Benign Familial Hematuria Or Thin Gbm Disease
Benign familial hematuria or thin GBM disease are a set of genetically heterogeneous conditions. In some families, heterozygous missense mutations have been found in COL4A4 in association with autosomal dominant transmission of hematuria in the absence of renal failure.89 However, linkage to these genes has been excluded in other families with benign familial hematuria. The observation that carriers of a single mutant COL4A4 allele may have hematuria provides further evidence that COL4A4 defects are involved in at least some families with benign familial hematuria, although other alleles may be involved in other families.90 Immunohistologic staining for type IV collagen chains reveals no abnormalities.
In , 2017
Risk Factors For Utis In Horses
Certain horses are at greater risk of developing urinary tract infections, most commonly bacterial cystitis. In addition to the increased risk assigned to mares and foals, horses are more likely to develop a UTI if they are geriatric or if they:
- Have an anatomical abnormality of the urinary tract
- Have overly dilute urine
- Have diabetes or another underlying disease
- Have a compromised immune system
- Have a blockage in the urinary tract
- Have chronic vaginitis
- Have a genetic predisposition to stone formation
Equine cystitis can also occasionally be the result of nerve damage or an adverse reaction to medication.
Be Alert For Urinary Problems In Older Horses
Horses normally have microscopic calcium crystals, even sludge, in their urine. Urine is normally alkaline , and these mineral crystals precipitate out at that pH, making the urine cloudy or milky at times. Urinary stones are formed predominantly by this same normal material, which has become concentrated in low urine volumes.
No one can truly explain why some horses form stones and some dont, although theyre the most common urinary problem in horses. Age is a factor simply because it takes a stone a significant amount of time to become large enough to cause a problem. Stones are more common in geldings and stallions than mares because the male urethra, the tube that carries urine from the bladder to the outside, is narrower, longer and more twisted. Small stones that a mare would pass easily may be held up in a male horse.
Infection causes stones in other species, with the mineral deposits forming around a core of bladder cells and inflammatory cells. However, this material isnt usually found in equine stones. It may seem logical that a diet excessive in calcium, which is excreted by the kidneys, may increase the likelihood of stones, but this hasnt been confirmed even though cloudy/milky urine is more frequent in a horse on mineral supplementation. What does make a difference, though, is the urine volume and how frequently the horse empties his bladder.
Altered bladder motility may be due to:
Illegal alcohol tail blocks in show horses.
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Symptoms Of Utis In Horses
Infections of the urinary tract are painful and debilitating. Symptoms of the disorder vary from mild to severe. It is always best to be aware of early signs of discomfort in the horse so a possible infection can be diagnosed and treated promptly. Symptoms of UTIs include:
- Frequent urination
- Blood in the urine, especially after exercise
- Depression or lethargy
Symptoms Of Cystitis In Horses
The symptoms of cystitis can be somewhat generalized however, there are some more specific signs and symptoms to be aware of. Some symptoms to look for in your horse are:
- Loss of control Your horse may not be able to control when or where he urinates as he was once able to
- Frequent urination You may notice your horse begin to urinate more frequently or less so compared to his former habits
- Urine dribbling Instead of having a steady stream of urine, your horse may dribble urine without completely relieving himself
- Urine scalding This is when your horse develops irritation and scabbing on his legs/hind quarters where urine splashes on his skin
- Straining to urinate Your horse may strain or struggle to urinate
- Blood in urine You may notice blood in his urine
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How Can Bladder Stones Be Prevented
Keeping urine dilute may help prevent stone formation. So any tricks you can use to keep your horses drinking lots of water will help . Minimizing use of drugs like NSAIDs that are damaging to the kidney will also help. While not necessary for every normal horse, in a horse that has had a stone before, we recommend removing legume hays like alfalfa from their diet as these are high in calcium. We also try to make their urine acidic to dissolve calcium crystals as they form. Things like vitamin C and ammonium chloride have been used, but recently we have had success in a few cases using a feed supplement designed for dairy cattle.
In goats, making sure that the bulk of their diet is forage is incredibly important. Any concentrate fed to them should have a calcium to phosphorus ratio of greater than 2:1. Castration should also be delayed in goats until at least 6 months as testosterone may influence the diameter of their urethra. And just like in horses, make sure they are drinking plenty of water. Acidification of their urine will also help. Historically we have used ammonium chloride, but most goats dont eat it well. We are currently conducting trials with SoyChlor to see if it will effectively acidify urine, as most animals will eat this product readily.
The Urinary Tract Is A Vital System That Should Never Be Taken For Granted If A Problem Develops It Can Rapidly Become A Crisis
The body produces many wastes and byproducts of energy production that must be regularly eliminated. The lungs dispose of gaseous wastes and carbon dioxide, and the digestive tract takes care of the solid wastes from feed. The urinary system excretes the liquid wastes containing nitrogen, salts, excess sugars, and other substances that are filtered out of the bloodstream.
