75 Questions
What is a common cause of urinary incontinence in horses?
Neurological diseases
How do horses with psychogenic polydipsia respond to water deprivation?
By concentrating urine
What is a rare cause of psychogenic polydipsia in horses?
Salt consumption
What is a common goal in understanding urinary tract infections in horses?
To understand common causes, treatment, and prognosis
What are the 3 general categories in which AKI may be classified?
Prerenal, Intrinsic, Postrenal
What is the driving force for glomerular filtration?
Renal blood flow (RBF)
What is the underlying pathophysiology of both acute and chronic renal failure?
Cytotoxic, ischemic, or inflammatory insults to the kidney
What is the most common cause of acute renal failure?
Secondary to some other disease process
What is anuria defined as?
Urine output of less than 100 mL/d
What are the etiologies of acute kidney injury (AKI)?
Prerenal failure, intrinsic renal failure, and postobstructive renal failure
What is the potential severe renal adverse effect associated with acute massive overdose or chronic long-term use of NSAIDs?
Renal papillary necrosis
What physical examination findings are associated with acute kidney injury?
Weight loss, anorexia, and polyuria
What diagnostic tests are used for AKI?
Urinalysis, SDMA test, and renal biopsy
What is the treatment for AKI based on?
Underlying pathophysiology
What are some symptoms of urolithiasis in horses?
Frequent urination, straining, dribbling of urine, mild recurrent colic
What is the only effective treatment for urolithiasis in horses?
Surgical removal
What causes sabulous bladder incontinence in horses?
Neurologic dysfunction
What is the treatment for sabulous cystitis in horses?
Bladder lavage, systemic antibiotics, anti-inflammatories, and urine acidification
What may improve urinary incontinence in mares with hypoestrogenism?
Estrogen administration
What does PU/PD in horses indicate?
Failure of normal water balance mechanisms
What conditions may cause PU/PD in horses?
Diabetes mellitus, diabetes insipidus, and others
How is PU/PD diagnosed in horses?
Ruling out conditions like diarrhea, acute renal failure, and high salt diet, and conducting clinical examinations, renal function tests, and water deprivation tests
What are some symptoms of PU/PD in horses?
Excessive thirst and frequent urination
What is the primary goal of treatment for acute kidney injury (AKI)?
Maintain glomerular filtration and urine production
What is the recommended initial intravenous (IV) fluid rate for AKI treatment?
80-100 ml/kg/day
What is the role of furosemide in converting oliguric AKI to nonoliguric AKI?
Furosemide has no role in this conversion
What is a helpful diagnostic clue in distinguishing prerenal from intrinsic renal disease?
Urine osmolality below 300 mOsm/kg
What is the hallmark of intrinsic acute kidney injury?
Structural injury in the kidney
What is the physiological hallmark of ATN?
Isosthenuria
What results in obstructive uropathy or postrenal AKI?
Mechanical obstruction of the urinary collecting system
What may not be apparent in the serum creatinine level with unilateral obstruction?
Decreased glomerular filtration rate
What is a diagnostic clue in distinguishing prerenal from intrinsic renal disease?
Low urine osmolality
What is the physiological response to pharmacologic doses of vasopressin in ATN?
Isosthenuria
What is the primary goal of treatment for postrenal AKI?
Relieve mechanical obstruction of the urinary collecting system
What is a common cause of postrenal AKI?
Mechanical obstruction of the urinary collecting system
What is the recommended initial intravenous (IV) fluid rate for AKI treatment?
30-40 ml/kg/hour
What is the primary goal of treatment for postrenal AKI?
Relieving urinary tract obstruction
What is the hallmark of intrinsic acute kidney injury?
Hyperkalemia
What may not be apparent in the serum creatinine level with unilateral obstruction?
Hyperkalemia
What causes sabulous bladder incontinence in horses?
Alkaline urine
What is a rare cause of psychogenic polydipsia in horses?
Brain tumor
What is the driving force for glomerular filtration?
Hydrostatic pressure
What is the most common cause of acute renal failure?
Toxic injury
What is the primary location of the lesion associated with urinary calculi in male farm animals?
Urethral process
Which of the following is a common causative agent of ascending urinary tract infections in farm animals?
Corynebacterium renale
What is the primary treatment for leptospirosis in farm animals?
Oxytetracyclines
What is the primary pathophysiological mechanism leading to the formation of urinary calculi in farm animals?
Increased phosphate in urine
What is a characteristic clinical pathology finding associated with urinary calculi in farm animals?
Stress leukogram
What is a potential consequence of unsuccessful urethral catheterization in farm animals with urinary calculi?
Catheter lodges in the urethral recess
What is a potential outcome of leptospirosis in calves?
High abortion rates in incidental infections
What is a characteristic symptom of urolithiasis in farm animals?
Stranguria
What is the primary fluid/electrolyte loss in a cow with rumen acidosis?
Loss of bicarbonate ions
What is the primary concern in a 4-hour-old goat kid with metabolic complications of dystocia?
Hypothermia
What is the primary clinical abnormality in a 9-year-old Shorthorn with 'choke'?
Feed in nostrils
What is the primary electrolyte abnormality in a 3-year-old Holstein cow with suspected RDA?
Hypokalemia
What is the primary electrolyte abnormality in a 3-year-old Holstein cow with suspected RDA?
Hypokalemia
What is the primary fluid/electrolyte loss in a cow with rumen acidosis?
