1. Prof. Mohamed Ghanem
Diseases of Urinary system
Equine Internal Medicine
Fourth Year Students
Professor. Mohamed Ghanem 1
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. Prof. Mohamed Ghanemwww.drghanem.co.nr 3
Cystitis
Definition :
Cystitis means inflammation of. m.m. of
U.B. characterized by frequent, painful
urination.
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. 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. www.drghanem.co.nr 6
A mare remains in the posture adopted for
urination for some minutes after urination ceased
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. 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.
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.
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. 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. 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. 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. 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
20. Prof. Mohamed Ghanemwww.drghanem.co.nr 20
Clinical signs
Clinical findings vary according the
location of the calculi
UB calculi
Uretheral calculi
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. 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. 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.
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 )