Urinogenital disorders

Chapter 10 Urinogenital disorders




Urinary tract





Introduction


The main infectious and bacterial diseases of the bovine urinary tract are pyelonephritis and leptospirosis. Urolithiasis is a multifactorial urinary problem resulting from metabolic and nutritional disorders. Finally, amyloidosis, although an uncommon sporadic disease of adult cattle, requires differentiation from pyelonephritis.


Conditions with secondary renal pathology include pruritus-pyrexia-hemorrhagica (PPH) (9.39), oak (acorn) poisoning (13.6, 13.7), renal infarction secondary to caudal vena caval thrombosis (5.33), babesiosis (redwater, 12.3912.43), and the many causes of bacteremia and septicemia.



Pyelonephritis




Clinical features


although worldwide in distribution, cases of pyelonephritis are sporadic only and overall incidence is low. Most often seen in the first 3 months postpartum, it may result from contact with infected urine or from a genital tract infection. Most infections start in the winter housing period when cow-to-cow contact increases. Affected cows are pyrexic, lose weight, show polyuria, hematuria or pyuria, and may develop a dry, brownish discoloration of the coat, often with urine staining over the tail and perineum which resembles cystitis (10.14). Rectal palpation may reveal a thickened ureter or enlarged (left) kidney. An 18-month-old Limousin heifer (10.1), ill for several days, showed at autopsy a granular renal cortex with areas of recent hemorrhage. In addition, several small discrete renal abscesses are evident, one of which has burst.



Severe chronic pyelonephritis is illustrated in 10.2 where the left kidney is contracted and pale, and the right kidney is enlarged and appears granular. Both ureters, particularly the left, are thickened as they contain pus and cellular debris (pyoureter).



Other cases of pyelonephritis have multiple caseous and purulent centers, primarily in the renal medulla which may be appreciated on rectal palpation.


In a case of chronic pyelonephritis (10.3) calculi (A) are present in the renal calyces, further calculi are in a thickened fibrotic ureter, and the bladder mucosa contains multiple petechiae (B).



Diagnosis is usually made on gross appearance of a urine sample, urine staining of the tail and perineum, and rectal palpation of the bladder and kidneys. Pyelonephritis and cystitis may coexist.





Leptospirosis




Clinical features


in adults the main effects of Leptospira interrogans serovar pomona or hardjo infection are multiple abortions (see 10.86 for a fetus from a possible leptospiral abortion), stillbirths, loss of milk production, and reduced fertility. In calves L. pomona causes an acute septicemia with hemoglobinuria, jaundice, anemia, and possibly death. Dark, swollen kidneys (10.4) are usually indicative of a hemolytic crisis. Recovered cattle show little more than ill-defined, grayish, cortical spots, indicative of a focal interstitial nephritis. The spirochetes may be seen under dark field microscopy of urine, but confirmation of diagnosis otherwise depends on serology or histopathology.




Differential diagnosis


babesiosis (12.39–12.43), anaplasmosis (12.4412.47), rape and kale poisoning (13.10), postparturient hemoglobinuria, bacillary hemoglobinuria. Note the completely different appearances of the kidney in pyelonephritis (10.2) and amyloidosis (10.13).





Urolithiasis





Clinical features


early cases are dull, anorexic, and walk stiffly. If grown sufficiently, rectal examination may reveal an enlarged and painful bladder. Diagnosis is made on the basis of changes in the preputial region. Although preputial crystals (often struvite, i.e., magnesium-ammonium-phosphate hexahydrate) appear in many calves (10.5), relatively few will develop signs of obstruction, which tends to occur in or just proximal to the sigmoid flexure, or in the distal portion of the penis. An intraoperative view (10.6) of the perineal region shows the dilated urethra proximal to the sigmoid flexure and the obstructing calculus. Continuing complete urethral obstruction results in either bladder or, more commonly, urethral rupture. The crossbred Charolais male in (10.7) has a large subcutaneous swelling containing urine as a result of urethral rupture in the sigmoid region. The swelling extends forward from the sigmoid to the preputial orifice, where dry preputial hairs are covered with crystals. A rear view (10.8) shows gross enlargement of the scrotum, especially at the neck, early bruising, and a superficial fluid ooze, all caused by accumulated urine. In occasional cases the swelling is discretely localized to the peripreputial area. In contrast, in a severe and advanced case the Friesian steer (10.9) had such severe swelling that ischemic necrosis has caused an extensive skin slough overlying the penis.







In another Hereford steer (10.10) it is the bladder rather than the urethra that has ruptured as a result of urethral obstruction. Urine has gathered in the ventral abdominal cavity, causing a progressive swelling and distension of the flanks (uroperitoneum).



Autopsy examination of a 6-year-old Shorthorn bull that died as a result of severe uremia following bladder rupture and uroperitoneum reveals a congested and hemorrhagic bladder mucosa (10.11). Numerous calculi (2–7 mm diameter) and fibrin are seen on the mucosal surface. The peritoneum tends to be diffusely inflamed, but the changes are less severe than those following septic reticuloperitonitis (4.90, 4.91). Urolithiasis frequently accompanies cases of severe pyelonephritis (10.110.3).




Differential diagnosis


in a mature bull this includes penile hematoma (10.23) or abscess formation, or, in a younger animal, urethral rupture due to faulty application of a bloodless castrator (Burdizzo) some days previously (see 10.36). Differentials for cases with ventral abdominal swelling not localized to the penis and prepuce include ascites (4.92), intestinal obstruction (4.88), and generalized peritonitis with massive exudation (4.91). Other differential diagnoses include cystitis (10.14), severe balanoposthitis, and severe preputial frostbite.







Male genital tract










Congenital male abnormalities







Penile conditions







Preputial conditions



Jul 8, 2016 | Posted by in SUGERY, ORTHOPEDICS & ANESTHESIA | Comments Off on Urinogenital disorders
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