Hypochloremia
What is the driving force for glomerular filtration?
Hydrostatic pressure in the glomerular capillaries
What is the primary concern in a 4-hour-old goat kid with metabolic complications of dystocia?
Acidosis
What is the most common type of calculi found in equine urinary tract?
Yellow-green, spiculated calculi
What is the primary electrolyte abnormality in a horse with suspected urinary tract obstruction?
Hyperkalemia
Which gender of horses is more commonly affected by bladder calculi?
Males
What is the most appropriate suture material for urinary tract surgery in horses?
Polydioxanone (PDS) suture material
Which surgical approach for bladder stone removal eliminates the need to reflect the prepuce?
Parainguinal
What is a potential complication of urolithiasis?
Hematuria
What is the primary goal of post-operative care to prevent recurrence of bladder stones?
Promoting diuresis and reducing calcium intake
Which method can be used for stone fragmentation in bladder stone removal?
Pneumatic lithotripsy
What is the surgical procedure for temporary urine diversion and access to bladder stones?
Perineal urethrotomy
What can cause urethral obstruction in farm animals?
Parasitic granuloma
What are the surgical options for urolithiasis?
Cystoplasty
What is a potential cause of PU/PD in horses?
Urolithiasis
What can be used for medical or surgical management in foals with specific conditions?
Cystoplasty
What is a potential complication of unsuccessful urethral catheterization in farm animals with urinary calculi?
Hematuria
What is a potential surgical treatment for infected umbilicus in foals?
Cystoplasty
What is a potential cause of obstructive uropathy in farm animals?
Urinary calculi
Study Notes
Equine Urological Disorders: Urolithiasis, Sabulous Bladder, and PU/PD
- Urolithiasis is influenced by factors such as urine pH, diet, and water intake, contributing to the formation of carbonate calculi due to increased alkalinity and urine solute concentration.
- All horse breeds and sexes are equally susceptible to developing calculi, with mares showing large calculi before symptoms appear, often concurrent with cystitis.
- Symptoms of urolithiasis include frequent urination, straining, dribbling of urine, mild recurrent colic, loss of condition, and stilted gait, with potential acute obstruction of urine flow in males.
- Diagnosis of cystic calculi involves urine analysis, rectal examination, urinary catheter passage, bladder ultrasound, and urinary tract endoscopy.
- Surgical removal is the only effective treatment for urolithiasis, with the approach and type of surgery determined by stone size and patient sex, sometimes requiring concurrent cystitis treatment.
- Sabulous bladder incontinence is caused by neurologic dysfunction, leading to urine dribbling due to the absence of effective detrusor contraction.
- Sabulous cystitis, caused by bladder paralysis, results in sandy sediment deposition, contributing to inflammation and irritation of the bladder mucosal lining.
- Treatment of sabulous cystitis involves bladder lavage, systemic antibiotics, anti-inflammatories, and urine acidification, with pharmacologic interventions such as phenazopyridine, bethanechol, and phenoxybenzamine.
- Estrogen administration may improve urinary incontinence in mares with hypoestrogenism.
- Polyuria/polydipsia (PU/PD) in horses indicates a failure of normal water balance mechanisms, caused by various conditions such as diabetes mellitus, diabetes insipidus, and others.
- Diagnosing PU/PD involves ruling out conditions like diarrhea, acute renal failure, and high salt diet, and conducting clinical examinations, renal function tests, and water deprivation tests.
- Causes of PU/PD in horses include psychogenic polydipsia, diabetes insipidus, and syndrome of inappropriate ADH secretion, with symptoms such as excessive weight gain and hyponatremia, which usually resolves with appropriate fluid restriction.
Bladder Stone Surgical Approaches and Procedures
- Surgical approaches for bladder stone removal include caudoventral midline, paramedian with reflection of prepuce, and parainguinal.
- The parainguinal approach eliminates the need to reflect the prepuce and allows for determining the optimal size and location of the incision.
- Surgical procedures for bladder stone removal involve gentle steady traction on the bladder and distending it with lidocaine and warm saline.
- Transurethral removal of bladder stones can be done in mares by dilating the urethra and removing the stone, while geldings may require perineal urethrotomy.
- Different methods of lithotripsy, such as pneumatic, mallet and osteotome, and laser lithotripsy, can be used for stone fragmentation.
- Perineal urethrotomy is performed for temporary urine diversion and access to bladder stones, typically healing in 3 weeks, and is done under standing sedation and caudal epidural.
- Urolithiasis complications may include peritonitis, midline incisional complications, stricture, hemorrhage, and urine scald.
- Post-operatively, promoting diuresis and reducing calcium intake can help prevent recurrence of bladder stones.
- Urethral obstruction can be caused by neoplasia, parasitic granuloma, and urolithiasis, and alpha 2 agonists should be avoided.
- Diagnostics for urolithiasis include physical exam findings, serum biochemistry, and clinical signs such as renal colic and frequent posturing to urinate.
- Surgical options for urolithiasis include urethrorrhexis, phallectomy, distal urethrotomy, and perineal urethrotomy.
- In foals, conditions such as patent urachus and infected umbilicus may require medical or surgical management, with cystoplasty being a potential surgical treatment for infected umbilicus.
Test your knowledge of equine urological disorders with this quiz. Explore urolithiasis, sabulous bladder, and polyuria/polydipsia in horses, including their symptoms, diagnosis, and treatment options. See how well you understand these important equine health issues.
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