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Exam 2
Urolithiasis
37
Veterinary Medicine
Professional
02/23/2017

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Cards

Term
What is the most economically signifianct renal dz of FA?
Definition
-urolithiasis
Term
What are the most common types of calculi in FA? Why?
Definition
-Struvite & apatitie
-diet: low Ca:P, high Mg feedlot diet
Term
What commonly causes Ca carbonate calculi FA?
Definition
-clover pasture
Term
What commonly causes Ca oxalat ecalculi in FA?
Definition
-halogeton, beet
Term
Where are silicate calculi common in FA?
Definition
-native grass in western US/Canada
Term
Describe the pathophysiology behind FA calculi.
Definition
-presence of nidus
-inc soluble ionized minerals in diet w/ dec water intake
-pelleted ration = less saliva
-concreting agents: mucoproteins in grain
-alkaline urine pH: promotes sturvite, apatitie, and Ca carbonate calculis
Term
Are calculis more common in females or males? Why?
Definition
-males
-due to longer urethra
-castration early = smaller urinary tract
Term
How does seasonality affect urinary calculi?
Definition
-more in winter due to dec water intake
Term
What are the common sites of obstruction in each species?
Definition
-urethral process: ov/cap
-sigmoid flexure: bo, Ov/Cap, swine, camelids
Term
What are the consequences of urolithiasis?
Definition
-urethral obstruction
-ruptured urethra
-ruptured bladder
-hematuria & abdominal pain: ureterolith
-hydronephrosis => renal failure
-possible ammonia smell in breath
Term
What are the clinical signs of uremia in FA?
Definition
-anorexia
-depression
-weakness
-bruxism
-ammoni odor in breath
Term
What are some of the clinical signs in uroliths in FA?
Definition
-crystals on hairs of prepuce
-elevated tail carriage
-pulsations of pelvic urethra
-distended urinary bladder
-stranguria, dysuria, anuria
-abdominal pain: kicking, vocalization (caprine > camelids)
Term
What are the clinical signs in FA w/ ruptured urethra?
Definition
-cool, non-painful swelling at base of scrotum to prepuce
Term
What are the clinical signs in FA w/ ruptured bladder?
Definition
-ventral abdominal distension
-fluid wave/splash on succession bilateral: water belly
-small bladder on rectal exam
Term
How do we diagnose urolithiasis in FA?
Definition
-hx + CS
-U/S: abdominocentesis if uroabdomen
-UA
-chem: inc BUN/creatinine, inc Mg/PO4, K inc in eveyrone except Bo, dec Na & Cl (ruptured bladder)
-rads
Term
What on our serum chem can be a prognostic indicator for FA urolithiasis?
Definition
-inc Mg/PO4
Term
What are the effects of inc K w/ FA urolithiasis?
Definition
-inc K => dec HR can just cause cardiac arrest
Term
What are the pros & cons of rads for FA urolithiasis?
Definition
-Pros: determine #, size, location of uroliths
-Cons: availability & cost, CANNOT SEE STRUVITES IN FA, ONLY CA-CONTAINING VISIBLE
Term
What are our goals w/ FA urolithiasis tx?
Definition
-relieve the obstruction
-correct dehydration & electrolytes
-urinary acidification: struvites & appatite
Term
What are hte general considerations for treatment of FA urolithiasis?
Definition
-location of obstruction: sigmoid flexure, urethral process (Ov/Cap)
-concurrent cystitis
-urethral diverticulum
-frenulum in young animals
Term
In general, how do we do PE for FA urolithiasis?
Definition
-standing: penile or pudendal nerve block
-recumbent: dorsoflex back
-sedation: NOT XYLAZINE, use butorphanol/diazepam, lidocaine in prepuce, epidural
Term
What are the general ways to stage FA urolithiasis?
Definition
-urethral obstruction: pain, hematuria, crystalluria
-baldder rupture: ascites/ water-belly
-urethral rupture: peripenile subcutaneous urine
Term
HOw can we fix an obstructed urethra in small rums esp?
Definition
-amputation of urethral process: Ov/Cap
-retrograde urethral catheterization & hydropulsion: occlude pelvic urethra, lidocaine in lavage
Term
What are our options for obstructed urethra if hydropulsion fials?
Definition
-urethrostomy
-targeted urethrotomy
-cystotomy
-tube cystostomy
Term
What is a Perineal urethrostomy (PU)?
Definition
-salvage procedure
-HIgh (ischial) short term to get to slaughter, catheter into baldder
-Low +/- penectomy: long term to allow growth, no catheter and sutured
Term
What is our major concenr w/ PU in FA urolithiasis?
Definition
-frequently strictures long-term so not good option for pets
Term
In general, how do we perform a high PU in FA?
Definition
-incision just below rectum over urethral process
-foly catheter into bladder: suture
-salvage in 3-4w
Term
Why do we perform a penectomy w/ a low PU?
Definition
-remove necrotic tissue
Term
In general, how do we perform low PU in FA?
Definition
-urinary catheter 1st
0anchoring suture
-spatulate urethra
-urethra to skin at apex
-urethra to tunica alb: on stump
-don't stricture in cattle
Term
When would we choose a targeted uretrhotomy in FA?
Definition
-early early cases in breeding animals
-incision over sigmoid
-ID stone and crush
Term
When would you perform a cystotomy for FA?
Definition
-breeding/pet small rums
Term
What commonly occurs w/ cystootmy for FA?
Definition
-most re-obstruct w/in 3 days
Term
When would we usea tube cystotomy in FA?
Definition
-breeding/pet animal
-gaol to divert urine and correct metabolic problems
Term
What is the advantage of a tube cystotomy?
Definition
-don't have to go back into abdoment to remove tube
Term
What are our considerations postop w/ FA tube cystotomy?
Definition
-prevent pulling of foley
-heimlich valve
-Beta-lactam bx
-Fluids
-NSAIDs acter azotemia & dehydration corrected
-ammonium chloride PO to acidify urine
Term
What can we give via bladder lavage w/ sturvites in FA?
Definition
-Walpole's >3d post-op or Hemiacidrin to acidify urine
Term
Prognosis of FA tube cystotomy?
Definition
-approx 75%
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