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Prof. Mohamed Ghanem
Diseases of Urinary system
Equine Internal Medicine
 Fourth Year Students
Professor. Mohamed Ghanem 1
Prof. Mohamed Ghanemwww.drghanem.co.nr 2
Diseases of Urinary system
 Cystitis
 Paralytic bladder
 Urolithiasis
 Acute ...
Prof. Mohamed Ghanemwww.drghanem.co.nr 3
Cystitis
 Definition :
 Cystitis means inflammation of. m.m. of
U.B. characteri...
Prof. Mohamed Ghanemwww.drghanem.co.nr 4
Etiology
 1- Introduction of infection into U.B.
 trauma to bladder
 stagnatio...
Prof. Mohamed Ghanemwww.drghanem.co.nr 5
Clinical findings
1- Painful sensation and desire to urination
(due to urethritis...
www.drghanem.co.nr 6
A mare remains in the posture adopted for
urination for some minutes after urination ceased
Prof. Mohamed Ghanemwww.drghanem.co.nr 7
Diagnosis
(I) History
(II) Clinical signs
(III) Lab. Diagnosis:
1- Microscopic ex...
Prof. Mohamed Ghanemwww.drghanem.co.nr 8
Treatment
1- Irrigation of U.B. using mild antiseptic
solution e.g. potassium per...
Prof. Mohamed Ghanemwww.drghanem.co.nr 9
Prof. Mohamed Ghanemwww.drghanem.co.nr 10
Paralytic Bladder
 Definition
 Paralysis of the bladder that results
in urinar...
Prof. Mohamed Ghanemwww.drghanem.co.nr 11
Etiology
 Lesions in the lumbosacral part of the
spinal cord e.g.
 - Neuritis ...
Prof. Mohamed Ghanemwww.drghanem.co.nr 12
Prof. Mohamed Ghanemwww.drghanem.co.nr 13
Clinical signs
 1- in the early stages, the U.B remains
fully and dribbling (ur...
Prof. Mohamed Ghanemwww.drghanem.co.nr 14
Treatment
Prognosis of paralytic bladder is poor.
1- Essential regular catheteri...
Prof. Mohamed Ghanemwww.drghanem.co.nr 15
UROLITHIASIS (URINARY
CALCULI)
Calculi may occur anywhere in the urinary
tract i...
Prof. Mohamed Ghanemwww.drghanem.co.nr 16
Etiology and pathogensis
1- The presence of mucous
(mucoproteins) and epith. deb...
Prof. Mohamed Ghanem
Two types of calculi are commonly found in
equines.
a) The first occurs in horses fed hay, is
yellow ...
Prof. Mohamed Ghanemwww.drghanem.co.nr 18
Nephroliasis in horse
Prof. Mohamed Ghanemwww.drghanem.co.nr 19
Endscopic examination showing
urolithiasis in horse
Prof. Mohamed Ghanemwww.drghanem.co.nr 20
Clinical signs
 Clinical findings vary according the
location of the calculi
 ...
Prof. Mohamed Ghanemwww.drghanem.co.nr 21
(a) Bladder calculi
 The initial calculi from in the renal
pelvis and pass to U...
Prof. Mohamed Ghanemwww.drghanem.co.nr 22
Signs of UB calculi
 Abdominal discomfort when exercised,
 Urination is accomp...
Prof. Mohamed Ghanemwww.drghanem.co.nr 23
b) Urethral calculi
1- Restlessness, abdominal pain, and
frequent urinary attemp...
Prof. Mohamed Ghanemwww.drghanem.co.nr 24
A mare remains in the posture of urination few
minutes after urination with stra...
Prof. Mohamed Ghanemwww.drghanem.co.nr 25
Renal colic in a horse
Back
Prof. Mohamed Ghanemwww.drghanem.co.nr 26
Treatment
 Smooth – muscle relaxant may help the
passage of stone (atropine sul...
