Path 1 - Urinary 4

rilohoji's version from 2016-11-20 18:15

Lecture 6 continued

Question Answer
**What uroliths are Miniature Schnauzers predisposed to?Predisposed to Struvite uroliths & calcium oxalate dihydrate w/ urolith formation
Bilirubin crystals → Who are these most common in? What do they signify?Most common in dog urine, esp if it's concentrated. In dogs, often no clinical sig. bc dogs usually have a little bit of bili in their urine
**In what animals is it normal to find some bilirubin in their urine? In what animals is it abnormal?In dogs, it is normal! Bilirubinuria +/- bilirubin crystals in feline, equine, bovine, or camelid urine is an abnormal finding & the animal should be investigated for an underlying cholestatic process
Calcium carbonate crystals → who is this usually found in? Who is this NOT usually found in? What do they signify?Common in the urine of normal horses, rabbits, guinea pigs & goats. Not common in canine & feline. Not associated w/ dz
If I say "Dalmatian" & I’m talking about urine crystal formation, what should you think of?Amorphous xanthine crystals occur in Dalmatians on Allopurinol therapy for Urate Urolithiasis.
“Amorphous” crystals → Usually made of what?Comprised of urates (if acidic urine), phosphates (if alkaline urine) or xanthine (occur in Dalmatians on Allopurinol therapy for Urate Urolithiasis)
Calcium oxalate *Dihydrate* crystals → How common? Clinical sig?Often seen in normal urine. Can also be an artifact of storage. Can cause urolithiasis in cats/dogs, or occur 2° to disorders of calcium metabolism (e.g. hyperparathyroidism). RARELY seen in Ethylene Glycol tox
**What 2 SIGNS would you find in the urine/clinically see which would strongly hint toward Ethylene Glycol toxicosis?ACUTE RENAL FAILURE+PICKET FENCE (calcium oxalate monohydrate crystals) CRYSTALS = EG TOX
**Calcium oxalate monohydrate crystals aka? When do you see this?A particular shape of calcium oxalate monohydrate crystals known as "picket fence" crystals are observed in dogs & cats w/ Ethylene Glycol toxicosis.
**Ammonium biurate crystals → When do you see these? (2)Common in dogs & cats w/ congenital or acquired portal vascular anomalies. Also can be seen in urine from normal Dalmatians & bulldogs, both of which are predisposed to Urate Urolithiasis
**Portal vascular anomalies crystal is?Ammonium biurate crystals
Cystine crystals → what do these usually indicate?Indication of cystinuria, which is a genetic abnormality involving defective renal tubular reabsorption of certain amino acids including cystine. Sex-linked inheritance is suspected since male dogs are almost exclusively affected. Usually not very serious, kidney not otherwise affected, just a tendency to form uroliths.
**What is the MOST COMMON EXAMPLE of drug associated crystals? Any dz associated w/ this?Trimethoprim-sulfadiazine. usually drug crystals are not associated w/ sig. renal dz. (less common examples include: radiopaque contrast agents (Hypaque, Renografin) & ampicillin which may precipitate in acidic urine as fine needle-like crystals)
What is the most common cause of obstructive uropathy?Urolithiasis
What are the usual consequences of urolithiasis?Most common cause of obstructive uropathy. Cause traumatic injury to the urinary mucosa → chronic ulcerative & hemorrhagic cystitis. Predispose to bacterial cystitis & Pyelonephritis. Predispose to chronic inflammatory dz (which can predispose to cancer)
*Know Developmental dzs: aplasia, hypoplasia, ectopic ureters, Patent urachus, urinary bladder diverticulumKey concepts
*For urolithiasis, know conditions of urine supersaturation, mineral salt precipitation, crystal growth & protein composition of urine. Also risk factors & predisposed speciesKey concepts
*For crystalluria, know different types of crystals & clinical significanceKey concepts

