Urinary 2 Modify 2 PDF

 = TUBULOINTERSTITIAL DISEASES INTERSTITIAL NEPHRITIS PYELONEPHRITIS  INTERSTITIAL NEPHRITIS = Histologic features: Causes 1) Interstitial inflammation...

 = TUBULOINTERSTITIAL DISEASES INTERSTITIAL NEPHRITIS PYELONEPHRITIS  INTERSTITIAL NEPHRITIS = Histologic features: Causes 1) Interstitial inflammation 1) Infections 2) Toxins immunologic disorders 2) Interstitial fibrosis 3) Chemicals 3) Tubular dilation and atrophy 4) Therapeutic drugs Txlocity  Actinobacillus equuli = Multifocal area of necrosis Shower of septic embolie Multiple cortical foci, pinpoint, and are uniformly distributed & O Inflammatory aggregates in the cortex and medulla replace normal architecture An abscess obscures normal architecture a colony of coccobacilli n -  &  Sleepy foal disease; septicemia of foals; navel-ill; joint-ill ra i s e  An acute, highly fatal septicemia of newborn foals -  Normal inhabitant of the adult horse respiratory, alimentary and genitourinary tracts T  I Transmission can occur in utero or at partuition, via the umbilicus Vestic transmission  - Bacteremia showers of septic emboli lodge in small capillaries (glomerular tufts) ↳ bactaim  * inflammatory infiltrate expands the interstitium Name n Laudition - WHITE-SPOTTED KIDNEYS OF C A LV E S & Neutrophils, lymphocytes, plasma cells and macrophages & & & & & & & &  => a  Interstitial (embolic) nephritis =  Incidental finding in young calves =  Secondary to bacteremia/septicemia – typically coliforms ⑤  Begins suppurative (microabscesses) → non suppurative over time + fibrosis *  Multifocal, often coalescing, limited to cortex p  => DIFFERENTIAL DIAGNOSIS: (Multifocal interstitial nephritis in cattle) 1. Malignant catarrhal fever Vi Site 2. Theileria parva (east coast fever) Paga 3. Lumpy skin disease Vito) 4. Leptospirosis Heaterin 5. Hairy Vetch J's *  - Multifocal cellular infiltrate surrounding, separating and tubules LEPTOSPIROSIS Spiral, filamentous bacteria within tubular epithelial cells stain black & &  A  Various serovars of leptospira interogans F  Worldwide distribution *  Survives months in warm, moist, neutral to alkaline soil, or stagnant water & = S1 , -b)  Zoonotic & O  Slender, motile, flexible, weakly gram-negative spirochetes with hooked ends #  Each serovar is adapted to one or more “maintenance hosts,” mild or subclinical (kidney or genital tract) ②  Disease in infected “incidental hosts” is generally more severe ②  & TYPICAL GROSS FINDINGS: ACUTE  Icterus, anemia, petechial and ecchymotic hemorrhages  Swollen, hemorrhagic kidneys  Port-wine or bile-colored urine in ruminants and horses CHRONIC  Kidneys shrunken and firm, with linear to radiating gray foci +/- uremia ABORTION Ruminants: autolytic fetus Swine: mummified fetuses ⑮  *-Lymphocytes - MALIGNANT CATARRHAL FEVER (MCF) Inflammatory cells are admixed fibrin and (vasculitis). & &  &  Sporadic, fatal, multisystemic disease of cattle, small ruminants and wild ruminants  Gammaherpesvirus:  Characterized by Lymphoproliferation & Vasculitis & Erosive to ulcerative mucosal  Mortality approaches 100% 1. Ovine herpesvirus-2: endemic in sheep; occurs worldwide; infects cattle, bison, water buffalo, deer jjz  & cystitis -  &  Diffuse petechial and ecchymotic hemorrhages (kidneys, adrenal glands, liver, lungs, and GIT)  F & CANINE HERPESVIRUS & & Inclusion are viral particles  *  Alphaherpesvirinae  A highly fatal, systemic disease of neonatal puppies (less than 4-6 weeks)  Foci of necrosis (including vascular necrosis) and hemorrhage in numerous organs  The virus is extremely temperature sensitive (37degrees C )  Pups are infected in utero or at birth * =  - FELINE INFECTIOUS PERITONITIS Fits in e exudate &   Mutated Feline Enteric Coronavirus = Fecal-oral transmission and possibly inhalation of FCoV replication in enterocytes / lymphoid system mutation (FIPV), virus able to replicate in macrophages secondary macrophage associated viremia and macrophage activation dissemination to multiple organs and vessels (systemic infection) host immune response  DIFFERENTIAL DIAGNOSIS For INTERSTITIAL NEPHRITIS - Sheep: 1) Sheep-pox (Capripoxvirus) 2) Small Ruminant Lentivirus (Maedi-Visna virus, can also cause membranoproliferative glomerulonephritis) Horses: 1) Equine Infectious Anemia (Lentivirus) 2) Equine Viral Arteritis (Arterivirus) Pigs: 1) Leptospirosis (L. interrogans serovar pomona) 2) Porcine Reproductive and Respiratory Syndrome (Arterivirus)  & Dogs: 1) Leptospirosis 2) Infectious Canine Hepatitis, recovery phase (Canine Adenovirus 1) 3) Encephalitozoon cuniculi 4) Canine herpesvirus 5) Leishmania spp 6) Borrelia burgdorferi 7) Hepatozoon canis Cats: 1) Feline infectious peritonitis  => EMBOLIC SUPPURATIVE NEPHRITIS Cats: Pasteurella multocida Dogs: Klebsiella pneumoniae Horses: Pigs: Erysipelothrix rhusiopathiae 1) Actinobacillus equuli, 2) Equine polyomavirus Sheep and goats: Cattle:Truperella pyogenes 1) Corynebacterium pseudotuberculosis 2) Sheep adenovirus  - PYELONEPHRITIS  =  Inflammation of the renal pelvis and parenchyma  Infection usually ascending from the lower urinary tract  Often accompanied by ureteritis and cystitis  Often bilateral  The acute disease is most commonly seen in sows  The chronic form is most commonly seen in cattle and dogs  E. coli, Enterobacter, Klebsiella, Proteus, Pseudomonas aeruginosa  Staphylococcus, Streptococcus  CATTLE:  Corynebacterium renale  * predispose females to urinary tract infections Cactum (4) to is slos 1. Short urethras 2. Urethral trauma 3. Possible hormonal effects 4-Proximal rectal urethra distance.  = INCREASE THE RISK OF PYELONEPHRITIS 1. Urinary tract obstruction & Urine stasis A. Urolithiasis B. Tumors 3. Prostatomegaly catheterization 4. Cystitis and bacterial endotoxins causing reverse peristaltic waves, and chronic cystitis may lead to chronic active pyelonephritis  Irregular red to gray streaks extending from the renal medulla toward the surface * ACUTE  abscesses in the renal cortex, with pus in the pelvis Congestion, hemorrhages  => Chronic  firm, pale, and shrunken with an irregular surface;  scars extend from capsule to pelvis DISEASES OF TUBULES  acute tubular injury *  Nephrosis the oldest term  Acute tubular necrosis (ATN)  Acute tubular injury (ATI)  =  Principal causes of ATI are ISCHEMIA and NEPHROTOXINS  ISCHEMIC ATI -  Marked renal ischemia Dehydration, hypovolemia, hypotension  Massive hemolysis ( hemoglobinuria ). GROSS FINDINGS:  Kidney: Swollen, red-brown to blue-black cortex with brown-red streaks in the medulla  T Gun metal blue kidney Ruminants Hemoglobinuric nephrosis o Chronic copper toxicoses (small ruminants) o Babesia o Clostridium haemolyticum o Leptospirosis, etc. Myoglobinuric nephrosis o Myopathy, trauma d  => Horse Red Maple ↳ Rhabdomyolysis S Nephrotoxic ATI =>  Ethylene Glycol (EG) - & & Dilated tubules:markedly swollen epithelial cells with abundant clear to Translucent, pale, yellowish, anisotropic crystals arranged in sheaves, prisms vacuolated cytoplasm (degeneration). and rosettes (calcium oxalates),  &  Acute tubular necrosis severe in proximal tubules  Cats are more susceptible, but dogs are more commonly affected  Antifreeze & a sweet taste Antifreeze and sweet teast  &  Glycoaldehyde and glyoxylate o Acting directly on the tubular epithelium  calcium oxalate o precipitates upon decreasing pH within renal tubules o Sequesters calcium,  Acid o severe metabolic acidosis o Nervous signs -  2  TYPICAL CLINICAL FINDINGS:  acidosis  Acute renal failure: azotemia  Calcium oxalate monohydrate crystalluria (crystals are needle-shaped or “picket fence” shaped  Proteinuria, glucosuria  Hypocalcemia  - TYPICAL GROSS FINDINGS:  Kidney  swollen and pale or mottled  pale yellow crystals may be visible grossly  => TYPICAL LIGHT MICROSCOPIC FINDINGS:  Kidney:  Tubular lesions; acute cellular swelling to necrosis to regeneration  Large numbers of calcium oxalate crystals  light yellow, anisotropic (birefringent with polarized light) crystals arranged in sheaves, rosettes, or prisms  ⑤ Neoplastic lesions in the kidneys RENAL CARCINOMA - RENAL ADENOMA NEPHROBLASTOMA &  # & LYMPHOSARCOMA  common in cat and cow.  a primary or secondary renal tumor LOWER URINARY TRACT Urolithiasis =>  *  Presence of calculi in the urinary passages  Aggregates of URINARY SOLUTES + PROTEINACEOUS DEBRIS  If matrix predominates, referred to as URETHRAL PLUGS  any part of the urinary system.  Impaction of the urethra is more common in males (longer, narrower).  Obstruction causes local pressure necrosis with ulceration and acute haemorrhagic urethritis.  sequelae of urethral or bladder rupture, or hydronephrosis  2 PHASES = NUCLEATION ( Nidus ) Requires: 2. Growth 1- Supersaturation of the mineral within the urine A. Nidus must stay in the urinary tract precipitates out and forms salts A. High dietary intake B. Concentrated urine (reduced water intake) B. Supersaturation and precipitation must continue. C. Decreased tubular absorption 2- Favorable pH for crystallisation (depends on minerals) 3- Others: infection, structural abnormalities, foreign bodies, drugs  ⑭ The common sites of urethral impaction: 1. Ruminants: the sigmoid flexure 2. Rams: The vermiform appendage 3. Dogs: proximal End of the os penis in ⑤ X - - INFLAMMATION OF THE LOWER URINARY TRACT  = CYSTITIS CHRONIC ACUTE DIFFUSE HEMORRHAGIC POLYPOID FIBRINOPURULENT FOLLICULAR NECROTIZING OR ULCERATIVE  1- BACTERIA *  Usually from the urethra (rectal flora)  Escherichia coli, Proteus vulgaris, streptococci, staphylococci, enterococci, Klebsiella, Pasteurella,, Enterobacter, and Pseudomonas  Corynebacterium renale group (C.renale, C. pilosum, C. cystitidis) is important in cows 2 – Viral  Malignant catarrhal fever: hemorrhagic cystitis in cattle  Feline lower urinary tract disease (FLUTD) - A variety of conditions that affect the bladder and urethra of cats 1. Infection 2. Uroliths& urethral plugs