Prof. Mohamed Ghanemwww.drghanem.co.nr 27
Questions
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Urinary system diseases in horse

  1. 1. Prof. Mohamed Ghanem Diseases of Urinary system Equine Internal Medicine  Fourth Year Students Professor. Mohamed Ghanem 1
  2. 2. Prof. Mohamed Ghanemwww.drghanem.co.nr 2 Diseases of Urinary system  Cystitis  Paralytic bladder  Urolithiasis  Acute Renal Failure  Chronic Renal Failure  Renal Colic Video  Straining photo
  3. 3. Prof. Mohamed Ghanemwww.drghanem.co.nr 3 Cystitis  Definition :  Cystitis means inflammation of. m.m. of U.B. characterized by frequent, painful urination.
  4. 4. Prof. Mohamed Ghanemwww.drghanem.co.nr 4 Etiology  1- Introduction of infection into U.B.  trauma to bladder  stagnation of urine e.g.  - Vesical calculus  - Contaminated catheterization.  - Paralysis of the bladder.  - Late pregnancy.  2- The infection causing cystitis is usually mixed bacteria but predominantly E.coli.  3- Sudax or sudan grass causes outbreak of cystitis in horses. It is caused possibly by a fungal toxin.
  5. 5. Prof. Mohamed Ghanemwww.drghanem.co.nr 5 Clinical findings 1- Painful sensation and desire to urination (due to urethritis which usually accompanies cystitis). 2- Frequent painful urination. 3- The horse remains in the posture adopted for urination for some minutes after urination ceased. 4- The volume of urine passed on each urination is usually small. 5-In very acute cases there may be moderate colicy pains and moderate febrile reaction. 6- In chronic cystitis there is inflammatory thickening of U.B. wall which is palpable on rectal examination
  6. 6. www.drghanem.co.nr 6 A mare remains in the posture adopted for urination for some minutes after urination ceased
  7. 7. Prof. Mohamed Ghanemwww.drghanem.co.nr 7 Diagnosis (I) History (II) Clinical signs (III) Lab. Diagnosis: 1- Microscopic exam. of urine sediment reveals the presence of blood cells (erythrocytes), pus cells (leukocytes) and desquamated epith. Cells. 2- Bacteriological exam. (isolation and culture and sensitivity test) of urine confirm the diagnosis.
  8. 8. Prof. Mohamed Ghanemwww.drghanem.co.nr 8 Treatment 1- Irrigation of U.B. using mild antiseptic solution e.g. potassium permanganate 1 : 5000. 2- The use of drugs which causing change in pH or urine (have bacteriostatic action) e.g. Hexamine (urotropine) and mandelic acid. 3- Antibiotics, based on culture and sensitivity control infection for 7-14 days. 4- Free access to water to ensure a free flow urine.
  9. 9. Prof. Mohamed Ghanemwww.drghanem.co.nr 9
  10. 10. Prof. Mohamed Ghanemwww.drghanem.co.nr 10 Paralytic Bladder  Definition  Paralysis of the bladder that results in urinary incontinence
  11. 11. Prof. Mohamed Ghanemwww.drghanem.co.nr 11 Etiology  Lesions in the lumbosacral part of the spinal cord e.g.  - Neuritis of the cauda equina.  - Enzootic equine ataxia – cystitis (sudan grass or sorghum ataxia – cystitis which contain HCN).  - Fractures, ostemyelitis or neoplasia involving the lower, sacral or upper coccygeal vertebrae.
