Urology Farm Animals Lecture #90 PDF

Learning Objectives Urology Farm Animals VM 654 Dennis D. French Urinary Tract Infections  Cystitis, ureteritis, pyelonephritis – Dysuria, pollakiuria – Anorexia if pyelonephritis  Ascending infection – Corynebacterium renale – Escherichia coli      Be able to perform physical exam Descri...

Learning Objectives Urology Farm Animals VM 654 Dennis D. French Urinary Tract Infections  Cystitis, ureteritis, pyelonephritis – Dysuria, pollakiuria – Anorexia if pyelonephritis  Ascending infection – Corynebacterium renale – Escherichia coli      Be able to perform physical exam Describe need for advanced diagnostics Identify primary location of lesion Discuss prognosis Describe treatment options Pathogenesis  Abnormal vulvar conformation  Urogenital trauma – Parturition – Obstetric manipulation Diagnosis  PE with rectal exam  Ultrasound  Urinalysis Leptospirosis  Multiple organ system  L. interrogans serovar Hardjoprajitno  L. borgpetersnii serovar Hardjobovis Leptospirosis  Acute fever, icterus, redwater and mortality uncommon – sporadic outbreaks in calves  Incidental serovar infection in adults often results in high abortion rates – Pomona, Grippotyphosa and Icterohaemorrhagiae are most frequently identified in incidental infections – transmission is related to pigs, rodents and wildlife Treatments  Oxytetracyclines  Penicillin  Ampicillin Urolithiasis  Metabolic disease of males  Present with – Stranguria – Vocalization Pathophysiology  Urine mucopolysaccharides and crystalloids  Influenced by urine pH  Grain high in phosphorous – Leads to increased phosphate in urine – Magnesium ammonium phosphate (struvite) calculi Urinary Calculi Common sites  Urethral process  Distal aspect sigmoid flexure Clinical Pathology  Stress leukogram  Hyperglycemia  Azotemia – BUN and Creatinine can be high Image of ultrasound examination of the bladder, note the hyperechoic debris as the calculi reflect the beam back to the transducer Clinical Pathology     Hyponatremia Hypochloremia Hypocalcemia Hyperkalemia Owner Counsel  Difficult and expensive to manage – Cardiac or respiratory arrest – Renal failure – Platelet and coagulation dysfunction – Additional uroliths – INCONSISTENT OWNER COMPLIANCE Treatment  Examine and remove urethral process  Fluids Treatment  Urethral catheterization – “urohydropulsion”  NOT successful in ruminants – Catheter lodges in the urethral recess – Contraindicated Physical Exam     Temperature 100.3F (37.9C) Heart rate 104 bpm Resp 65 bpm 290 lb (132 kg) 2-year-old Corriedale Ram 282301  48-hour hunched body posture  Owner Rx- Oxytet and mineral oil  Hesitant to walk Urinary Calculi Examination of penis  Vermiform appendage – Gritty material at distal end – Amputation resulted in 4-5 drops of red urine Further workup  Abdominal ultrasound  Assessment of electrolytes Ultrasound  Grossly enlarged urinary bladder – Multiple crystals – Urine pH 10 Electrolytes     BUN = 228 Creatinine = to high to quantitate Potassium = 7.56 Fibrinogen = 1100 g/dl Surgical Options     Perineal Urethrostomy Perineal urethrostomy Urethrotomy Cystotomy Tube Cystostomy Tube Cystotomy Tube Cystotomy Dorsal recumbency/general anesthesia prep and drape Paramedian skin incision adjacent to prepuce Incision should extend ~10 cm and finish between the nipples Skin/prepuce shoved to the side Abdomen opened through the linea alba Identify bladder place two 3-0 stay sutures at dorsal aspect Kidneys!!!  Hydronephrosis  May be present with signs > 24 hours Gross hydronephrosis of the right kidney imaged from the right flank with the dilated renal pelvis, represented by the anechoic centre of the kidney and reduced depth of renal cortex Section of kidney revealing gross hydronephrosis. Transabdominal Ultrasonographic Examination of 26 Sheep with Suspected Urinary Tract Disease (2010-2012) P. Scott 2013 Journal of Veterinary Science & Medical Diagnosis Left kidney Prevention      Adjust Ca:P ratio to 2:1 or greater Increase forage Abandon pelleted rations Add NaCl Ammonium Chloride NH4Cl pulse feeding Right Kidney Ulcerative Posthitis/Vulvitis  Affliction of prepuce and vulva – Unknown etiology (bacteria; OHV2) Vet Record 2008. 163(3) (Photo courtesy Petrea Waite) Adult Female Simmental  3 days post partum (March) Re-examined May • Constant straining – Straining, normal temp, eating well  Mass in the vaginal vault – Differentials Clinical Pathology  Neutrophilia  Hyperfibrinogenemia  Azotemia Bladder  Eversion or Retroflexion  Defined by neck of bladder exiting – External os of urethra= eversion – Defect in vaginal wall= retroflexion Eversion Retroflexion