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Why are castrated males at higher risk for urethral obstruction?
urethral diameter in influenced by testosterone [this is why you should wait as long as it is feasible to castrate]
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Signs of urethral obstruction. (5)
straining to urinate, hematuria, crystals on prepuce, dribbling, colic
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How do you diagnose urethral obstruction? (6)
rectal palpation [urethral pulsation, enlarged bladder], abdominal ultrasound, radiography (small ruminants), Chem profile, UA, exploratory cystotomy
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What biochem profile derangements will you see with urethral obstruction? (5)
azotemia, hyponatremic, hypochloremic, hyperkalemic, metabolic alkalosis
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__________ is a sequelae to urethral obstruction; it is diagnosed by...
Bladder rupture; abdominocentesis and measure Cre of tapped fluid, US find free fluid in abdomen
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Causes of urethral obstruction. (7)
urinary calculi, trauma/inflammation of urethra, tumors/polyps, hemorrhage, surgical mistakes, neurogenic bladder, prostatic disease
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Why are uroliths so common in small ruminants?
dietary imbalances
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Factors influencing development of obstructive urolithiasis? (7)
sex (male/castrated), high conc/low roughage diet, Ca:P imbalances, high Mg diets, alkaline urine, dehydration, UTI
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What factors predispose to struvite stones? (4)
high conc/low roughage diet, low Ca:P ratio, high MG diet, alkaline urine
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What factors predispose to calcium carbonate stones? (2)
ingestion of plants with high Ca2+ conc, ingestion of legumes
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What factors predispose to silicate stones? (3)
ingestion of plants high in silicates, plants grown in sandy soils, high Ca:P ratio
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Where do stones usually lodge in cattle?
distal end of the sigmoid flexure (urethra narrows here)
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Describe general aspects medical therapy for urolithiasis.(3)
stabilize patient (correct metabolic derangements), dissolve calculi, prevent formation of additional stones
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How do you correct the metabolic derangements associated with urolithiasis? (3)
IV saline fluids, diuresis [be careful if the animal is completed obstructed], decrease urine pH
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What are the options for surgical management of urethral obstruction? (3)
perineal/vental urethrostomy, tube cystostomy, bladder marsupialization
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Disadvantages to urethrostomy. (3)
short term fix (stricture w/i 6-12 months), urine scalding, not for breeding bulls
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What are advantages and disadvantages of tube cystostomy?
- advantage: functional urethra/penis, good for breeding males, allows for bladder/urethra healing (back to normal)
- disadvantage: abdominal surgery, costly, longer recovery, cystitis
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How should you manage urethral obstruction in a breeding animals?
tube cystostomy
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Disadvantage of bladder marsupialization? (5)
costly, abdominal surgery, susceptible to cystitis, not viable for breeding animals, last resort
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