder rupture during/after parturition (due to bladder necrosis), urethral obstruction by calculi (in males).
- Aetiology (Foals): Bladder rupture and urachal tears, ureteral defects, prenatal bladder distension (possibly due to umbilical cord torsion) leading to rupture during parturition.
- Aetiology (Other): Congenital bladder defects, urinary tract infections, tenesmus (straining to defecate or urinate), and thinning of the bladder wall potentially contribute to uroperitoneum cases.
- Clinical Signs (Foals): Typically occur within the first week postpartum. Includes abdominal distension (fluid that can be "balloted"), tachycardia/tachypnea.
- Clinical Signs (Foals): Anorexia, depression, polyuria, anuria (no urination), urine dribbling, straining to urinate, normal urination, or outward vaginal mucosa bulging in fillies with ureter rupture.
- Clinicopathological Findings: Increased creatinine concentration in peritoneal fluid (often double serum creatinine, with exceptions in foals early after rupture). Electrolyte abnormalities (hypochloremic, hyponatremic, hyperkalemic) are common in foals.
- Diagnosis: Clinical signs, ultrasonography, dye injection into the bladder (methylene blue/fluorescein).
- Diagnosis Positive contrast cystography without barium.
- Diagnosis Exploratory laparotomy/cystotomy to examine ureters for dye leakage.
- Treatment: Cystorrhaphy (repair of bladder)/resection of the urachus is frequent.
- Treatment Preoperative Therapy for maintaining potassium balance, might involve isotonic/hypertonic saline, 5% dextrose, IV insulin, and calcium IV, and sodium polystyrene sulfonate (a potassium-removing resin) enemas.
- Treatment: Using inhalants like isoflurane/sevoflurane (less arrhythmogenic than halothane) for anesthetic induction.
- Treatment Consider peritoneal drainage and administer antimicrobial drugs.
Patent and Persistent Urachus
- Urachus: The urachus typically connects the foal's bladder to the allantoic cavity and normally closes at or shortly after birth.
- Patent Urachus: A persistent urachus (i.e., a urachus that does not close after birth) or a patent urachus (i.e., a urachus that reopens after being closed) involves the failure of normal urachus closure.
- Aetiology: Causes often include umbilical torsion before birth, inappropriate clamping of the umbilicus, and umbilical infection.
- Clinical signs: Moist navel, urination from the navel, likely enlarged navel region due to infection, septicemia, or joint illnesses.
- Diagnosis Evaluate clinical signs and perform umbilical ultrasonography.
- Treatment: Evaluate the cause, administer prophylactic antimicrobial drugs, consider cauterization of the urachal opening (silver nitrate, phenol, Lugol’s iodine) in uncomplicated cases.
- Treatment: Surgical resection of the urachus if conservative therapy fails or if there's evidence of infection or systemic disease.
Haematuria
- Definition: Blood in the urine, which can originate from the kidney, bladder, urethra, or reproductive tract.
- Aetiology: Urethral rents, resulting from tears; Urethritis (especially misdiagnosed from endoscopic views); Bacteria Cystitis (secondary to bladder paresis or paralysis which causes urine retention, or from cystic urolithiasis); Pyelonephritis (severe, potentially life-threatening renal hemorrhage; often debated); Idiopathic renal hemorrhage.
- Aetiology (Other): Urolithiasis, verminous nephritis from Halicephalobus gingivalis; Renal neoplasia (adenocarcinomas and transitional/ squamous cells are most common); Blister beetle toxicosis from horses consuming contaminated vegetation; Exercise-induced hematuria (microscopic but sometimes macroscopic); Nephrotoxic drugs (especially phenylbutazone in dehydrated horses); Vascular anomalies (rare, e.g., renal arteriovenous fistulas).
- Aetiology: Polycystic kidney disease (congenital deformity often causing cysts which lead to renal failure and hence, haematuria in some cases).
- Diagnosis: Urethral rents (especially visualized at the end of urination).
- Diagnosis: Urethritis (likely misdiagnosed because of normal male urethra endoscopic view showing inflammation).
- Diagnosis: Bacteria cystitis (confirmed with clinicopathological, and possibly urine culture, and sensitivity findings to confirm infection.
- Diagnosis: Pyelonephritis (examination may identify urine infection originating from the kidney, renal biopsies are confirmatory).
- Diagnosis: Idiopathic renal hemorrhage (when excluded other causes to determine if it is the underlying cause).
- Diagnosis: Urolithiasis (history and examination to discover if uroliths are present and haematuria observed post-exercise).
- Diagnosis: Verminous nephritis (signs of other systems problems).
- Diagnosis: Renal neoplasia (findings of a renal mass).
- Diagnosis: Blister beetle toxicosis (history of feeding alfalfa, also related to other abdominal pain conditions).
- Diagnosis: Exercise-induced hematuria (history of frequent exercise and hematuria after).
- Diagnosis: Nephrotoxic drugs (often excessive and administered to dehydrated horses).
- Diagnosis: Vascular abnormalities (ultrasonography).
- Diagnosis: Polycystic kidney disease (enlarged kidney and cysts typically observed during ultrasonography).
- Treatment (Urthral Rents): Some cases heal without treatment. An incision centred on the ischial arch and extended through the tunica albuginea can allow blood to escape from the urethra externally for faster healing.
- Treatment (Urethritis): Antimicrobial therapy coupled with urethral lavage and sexual rest is common treatment.
- Treatment (Bacterial Cystitis) Often involves correcting predisposing factors; antibacterial therapy guided by urine culture and sensitivity tests.
- Treatment (Pyelonephritis): Antimicrobial therapy targeted at the kidney and based on urine culture results and sensitivity results are important.
- Treatment (Idiopathic Renal Hemorrhage): Nephrectomy in cases involving one kidney is often the treatment of choice.
Polyuria/Polydipsia (PU/PD)
- Normal Equine Hydration: Horses consume 4-6% of their body weight in water and produce 15-30 mL/kg of urine daily.
- Polyuria/Polydipsia (PU/PD): Diagnosed when water consumption exceeds 10% body weight, and urine production surpasses 5% body weight daily.
- Aetiology (Excessive water intake): Psychogenic polydipsia (common in stabled horses), stereotypic behavior (rare).
- Aetiology (Excessive urine production): Cushing's disease (pars intermedia dysfunction), Type 2 diabetes mellitus (hypercortisalism), Type 1 diabetes, chronic renal failure, and nephrogenic diabetes insipidus (either inherited or secondary to kidney infections).
- Cortisol, Diabetes Mellitus: Cortisol in the collecting duct antagonizes ADH, resulting in peripheral diabetes insipidus.
- Pituitary/Diabetes Insipidus: Pressure within the pituitary gland can also reduce the secretion of ADH (central diabetes insipidus).
- Diagnosis: Evaluate water consumption, urine output; clinical findings and diagnostics of possible causes must be performed based on examination and clinical conditions.
- Treatment (Psychogenic polydipsia): Limit water access as appropriate.
- Treatment (Cushing's syndrome): Pergolide, trilostane, or cyproheptadine.
- Treatment (Central diabetes insipidus): ADH replacement (often cost prohibitive).
- Treatment (Other): Considerations for restricting water and salts, dietary supplements (with carbohydrates and fats, with reduced dietary proteins), and possible need for kidney examination will be considered on a case-by-case basis.
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Description
Test your knowledge on equine urinary system diseases, including conditions like Urolithiasis and Uroperitoneum. This quiz covers the key aspects, symptoms, and diagnosis related to the diseases affecting horses. Explore various urinary conditions and their implications in equine health.
