What are potential causes of lower UTI in large animals?
-urine stasis secondary to micturition disorder
-urolithiasis in bladder or urethra
-non-sterile catheterization
-stricture
-adhesions
-conformation
-trauma
What are potential causes of upper UTI in large animals?
-hematogenous spread
-ascending infection from lower urinary tract
-renal calculi
What are the clinical signs of lower UTI in large animals?
-dysuria
-pollakiuria
-urine scalding (skin irritation from prolonged contact)
-hematuria if severe or secondary to urolith or neoplasia
What are the clinical signs of upper UTI in large animals?
-fever
-depression
-anorexia
-weight loss
-possible hematuria
-dysuria and pollakiuria if concurrent with lower UTI
What are the characteristics of UTI diagnosis?
-UA on midstream voided or catheter-collected urine
-pyuria if > 10 WBC/high power field
-bacteriuria if > 20 organisms/high power field
-significant culture if > 10,000 organisms/mL urine and/or pure culture (one organism)
What is the treatment for UTI?
-broad spectrum antibiotics to start; narrow with C&S results
-treat lower UTI for 7 to 14 days
-treat upper UTI for 2 to 6 weeks
-treat underlying causes
What are the limiting factors to UTI treatment?
-ease of administration
-toxicity of medications
-expense of medications
What are the characteristics of contagious bovine pyelonephritis?
-caused by Corynebacterium renale
-pili of bacteria cling to mucus membranes of vulva
-transmitted by clinically-normal cattle carriers
-ascending urinary tract infection
-colonizes ureter(s) and kidney(s)
-bilateral infection can lead to azotemia and death
What is the signalment and epidemiology of contagious bovine pyelonephritis?
-adult dairy cattle
-close proximity housing
-late winter months
-high producing individuals
What are the clinical signs of contagious bovine pyelonephritis?
*anorexia
*decreased milk production
*signs of lower and upper UTI
*abnormal rectal exam:
-enlarged, painful kidneys
-thickened, contracted bladder
-dilation of ureters
What is the treatment for contagious bovine pyelonephritis?
-long term antibiotics for 20 to 30 days
-start with procaine penicillin; narrow based on C&S
-unilateral nephrectomy
-cull animal
Which aspects of client education are important to preventing spread of contagious bovine pyelonephritis?
-early detection and treatment of cases
-isolate clinically affected animals
-eliminate carriers from heard
-use of proper AI breeding techniques
What are the characteristics of ulcerative posthitis/vulvitis?
-seen in small ruminants
-known as pizzle rot, sheath rot, or enzootic balanoposthitis
-caused by Corynebacterium renale
-bacteria interacts with urea in urine around external urethra and surrounding area
What is the treatment and control for ulcerative posthitis/vulvitis?
*treatment:
-debriding ulcerative areas
-topical ointments
*control:
-decrease protein in diet
-isolate affected animals
-remove wool/hair around prepuce/vulva
What are the characteristics of urinary system neoplasia?
-rare in horses
-squamous cell carcinoma and transitional cell carcinoma possible in bladder
-fibromatous polyps seen in younger horses
-renal cell carcinoma possible
What are the treatment options for urinary system neoplasia?
*bladder:
-surgical removal of mass w/ local chemo (poor prognosis)
*kidney:
-nephrectomy
What are the characteristics of enzootic hematuria?
-intermittent hematuria of adult cattle older than 4 years
-weeks to months between episodes
-associated with bracken fern exposure
-wart-like bladder tumors of varying histological type
What are the characteristics of equine idiopathic hemorrhagic cystitis?
-idiopathic cause of hematuria and stranguria in horses
-proliferative, hemorrhagic bladder mucosa on cystoscopy
-culture of urine often negative
-treated with TMS
-affected horses should be re-evaluated after 2 to 4 weeks of treatment
-good prognosis
What are potential causes of micturition disorder in horses/large animals?
*neuro. disease
*intramural bladder/urethral disease
-neoplasia
-inflammation
-trauma
*hormonal causes
*congenital causes
-ectopic ureter
What are the possible neurologic causes of micturition disorders?
-equine herpes virus 1 myelitis
-cauda equina neuritis
-polyneuritis equi
-equine protozoal myelitis
-west nile virus
-spinal abscesses
-fractures/compressive lesions
-neoplasia
How are neurologic causes of micturition disorders diagnosed?
-complete history, including duration
-observation of horse urinating
-examination of external urethral opening
-rectal palpation and evaluation of anal sphincter tone, rectal tone, and bladder tone
What are the clinical signs of upper motor neuron urinary disease?
-incomplete voiding/large residual volume
-normal anal tone and tail tone
-difficulty emptying bladder with rectal palpation
What are the clinical signs of lower motor neuron urinary disease?
-bladder easily emptied/expressed on rectal palpation
-loss of urinary sphincter tone
-dribbling/incontinence
-decreased anal tone and tail tone
-sabulous debris retained in bladder
What are the clinical signs of pelvic nerve and bladder wall lesions?
-distended bladder that is hard to express
-normal anal tone
-sabulous sediment retained
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