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Rumi Urinary

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sihirlifil's version from 2018-04-03 23:54

Anatomy & “-urias”

Question Answer
What is this?
Persistent frenulum
Anatomy… keep in mind about clients?Start w/ basics lol
Urethral recess: clinical relevance?
(outpocketing of urethral lumen at lvl of ischium) Catheter gets stuck there!
What are the letters? (pos contrast urethrgram)
A: Bladder
B: Diverticulum! (sharp angle to try to get into bladder)
C: Urethra
What are the issues here?
(retractor penis mm. originate on ventrum ofischium attach at distal aspect S-shaped curve) Hard to pass catheter through, sometimes need sedation/ANX, manipulate to get straight for polypropylene catheter
Debris builds up, uroliths get sruck!
Breeding issues: Bull try to jump up, aim not so good (can break penis b/c fibrocartilaginous, or tear musc attachments --> hematoma)
What happened here?
Penile hematoma! Penis extended during erection --> mounted female & missed target --> bent forcefully, ruptured tunica albuginea at distal aspect of sigmoid flexure --> large vol of blood into peripenal ST
What is this? clinical relevance?
Urethral process (SR ONLY!) aka vermiform appendage, pizzle
If obstructed, can relieve when removed
Clinical relevance?
Right at entrance to bladder: problems with passing catheter, blind pouch (usually not done, there are other ways to get urine)
Clinical relevance?
Conduit for urine to exit fetal bladder in utero
Patent urachus: dribbling from urachus (O may not notice at first, prepuce in close proximity)
Usually can only _________ kidney on transrectal palpationLeft
In rumis, kidneys are on _________ sideRight! b/c of rumen. If US,go for both of them on R side (can be harder to find R)
Urinary issues: Hx questions?Management, client observations (chronology, urine color/abnormalities, straining/posturing, frequency etc), presenting complaint
Urinary issues: PEALL of the animal! not just presenting problem (UT problems mimic other systems)
Examine urinary tract, collect urine
How to collect urine in cowLightly rub perineum immediately ventral to vulva when standing. no touching elsewhere
How to collect urine in bull/steerLightly rub preputial mucosa… preferably with gloves
How to collect urine in sheepIf stable cardiac & respiratory fxns!
How to collect urine in goatsbe ready when they stand up
How to collect urine in camelids
Clip/tie small plastic bag over vulva/penis; follow animal into dung pile!
Remember males urinate caudally
Normals: USG?1.020-1.050
More dilute in neonates due to high water content of milk
Normals:
pH: usually alkaline (7.0-8.5) due to forage-based diet
Ketones: should be neg
Protein: neg (+ trace from alk urine reacting with dipstick)
True proteinuria can be detected by?SSA precipitation test (detects alb & globulins)
How would you classify this urine?
Pigmenturia
Can’t tell yet if hematuria, hburia, or myoglobinuria
How would you classify this urine (after centrifugation?
RBC pellets at bottom of tube = hematuria
How would you classify this urine?
Hemoglobinuria. Plasma reflects hemolytic state, centrifugation does not clear
What does myoglobinuria look like?Red/brown urine, plasma is clear, centrifugation doesn’t clear pigmenturia
What does bilirubinemia look like?Strong positive on dipstick (only conjugated excreted)
memorize

Diseases of the Lower UT & Urolithiasis

Question Answer
Ulcerative posthitis aka? in who? caused by?Pizzle rot (or ulcerative vulvitis in female) Male >>> female small ruminants
Corynebacterium renale (anaerobic g(+) rod), normal flora in low ##
Ulcerative posthitis: pathogenesisC. renale is ureolytic (cleaves urea to ammonia)
Ulcerative posthitis: predispositionHigh-protein diets (>14%)
Excess protein --> excess N2 --> metabolized to urea. Incr urea --> incr bacteria --> incr ammonia = chemical dermatitis
Ulcerative posthitis: CSPain! hurts to breed, arched back, reluctance to breed
Ulcerative posthitis: what does it look like?Moist, exudative, hemorrhagic scab. swollen sheath if internal preputial infection. Scarring & distortion, urethral obstruction
Ulcerative posthitis: TxRemove the protein! Break the cycle
Systemic/topical antibx (Penicillin, tetracycline, ampicillin, cephalosporins
Antibiotic ointments (Neosporin, “petercillin” aka lanolin + dexamethasone + penicillin
Sx resection if stricture
**Pet SR ruleBlocked until proven otherwise
Urolithiasis aka?Urinary calcinosis, stones, obstructive urolithiasis, water belly
How does urolithiasis occur? in who?Sporadic metabolic dz in MALE cattle, sheep, goats, camelids, pigs
How do stones form?Supersaturation of urine with crystalloids exceeds protective capabilities of intrinsic crystallization inhibitors (normal urine contains variable concentrations of mucopolysacc, pepties, ions, organic acids)
Obstruction usually occurs inUrethra
What happened? Stones in the bladder (less common)
SR more positional, can’t use gravity as much to get everything out of bladder
Risk factors for urolithiasisUTI NOT MAJOR RISK FACTOR
Dietary mineral imbalances, water deprivation (minerals can precipitate out better in dilute urine)
Breed, individual variations, gender
Castration age (early: testosterone exerts trophic effect on urethral diameter)
Most common site of urethral obstruction in cattleDistal aspect of sigmoid flexure
Most common site of urethral obstruction in SRUrethral process (2nd most common)
(urolith types)
How is urolithiasis dx?Signalment: gender! & Hx
PE: can palpate bladder & pulsatile urethra. Painful = incr HR & RR
No urination observed
Blood or crystals on prepuce
Exteriorize penis
Rads/US
+/-Catheterization (urethral trauma risks)
What is this a sign of?
Urolithiasis! check hairs, feel if gritty
What’s going on??
Urolithiasis
What additional dx can you do for urolithiasis?Bloodwork, abdominocentesis (serum vs. fluid CR), Rectal (floating contents)
Contrast rads
*** Super important flowchart for Sx management of urolithiasis
Sx management of urolithiasis: If salvage for slaughter is the goal?Cattle: Perineal urethrostomy (PU)
SR & camelids prone to stricture at sx site, so PU not good long-term
Slaughter 4-8w
Sx management of urolithiasis: if long-term survival is the goal?PU NOT AN OPTION FOR BREEDING ANIMALS
Cysto + Warpole’s soln if struvite suspected
Urolithiasis: PreventionIncrease water intake to keep urine dilute, increase salt intake to promote thirst, acidifyers for struvites
Urolithiasis: what should you do about the diet for prevention?Analyze the calculi for mineral types (visual, send to U of Minnesota, Hx, geographical differences) then change diet accordingly
Goal is to reduce concentration of contributory minerals in the urine
Acidifying diet (doesn’t work for all crystals/stones! e.g. struvite. Long-term use issues i.e. refraction, bone resorption). Monitor pH, keep btw 5.5-6.5
memorize

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