Lecture 7

Cystitis + Neoplasia of lower tract

Question Answer
*Acute Cystitis is more common in which gender & why?Most common in females due to shorter & wider urethra
*Acute Cystitis → What might occur concurrently?May have concurrent ureteritis & urethritis
**Bacteria that cause Acute Cystitis in → All speciesE. coli, Proteus sp., Streptococcus sp., Staphylococcus sp
**Bacteria that cause Acute Cystitis in → CattleCorynebacterium renale
**Bacteria that cause Acute Cystitis in → PigsActinobaculum suis
**Bacteria that cause Acute Cystitis in → CatsEnterococcus faecalis
**Bacteria that cause Acute Cystitis in → HorsesKlebsiella sp.
**Risk factors for acute bacterial cystitis include~Stagnation of urine (obstruction, incomplete voiding, diverticulum), trauma from urolithiasis, catheterization, or cystocentesis, vaginoscopy, vaginitis, coitus, AI, urinary incontinence, prolonged antibiotics that may cause antimicrobial resistance, diabetes mellitus, prolonged corticosteroids or Cushing’s, immunosuppression
**What is a big TOXIC cause of cystits in HORSES?Cantharidin toxicosis!!! From eating BLISTER BEETLES in ALFALFA hay
**What is a big TOXIC cause of cystitis in COWS?Bracken Fern toxicosis!!! Can cause cystitis, Hematuria & urinary bladder neoplasia
How does Bracken Fern affect WHO?COWS, cystitis, Hematuria & urinary bladder neoplasia
What situation usually causes mycotic cystitis? What are the 2 most common fungi for this?Mycotic cystitis may occur 2° to bacterial cystitis, antimicrobial therapy, immunosuppression (Aspergillus sp., Candida albicans)
**What are the gross lesions of Acute Cystitis?Edema, hemorrhage, ulceration, purulent exudate
**What are the microscopic lesions of Acute Cystitis?Epithelial denudation, ulceration, hemorrhage, edema, suppurative infiltration, bacterial colonies
**What are the CS of Acute Cystitis?Dysuria, Stranguria, Hematuria, sedimentation, blood, +/- bacteria on urinalysis, pyrexia
**What are the 2 MOST COMMON causes of Chronic?Chronic bacterial infxn & urolithiasis
**What are the 3 TYPES of Chronic? (Based on morphological pattern)Diffuse, lymphofollicular & polypoid
**What are the GROSS LESIONS of Chronic?Diffusely reddened, roughened & thickened mucosa, may see lymphoid follicles or polypoid hyperplasia
**What are the MICROSCOPIC lesions of Chronic?Epithelial hyperplasia, fibrosis, hemorrhage & mononuclear infiltration, few neutrophils
**Of the lower urinary tract, where is the most common place to have a neoplasm?BLADDER
**Bladder cancer is most common in WHO? WHEN?Most common in OLD DOGS & occasionally cats & cattle
**What is the most common epithelial tumor of the lower tract, who is it most common in & where? Important things to note?**Transitional Cell Carcinoma (TCC) (or papilloma) is COMMON In dogs, rare in cats. It happens most often in the TRIGONE AREA Important to note that it has a very high metastatic rate to regional lymph nodes, lungs, kidneys, other
**What is the most common mesenchymal tumor of the lower tract?Leiomyoma (mesenchymal tumors are much less common! others reported tumors include fibroma, fibrosarcoma, leiomyosarcoma, embryonal rhabdomyosarcoma, hemangioma, hemangiosarcoma & lymphosarcoma)

Disorders of Horses

Question Answer
*Bacterial Embolic Nephritis → Aka? etiological agent & what should you know about the agent?aka Suppurative Glomerulitis, caused by Actinobacillus equuli! A. equuli is a normal inhabitant of the alimentary tract
Bacterial Embolic Nephritis → Who is most affected by this & how do they get infected?(Remember it's the commensal Actinobacillus equuli). Foals are most commonly infected by contamination of the umbilicus & mares can be chronic carriers & infect foals by shedding in the urine
Bacterial Embolic Nephritis → What are the results of this?Causes systemic infxn w/ bacterial emboli & microabscessation in many organs including the kidney
Myoglobinuric Nephrosis → Aka? What causes this?aka Rhabdomyolysis acute muscle necrosis leads to severe myoglobinemia. It occurs w/ exertional myopathy or muscle trauma → myoglobin becomes concentrated in the glomerular filtrate & is damaging to the tubular epithelium in conjunction w/ renal ischemia. ALSO, Also, Hemoglobinuric Nephrosis occurs in horses w/ Red Maple toxicosis (remember?)
Papillary necrosis → WHAT CAUSES THIS? PATHOGENESIS?caused by NSAID administration (in horses, obv). Most common would be Phenylbutazone & Flunixin Meglumine, then. NSAIDS block prostaglandin production which causes vasoconstriction, hypoxia & ischemia. Can be exacerbated w/ hypovolemia
Patent urachus → What should you know about this deformity? what does this happen?Most common malformation of the urinary bladder! Caused by failure of the fetal urachus to completely involute → urine dribbles from the umbilicus. It is often associated w/ umbilical abscesses
What is Klossiella equi?Protozoon parasite w/ various stages of development in the kidneys
Describe what Klossiella equi does to the kidneySchizogony & sporogony occur in tubular epithelium & sporocysts shed in urine & transmitted orally. There are typically no gross lesions, but there is mild to moderate tubular degeneration & necrosis. However, typically no significant renal d
**What is a big TOXIC cause of cystits in HORSES?Cantharidin toxicosis!!! From eating BLISTER BEETLES in ALFALFA hay