Lecture 17

Question 1

What are the general characteristics of ruminant urolithiasis?

Answer 1

-common cause of illness and death in feedlot ruminants
-seen in show animals and pet goats
-common problem in any castrated ruminant

Question 2

What are the characteristics of urolithiasis in cattle?

Answer 2

-single, hard, discrete calculi
-distal portion of sigmoid flexure of pelvis

Question 3

What are the characteristics of urolithiasis in small ruminants?

Answer 3

-sand-like, multiple calculi
-pearl necklace appearance in urethra
-in the vermiform appendage or sigmoid flexure

Question 4

What are the dietary factors that predispose to stone formation?

Answer 4

-increased phosphorus
-increased magnesium
-low dietary potassium
-low vitamin A

Question 5

What are the multifactorial causes seen in all stone types?

Answer 5

*nidus formation/epithelial cell turnover
-growth implants
-vitamin A deficiency

*precipitation of urinary solutes
-alkaline urine
-increased urine concentration; water intake decreased in hot or cold climates
-mineral imbalances

Question 6

What are the characteristics of struvite calculi?

Answer 6

-most common in feedlot ruminants and any ruminants fed grain
-high recurrence rate
-smooth, soft, small calculi

Question 7

What are the characteristics of silicate calculi?

Answer 7

-seen in range fed animals in arid or semi arid regions
-high dietary silicates and water silicates; prairie grasses, wheat stubble, oat stubble

Question 8

What are the characteristics of calcium carbonate calculi?

Answer 8

-common in goats
-grazing plants that concentrate calcium; alfalfa, clover, kudzu

Question 9

What are the characteristics of oxalate calculi?

Answer 9

-animals eating excessive quantities of oxalate-containing plants
-pokeweed, pigweed, sugar beet leaves, halogeton

Question 10

What are the clinical signs of urolithiasis with incomplete obstruction in cattle?

Answer 10

-urine dribbling from urethral orifice
-blood tinged urine around prepuce
-white powdery crystals on prepucial hairs
-prolonged, painful urination

Question 11

What are the clinical signs of urolithiasis with complete obstruction in cattle?

Answer 11

-inappetence
-depression
-kicking at abdomen/colic
-grinding teeth
-shifting weight in hind limbs
-straining to urinate
-pulsation of urethra
-distended bladder

Question 12

What are the sequelae of complete urinary obstruction?

Answer 12

*ruptured urethra
-ventral abdominal swelling

*ruptured bladder
-bilateral distended abdomen; pear-shaped

Question 13

What the medical management steps for early cases of urolithiasis obstruction in cattle?

Answer 13

*tranquilization
-relaxes sigmoid flexure and urethra
-smooth muscle relaxants like acepromazine
-antispasmotics like xylazine

*re-examine
-repeat treatment in 6 hours if necessary

Question 14

What are the characteristics of low urethrostomy surgery?

Answer 14

-done in cattle with ruptured urethra
-salvage procedure that allows animals to survive until market
-incisions made to remove SQ accumulation of urine
-urethrostomy performed above the sigmoid flexure

Question 15

What are the steps to surgical management of a ruptured bladder in cattle?

Answer 15

-drain abdominal fluid
-percutaneous or surgical cystostomy tube into bladder
-urethrostomy to remove calculi
*50% recovery rate

Question 16

What are the supportive therapies done in cattle with urethral or bladder ruptures?

Answer 16

-systemic antibiotics
-oral or IV fluid therapy
-correction of uremia and passage of withdrawal times before salvage

Question 17

What are the clinical signs of urolithiasis in pet goats?

Answer 17

-anxiety/restlessness
-anorexia
-depression
-tail switching
-colic signs
-vocalization
-straining

Question 18

How is urolithiasis diagnosed in goats?

Answer 18

-examine preputial hairs and presence of urine
-exteriorize penis and examine urethral process
-palpate abdomen
-ultrasound +/- radiographs
-CBC/chem/electrolytes
-urinalysis

Question 19

What are the laboratory findings in goats with urolithiasis?

Answer 19

-azotemia
-possible hyperphosphatemia
-hyperkalemia
-hypochloremia
-hyponatremia
-metabolic akalosis

Question 20

What are the emergency stabilization steps for goats with urolithiasis?

Answer 20

-correct dehydration with IV catheter and fluid therapy
-correct electrolyte imbalances; especially hyperkalemia

Question 21

What are the characteristics of urethral process amputation?