  12. 12. Prof. Mohamed Ghanemwww.drghanem.co.nr 12
  13. 13. Prof. Mohamed Ghanemwww.drghanem.co.nr 13 Clinical signs  1- in the early stages, the U.B remains fully and dribbling (urinary incontinence) occurs especially during movement, exercise or even coughing, which increase the intraabdominal pressure.  2- In the later stages, the U.B. will begin to empty involuntarily although evacuation is usually incomplete and some urine is retained causing cystitis .  3- Scalding of perineal area and rear limbs may be present in mares
  14. 14. Prof. Mohamed Ghanemwww.drghanem.co.nr 14 Treatment Prognosis of paralytic bladder is poor. 1- Essential regular catheterization (but avoid introduction of infection) 2- Adm. of antibiotics as a prophylaxis against the development of cystitis and may be a useful therapy for osteomyelitis. 3- Corticosteroid (0.5-1 mg/kg prednisone orally or 0.1 mg/kg dexamethzone injection I/m) every other day for 8-10 days if equine herpes virus-1 myeloencephalitis suspected. 4- Application of petroleum jelly to rear limbs to prevent urine scalding.
  15. 15. Prof. Mohamed Ghanemwww.drghanem.co.nr 15 UROLITHIASIS (URINARY CALCULI) Calculi may occur anywhere in the urinary tract in horses, but are found principally in the U.B. or urethra.
  16. 16. Prof. Mohamed Ghanemwww.drghanem.co.nr 16 Etiology and pathogensis 1- The presence of mucous (mucoproteins) and epith. debris in equine urine leads not only to viscous and turbid appearing urine, but also may serve as a nuclei for calculi 2- Consumption of feed and water high in mineral content may increase urinary solute concentrations and thereby promote crystallization and precipitation.
  17. 17. Prof. Mohamed Ghanem Two types of calculi are commonly found in equines. a) The first occurs in horses fed hay, is yellow – brown and crystalline, and composed principally of calcium carbonate. b) The second from in horses being fed grain ration, this type is smooth white and composed of phosphates. www.drghanem.co.nr 17
  18. 18. Prof. Mohamed Ghanemwww.drghanem.co.nr 18 Nephroliasis in horse
  19. 19. Prof. Mohamed Ghanemwww.drghanem.co.nr 19 Endscopic examination showing urolithiasis in horse
  20. 20. Prof. Mohamed Ghanemwww.drghanem.co.nr 20 Clinical signs  Clinical findings vary according the location of the calculi  UB calculi  Uretheral calculi
  21. 21. Prof. Mohamed Ghanemwww.drghanem.co.nr 21 (a) Bladder calculi  The initial calculi from in the renal pelvis and pass to U.B., where they increase in size by  mineral deposition around the initiating nuclei of  white or red blood cells,  albumin,  fibrin or  Epith cells.
  22. 22. Prof. Mohamed Ghanemwww.drghanem.co.nr 22 Signs of UB calculi  Abdominal discomfort when exercised,  Urination is accompanied by straining  Occasional blood in the urine (hematuria) toward the end of voided urine  Affected horses frequently stretch out to urinate and may maintain this posture for variable periods before and after micturation.  scalding of the perineum in females or of the medial aspect of the hindlimbs in males.  stallions may protrude the penis flaccidly for prolonged periods with dribbling urine.  Affected horses have recurrent bouts of colic or an altered hind limb gait  Rectal exam. identifying the calculus in the bladder
  23. 23. Prof. Mohamed Ghanemwww.drghanem.co.nr 23 b) Urethral calculi 1- Restlessness, abdominal pain, and frequent urinary attempts. 2- On rectal exam, the U.B. found distended 3-The stone may be located anywhere in the urethra, but is more commonly found at the turn at the pelvic inlet.
  24. 24. Prof. Mohamed Ghanemwww.drghanem.co.nr 24 A mare remains in the posture of urination few minutes after urination with straining
  25. 25. Prof. Mohamed Ghanemwww.drghanem.co.nr 25 Renal colic in a horse Back
  26. 26. Prof. Mohamed Ghanemwww.drghanem.co.nr 26 Treatment  Smooth – muscle relaxant may help the passage of stone (atropine sulphate 16-32 mg by SC injection, Buscopan ampules)  Laser lithotripsy  Otherwise surgery is indicated (laparotomy and cystotomy )
  27. 27. Prof. Mohamed Ghanemwww.drghanem.co.nr 27 Questions MANUNext disease
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Cystitis- paralytic bladder - urolithiasis in horses

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