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Mawad
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What crystals are normal in equine urine?
calcium carbonate
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How can a GI problem lead to a kidney problem?
diarrhea--> dehydration--> hypotension--> decreased renal perfusion
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Endotoxemia causes... (2)
neutropenia, leukopenia
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What suggests that azotemia is primarily pre-renal?
50% decrease in serum creatinine after 24 hr of fluid therapy
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Horses with __(2)__ are at high risk for acute kidney injury.
large volume blood loss or myonecrosis
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Why does myonecrosis and hemorrhage cause kidney injury?
myoglobin and hemoglobin are toxic to the tubules, causing acute tubular necrosis; pigment nephropathy
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Mechanisms for pigment nephropathy. (4)
iron is toxic, tubular obstruction, hemoglobin is vasoconstrictive (removes nitric oxide, which is vasodilatory), tubular necrosis
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Bug that causes acute tubular necrosis/acute kidney injury.
blister beetles
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Typical findings in a horse with CKD. (4)
weight loss, azotemia, hypercalcemia (unique to horses), anemia
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2-3 day old foal with mild colic, abdominal distention, bradycardia, cold, depressed, normal IgG. Top differential?
uroabdomen
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What is an abnormality in adult horse biochem panel that is normal in foals?
increased serum phosphorous is normal in foals
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What fluids do you give to an animal with hyperkalemia?
saline (not LRS, which has K+)
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Treatment of hyperkalemia. (4)
bicarbonate, calcium, dextrose, insulin (small animals)
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What is the sympathetic innervation to the kidney?
aortico-renal and celiaco-mesenteric ganglia
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What is the parasympathetic innervation to the kidney?
vagus nerve
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Renal innervation is primarily ___________.
sympathetic
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Adrenergic stimulation of the kidney increases __(2)__; as evidenced by administration of __(2)__ [drugs].
RBF and diruesis; xylazine and detomidine
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Autonomic sympathetic innervation to the bladder.
hypogastric nerve
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Autonomic parasympathetic innervation to the bladder.
pelvic nn.
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Somatic innervation to the bladder.
pudendal n.
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What is important to know about bladder contraction that that you can appropriately manage urinary incontinence? (2)
bladder contraction is primarily a cholinergic process; complete denervation is unlikely because they are nerve fibers within the equine bladder wall
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Describe the innervation process that leads to urination.
stimulation of pelvic nerve--> contraction of detrusor m. and relaxation of internal urethral smoother muscle sphincter--> urination
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Differentials for diseases of the equine bladder. (4)
uroabdomen, urinary incontinence, lithiasis, cystitis
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Common biochem findings with uroabdomen in a foal.
hyponatremia, hypochloremia, hyperkalemia, hyperphosphatemia, azotemia
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What will you find on an abdominal tap from a foal with uroabdomen?
fluid with biochemical properties similar to the plasma of the animal
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Describe the treatment of a foal with uroabdomen.
correct electrolyte imbalances before surgery; prognosis is good
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With urinary incontinence in horses, ________ exceeds __________.
intravesical pressure; urethral pressure
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3 types of micturition problems in horses.
reflex or UMN bladder (spastic), LMN bladder (paralytic), myogenic bladder (non-neurogenic)
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What are clinical signs of bladder dysfunction? (2)
dribbling of urine, scalding and depilation of the perineum in mares/ventral abdomen and limbs in both sexes
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You perform a rectal palpation of a horse with bladder dysfunction and feel a firm, full bladder; what is this suggestive of?
UMN bladder- spacity and loss of inhibitory function
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UMN bladder is associated with ___________; thus, horses may be _________.
spinal cord trauma/lesions; recumbant
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Conditions that may play a role in UMN bladder dysfunction. (3)
EPM, trauma, compression
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Describe LMN bladder dysfunction and how it affects the bladder.
still have inhibition from UMN but lose excitatory influence from LMN- flaccid, atonic bladder, relaxed urethra, dribbling bladder from overflow
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Clinical signs of LMN bladder dysfunction. (5)
loss of anal tone, tail paralysis, hypoalgesia, atrophy of muscles, distended/atonic bladder
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Conditions that may cause LMN bladder dysfunction. (6)
trauma, equine herpes virus 1, sudan grass, tumors, infections, injections
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In general, myogenic incontinence occurs with ___________.
sabulous urolithiasis (can also be a consequence of cystitis leading to urine accumulation)
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When does myogenic incontinence become clinically evident?
when the cranial aspect of the bladder protrudes over the edge of the pubis (due to urolithiasis)--> stretches beyond capacity to contract--> urine retention
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Describe the treatment of urinary incontinence. (4)
antimicrobials, cholinergic agents, anti-adrenergic agents, relaxants
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What horses are predisposed to urolithiasis? (2)
10 years and older, geldings
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Calculi composition in equids is mostly _________; to a lesser extend, __(2)__.
calcium carbonate; struvite and calcium oxalate
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Often, uroliths are positive for ________ in males and ________ in females.
E.coli; Streptococcus [ie. ALWAYS CULTURE URINE FROM HORSES WITH LITHS OR SUSPECTED LITHS]
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2 components of equine urine that are abnormal in other species?
calcium carbone, mucus
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Clinical signs of urolithiasis. (4)
dysuria, straining to urinate, hematuria, and urine scalding
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Clinical signs associated with nephroliths, but not uroliths. (2)
colic, weight loss
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________ may contribute to urolithiasis because...
NSAIDs (ESP BUTE); cause medullary necrosis (nephrotoxic)
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Describe the treatment of urolithiasis. (4)
antimicrobials, analgesics, urine acidifiers, surgery (cystotomy, urethrotomy, lithotripsy)
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Causes of cystitis. (5)
alterations in urine flow from anatomic defects, urolithiasis, neoplasia, paralysis, iatrogenic (catheters)
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Cystitis can lead to... (4)
pollakiuria, stranguria, pyuria, and incontinence
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What is necessary for diagnosis of cystitis?
culture of urine sample MUST be quantified to be significant; endoscopy often helpful to assess extent of damage
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Organisms associated with cystitis in horses? (8)
E. coli, Proteus, Klebsiella, Enterobacter, Streptococcus, Staphylococcus, Pseudomonas, Corynebacterium renale
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Describe the treatment of cystitis in horses.
antimicrobials, NSAIDs, access to pasture, salt to increase water intake, [if necessary] correct anatomical defect or urolithiasis
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