Answer 21

-sedation required
-amputate at base near glans penis
-follow with urine acidifiers and NSAIDs

Question 22

What are the steps of retrograde urethral lavage?

Answer 22

-done under sedation or anesthesia
-position animal in dorsal recumbency
-extrude penis and place catheter in distal urethra
-flush urethra with a lidocaine-saline flush
-be careful to avoid trauma

Question 23

What are the characteristics of surgical tube cystostomy in goats?

Answer 23

-bypasses the urethra
-can flush the urethra at time of surgery to try and remove stones
-tube exits out a separate incision in the abdomen
-procedure of choice in most cases

Question 24

What is the post-op management for surgical tube cystostomy?

Answer 24

-elizabethan collar or belly bandages
-intermittent clamping on day 4 to check for urethral patency
-keep catheter in place for minimum of 7 days
-normal urination must occur for 2 days before catheter is removed

Question 25

What are the advantages of surgical tube cystostomy?

Answer 25

-able to secure catheter into bladder -able to lavage bladder -access to normograde flush of urethra -no affect on fertility

Question 26

What are the disadvantages of surgical tube cystostomy?

Answer 26

-general anesthesia required -long hospital stay; costly

Question 27

What is the advantage of a perineal urethrostomy?

Answer 27

able to flush bladder via catheter

Question 28

What are the disadvantages of a perineal urethrostomy?

Answer 28

-stricture formation -no longer able to breed -urine scald

Question 29

What are the characteristics of bladder marsupialization in goats?

Answer 29

-urine is voided from the bladder through a marsupialized site -marsupialized to ventral body wall -considered a salvage procedure

Question 30

What is a vesiculopreputial anastomosis?

Answer 30

bladder marsupialization to the ventral body wall within the prepuce

Question 31

What are the characteristics of urine acidification as part of medical management?

Answer 31

-used with both medical and surgical procedures -can do direct instillation into the bladder for struvite or apatite stones -oral supplementation with ammonium chloride until urine pH is 6 to 6.5 -not effective against calcium oxalate stones

Question 32

How can uroliths in goats be prevented?

Answer 32

-no grain in the diet -provide plenty of fresh, clean water -delay castration until after 3 months of age -analyze any stones that do occur

Question 33

What are the characteristics of urolithiasis in potbellied pigs?

Answer 33

-predisposed due to small urethral diameter and unregulated diets -most common in males at the ischial arch

Question 34

Which factors contribute to struvite stones in potbellied pigs?

Answer 34

-high phosphorus diets -high salt diets -low water intake

Question 35

What are the surgical options for urolithiasis in potbellied pigs?

Answer 35

-tube cystostomy -perineal urethrostomy -cystotomy/cystostomy -prepubic urethrostomy

Question 36

What are the characteristics of urinary calculi in horses?

Answer 36

-infrequent -bladder and urethral stones most common in stallions and geldings -may be caused by calcium carbonate presence, bacterial nidus, or mucins in urine

Question 37

What are the signs of urinary bladder stones in horses?

Answer 37

-cystitis -dysuria/straining -blood in urine -colic

Question 38

Where do horses typically get urethral blockages?

Answer 38

in the pelvic urethra near the ischial arch

Question 39

How are bladder and urethral stones diagnosed in horses?

Answer 39

typically palpable per rectum

Question 40

What is the treatment for uroliths in horses?

Answer 40

-flank or ventral laparotomy -ischial urethrostomy -removal via urethra in mares

Question 41

What is the prognosis for urolithiasis in horses?

Answer 41

-poor prognosis with sabulous/sandy deposits -recurrence is likely in horses -want to try and acidify diet for prevention; this is difficult -long-term follow up not available

Question 42

What are the clinical signs of bladder rupture in foals?

Answer 42

-starts 24 to 48 hours after birth -depression -not nursing -stranguria -abdominal enlargement -progressive resp. distress and death

Question 43

What are the lab findings in foals with bladder rupture?

Answer 43

-hyponatremia -hypochloremia -hyperkalemia -azotemia -increased PCV and TP -peritoneal creatinine:serum creatinine > 2 (diagnostic) -peritoneal UN:serum UN > 2 (less diagnostic) -methylene blue dye injected into urinary bladder

Question 44

How is urinary bladder rupture treated in foals?

Answer 44

-drainage of peritoneal fluid -surgical correction -fluid therapy to decrease potassium perioperatively