Urinary Problems

Equine: Why would a Paint horse who looks to be in pain when forced to walk have myoglobinuria and normal appearing plasma sample

To check that it is myglobinuria we centrifuge and the urine does not clear.

Horse has some form of myopathy

1. Polysaccharide storage myopathy

2. Exerrtional myopathy

3. Etc

Equine:Why should you not give horses with glomerulonephritis furosemide? What should you give instead

Because these horses are usually polyuric instead give:

1. Low protein diet

2. Plasma transfusion

3. Corticosteroids

Equine:Whats a common antibiotic that can cause acute renal failure in horses( nephrootoxic)

Neomycin (Aminoglycosides)

Equine:What is the specific gravity of a horse with chronic renal insufficiency and moderate azotemia

Isosthenuria (1.008-1.015)

Equine:Common differentials for a young foal presenting for urine dribbling from her vulva

1. Sudan grass/sorghum toxicosis:cause myelomacia of spinal cord

2. Sacral Fractures

3. Ectopic Ureters

Equine: On a routine screening physical exam, you have noted low serum potassium in a 4-year old Thoroughbred racehorse. Which one of the following is the most likely cause of hypokalemia in a horse?

1. A.Salt poisoning

2. B.Dietary insufficiency of potassium

3. C.Psychogenic polydipsia

4. D.Chronic use of furosemide, a diuretic

5. E.Hyperlipidemia

Furosemide

Loop diuretics cause excessive amounts of potassium to be lost via the urine.

Equine: What is an effective way at reducing the risk of aminoglycoside toxicity

Maintaining adequate hydration

Equine: What are the most common serum electrolyte abnormalities in a foal with uroperitoneum?

1. Hyperkalemia

2. Hyponatremia

3. Hypochloremia

Feline:What drug is used to reduce internal urethral sphincter tone

Phenoxybenzamine

Feline:What specific gravity and pH do you want a cat who has a history of calcium oxalate

1. Specific gravity: <1.030

2. pH: >6.25 with no or few crystals

Feline:What is the most common urinary issue for cats

Idiopathic cystitis

CATS RARELY GET UTI’s

Feline:What pH of urine are struvites made in

Struvites are made in alkalinized urine

Feline:A male neutered domestic short hair cat presents to you with urinary obstruction. Your treatment room diagnostics show a BUN > 140 mg/dL (19-34 mg/dl) and a K+ of 9.0 mEq/L (3.7-6.1 mEq/L). You immediately give the cat dextrose and fluids and successfully unblock your patient. An hour later, you monitor your patient and find him trembling uncontrollably. What should you check first?

Ionized calcium level

some cases, during the immediate post-obstructive period, cats will develop hypocalcemic tetany. The mechanism is considered to be secondary to laws of mass action that drive down calcium as a result of existing hyperphosphatemia. Judicious use of calcium gluconate can quickly restore their electrolyte balance and prevent further complications such as hypocalcemic seizures.

Feline: What should you give a cat to reduce internal urethral sphincter tone so that he maybe able to pee more easily

Phenoxybenzamine

Feline: What can you use to treat urinary incontinence from urethral hypotonicity

Phenlypropanolamine

Feline: 3-year-old female spayed Persian cat is presented for a suspected urinary tract infection. Her owner reports seeing her straining in the litter box several times a day, and she appears to have blood in her urine. Physical exam reveals a body condition score of 7/9, temperature of 100.8°F, pink and moist mucous membranes, mild dental calculus, and no abnormalities on thoracic auscultation. She is anxious on palpation of her abdomen and as you move towards her bladder, she urinates on the exam table. You collect this urine sample for urinalysis, which reveals the following: pH 7.5, SG 1.033, protein ++, leukocytes ++, blood ++. Your technician examines her urine sediment and notes the following: TNTC RBC, 5-10 WBC/hpf, remainder within normal limits. What do you recommend to the owner?

1. A.Treat the cat with amitriptyline

2. B.Treat the cat with amoxicillin/clavulanic acid

3. C.Multimodal environmental modification

4. D.Treat the cat with prednisolone

5. E.Transition the cat to a prescription diet

Based on the signalment, physical exam, and urinalysis results, this is likely a case of feline idiopathic cystitis (FIC). Feline idiopathic cystitis is a frustrating disease for patients, owners and clinicians. Persians are predisposed to this condition, as are cats that are overweight. Although these cats present with a UTI complaint, there is no infection present. Therefore, antibiotics are contraindicated.

Prednisolone was previously recommended for treatment, but later studies showed that its benefits were no greater than placebo.

Amitriptyline is not effective for acute interstitial cystitis, but may sometimes be needed for long-term management in patients with chronic anxiety.

A prescription diet is not indicated in this cat, because she has no evidence of stones or crystals.

Multimodal environmental modification is the primary recommendation for acute feline idiopathic cystitis. Decreasing the cat's stress through environmental modification is often all that is necessary for treatment, although analgesia, nutritional changes, and anxiolytics may be added to refractory cases.

