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Equine Urinary Disease Pt.2 - Coggle Diagram
Equine Urinary Disease Pt.2
neoplasia
urinary tract neoplasia is rare
most common bladder tumors
squam. cell carcinoma
transitional cell carcinoma
lymphoma
most common renal tumors
renal carcinoma
nephroblastoma
lymphoma
CS
hematuria
weight loss
recurrent colic
pollikuria
stranguria
diagnosis
US
cystoscopy
biopsy
thoracic rads (metastasis)
idiopathic renal hematuria
sudden onset of hematuria from one or both kidneys
not
associated w/ infection, inflammation, neoplasia
unknown cause
genetic? Arabians.
diagnosis
blood from urethral openings on cystoscopy
blood clots in renal pelvis on US
other ddx
renal trauma
acute renal failure
pyelonephritis
nephrolithiasis
bladder/urethral hemorrhage
neoplasia
treatment
may resolve spontaneously
may req blood transfusion
nephrectomy if severe and unilateral
may develop into bilateral problem
ectopic ureters
occassionally reported in foals
90% girls
incontinent from birth
urine scalding on skin
may be accomplanied by other congential abnormalities
renal aplasia/dysplasia
diagnosis
excretory urogram/pyelography
vaginoscopic/cystoscopic exam
US for concurrent anormalities
treatment
surgical relocation ureters to bladder
consider nephroctomy if unilateral + no azotemia
urethral hemorrhage
male horses at level of ischeal arch
diagnosis
urethral endoscopy
whole blood or blood clots at
end of urination
management
sexual rest for stlallions
NSAIDs if evidence of discomfort
50% require laser/surgical management
cystic urolithiasis (calculi)
much less common in horses than ruminants
usually involved bladder w/o complete obstruction
stones usually consist of calcium carbonate/phosphate
single stone is typical
CS
hematuria after exercise
traumatic +/- bacterial cystitis
pollikuria
stranguria
dysuria
treatment
surgical removal of urolith
combined with
abx for infection
TMS
urinary acidification for recurrent cases
ammonium chloride
soychlor
DCAD mangement
unlike ruminants
not a primary nutritional disease,
recurrence is rare if all stones removed
urinary incontinence
PU/PD
water consumption
normal is about 50-70mL/kg
polydipsia >100ml/kg/day (>50L/day)
urine output
higher in foals
normal 15-20 ml/kg/day (5-15L/day)
considerations
hot weather?
lactating mare?
nursing foal?
pollakiuria related to lower UTD
ddx
psychogenic polydipsia (common)
behavioral problem related to confinement/boredom
urine is hyposthenuric (SG <1.008)
becomes concentrated in response to water deprivation test
confounded by medullary washout
treatment
control water intake
alleviate boredom
PPID in geriatric patients
diabetes insipidus (rare)
hyposthenuria
not able to concentrate urine with deprivation
nephrogenic
renal tubules do not respond to ADH
elevated endogenous ADH levels
no concentration of urine in resposne to exogenous ADH
central
failure of production/release of ADH
low/absent levels of endogenous ADH
kidneys
can
concentrate urine in response to exogenous ADH
diabetes mellitus (extremely rare)
primary renal disease (uncommon)
lab tests
CBC/chem
rule out azotemia/renal failure
normal if psychogenic
test for PPID if age-appropriate
urinalysis
expect
hyposthenuria
(SG <1.007) with psychogeneic
isosthenuria suggests renal insufficiency/failure
ruling out primary renal disease
water deprivation test
differentiates psychogenic PD from DI
if psychogenic, urine will concentrat
if DI, ability to concentrate is limited or absent
contraindicated if there is evidence of renal failure
normal response
ADH release
increased [urine]
increased USD
terminate if
USG exceeds 1.025
BW decreases by 5%
clinical dehydration
cystitis and pyelonephritis