Feline: A sign seen more commonly with acute renal failure than with chronic renal failure.

Anuria

Feline:A 4-year old female Abyssinian cat presents to you with a complaint of weight loss and polyuria and polydipsia. On exam, the cat appears slightly underweight, but otherwise there are no significant findings.

You perform a complete blood count, chemistry panel, and urinalysis. The cat has a hematocrit of 27%, white blood cell count of 4,500/uL, and 350,000 platelets/uL. The chemistry panel shows Ca=10.5 mg/dL, P=3.5 mg/dL, bilirubin=0.l mg/dL, albumin=2.7 g/dL, globulin=2.7 g/dL, ALT=50 IU/L, glucose=104 mg/dL, BUN=59 mg/dL, Creatinine=3.8 mg/dL, and cholesterol= 120 mg/dL. Urinalysis shows a specific gravity of 1.010 with no bilirubin, glucose, or ketones detected and trace protein.

You measure systolic blood pressure of 160 mmHg. Abdominal ultrasound shows subjectively small kidneys with increased renal echogenicity.

Due to the cat's young age and breed, you suspect an underlying hereditary condition to the cat's renal disease. The owner reports that the breeder she obtained the cat from promised her that the line was free of any genetic disorders. You explain to the owner that a kidney biopsy may be the only way to rule in or out this hereditary disease. What specific test should you recommend on the biopsy sample?

1. A.Trichrome staining for connective tissue

2. B.Immunoflourescent staining for immune complexes

3. C.Hematoxylin and eosin staining for polycystic regions

4. D.Congo red staining for amyloid

5. E.Silver stain for type III collagen deposition

Of the many forms of amyloidosis, reactive (secondary) systemic amyloidosis is seen in the cat as a familial disorder of the Abyssinian, Siamese, and Oriental Shorthair. Amyloid deposition occurs most frequently in the kidney (Abyssinian) and liver (Siamese and Oriental Shorthair) although other sites can be affected. Clinical signs in the Abyssinian are typically those of chronic renal failure. Hypertension may be secondary to glomerulotublar disease.

Renal or liver biopsies can confirm the diagnosis but are often unnecessary due to the risk of hemorrhage, and there may only be minimal change to therapeutic decision making. Congo red staining of biopsy samples should be requested because hematoxylin and eosin staining do not always show amyloid deposits.

Therapy consists of general management of the renal failure, proteinuria, hepatopathy, and hypertension if they exist. There are reports of using dimethyl sulfoxide (DMSO) or colchicine for these cats as well.

Obviously, this cat should not be bred.

Bovine:How would a cow with renal amyloidosis present

1. Ventral edema

2. Enlarged kidney

3. Hypoalbuminemia

4. Hypoglobinemia

5. Proteinuria

6. Elevated serum creatinine

7. NO FEVER NOR WBC IN URINE

Bovine:What type of urolith is most common in feedlot cattle eating large amounts of grain

Struvite

Bovine:How would a steer with ruptured urethra present

1. Large ventral swelling that pits on palpation

2. Small bladder is palpable

Urolithiasis often causes rupture of the urethra

Bovine:How would the urine of a cow with pyelonephritis be describe

Cloudy and bloody

Bovine:What is the most likely causative agent of cattle grazing on western pasture with chronic intermittent hematuria and hemorrhagic cystitis

Bracken fern

Canine: What is a potential side effect of administering diethylstilbesterol in an incontinent bitch?

Bone marrow suppression

This is why vets prefer phenlyropanolamine

Canine: Voiding oft he bladder involves

Parasympathetic stimulation and sympathetic inhibition

Canine: How would a dog with urethral prolapse present

1. Usually young english bulldogs

2. Masterbates often

3. Descrbed as a small mushroom-like mass at the tip of the penis

Castration is recommended to decrease incidence of recurrence

Canine: How to treat a dog w/ urethral prolapse

There are several treatment options for urethral prolapse, including placing a purse string suture, amputation of the prolapsed region, and urethropexy.

The urethropexy technique is (although not proven) thought to be associated with the least likelihood of recurrence.

Although an amputation of the penis can be performed, this would be excessive for a urethral prolapse and therefore is not recommended due to urethrostomy-associated complications.

Attempting medical management is likely to result in recurrence, so it is generally not recommended.

Canine:UPC benefits

The correct answer is a urine protein:creatinine ratio (UPC). When a urinalysis is positive for protein, but the urine sediment is inactive, the next step is a UPC. A UPC is a quantitative measurement of protein in the urine that is unaffected by urine concentration

Canine: The most appropriate medical treatment for transitional cell carcinoma at the trigone of the bladder

Piroxicam + Carboplatin chemotherapy

Canine: What is the treatment for nephrogenic diabetes insipidus

Hyrochlorothiazide

Canine: What is the treatment for central diabetes insipidus

DVAP

Canine: A dog with a history of urate stones should be on what kind of diet

1. Alkalizing diet and allopurinol therapy.