Urinary tract problems can range from fatal to minor . The kidneys filter the blood and kidney damage can result in impaired filtering function, which might be life-threatening, depending on the extent of damage. A bladder stone might pass, and the horse will be fine, or it might plug the urethra, prevent urine from passing, and cause eventual rupture of the bladder. The main signs of urinary disease include abnormality in urine output, pain or discomfort, and difficulty urinating.
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Diagnosis Of Cystitis In Horses
If you suspect your horse is suffering from cystitis, a veterinarian examination will be necessary. Your horse will most likely have a full physical exam along with a visual identification of any of the symptoms such as urine scalding. A urine sample will be necessary to test for bacteria to diagnose cystitis.
Other possible tests that may be necessary are endoscopy and ultrasound which will allow for a very detailed evaluation of the extent of the cystitis. Your veterinarian will want to know what symptoms you noticed, when you noticed them, and whether the symptoms are evolving in severity. It will be important to identify any behavioral changes you have noticed in your horse as well.
What Are Clinical Signs Of Bladder Stones
The most common sign in horses is blood in the urine, especially after exercise. Horses may also show low grade signs of colic or abdominal pain. Fortunately, horses rarely have stones that fully obstruct their urine flow. On the other hand, small ruminants can have stones that fully block their urethra and make them unable to urinate. They will show more obvious straining, pain, and vocalization when trying to urinate. The disease is much more common in males of every species because of their longer, narrower urethra. Females can generally pass sludge and small stones before they become large enough to cause a problem.
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How Are Bladder Stones Diagnosed And Treated
In goats and sheep, the stones are usually stuck in the urethra. They can be diagnosed based primarily on consistent signs in a male animal, but ultrasound can confirm that the bladder is full and unable to empty. Medical treatment may be attempted but is usually unsuccessful. Surgery consists of general anesthesia and making either a temporary or permanent connection directly between the bladder and the outside.
Causes Of Positive Occult Blood
Hematuria is the most common cause of a positive dipstick finding of occult blood therefore, a urine sediment examination should be performed. If RBCs or RBC ghosts are found in the sediment, hematuria is confirmed. Dilute or alkaline urine may cause RBC lysis, and hemolyzed RBCs are not always visible. Hemoglobinuria because of hematuria is followed up as for hematuria .
If no RBCs are found, especially if the urine is grossly discolored after centrifugation, one should determine hematocrit and plasma color. If the plasma is pink or red despite proper venipuncture technique , hemoglobinuria is present. Hemoglobinuria because of hemoglobinemia indicates hemolytic anemia , and a complete CBC is indicated. If no evidence of hematuria or hemolysis exists, myoglobinuria must be considered. One may test for myoglobinuria by requesting urine precipitation with 80% saturated ammonium sulfate. If the urine supernate remains red-brown after centrifugation, 2.8 g ammonium sulfate should be added to 5 ml of urine with a neutral pH. After centrifuging this mixture, if the supernate remains dark, myoglobin is confirmed. Occasional interpretation problems occur if the urine is colored because of nonprotein pigments. Myoglobinuria requires a search for rhabdomyolysis or myositis , and serum creatine kinase activity should be measured.
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Kidney Infection In Horses
Pyelonephritis is inflammation of the kidneys. This is usually caused by a bacterial infection in the urinary tract that climbed upwards into the bladder and then continued into the kidneys. The risk factors for pyelonephritis and those for bacterial cystitis are similar. Stones in the kidney or ureter, which prevent urine from flowing normally, are a common cause.
Signs of pyelonephritis include pain in the sides, especially in the area around the kidneys fever weight loss and a general sense of not feeling well. Other signs include excessive thirst or excessive urination. Diagnosis of this condition requires blood and urine tests. Longterm cases may not show abnormalities on these tests. If this is the case, x-rays or ultrasonography may be needed. Treatment for pyelonephritis includes high dosages of antibiotics. In some cases, intravenous fluids or even surgery to remove the affected kidney may be required.
Diagnosis Of Utis In Horses
In order to diagnose a urinary tract infection, a urine sample must be obtained for urinalysis and a urine culture. The culture will hopefully determine precisely which bacteria are causing the infection so they can be targeted with the correct antibiotic. Blood tests are usual as well. If other urinary tract conditions are suspected, ultrasound and MRI scans may also be necessary.
When bladder stones are diagnosed as the cause of the problem and are surgically removed, they are typically analyzed for chemical content. This is helpful in determining which minerals in the environment may be leading to the production of stones. It is possible that changing the horse’s feed or water source may prevent the problem from recurring.
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As Seemingly Short And Small As This System Is Its Vulnerable To Certain Malfunctions That Can Have A Devastating Effect On Your Horse Lets Zip Through A List Of What You Might Come Across And What You Can Spot
- Stones can develop in your horse, sometimes they start in the kidneys, sometimes in the bladder. Stones can cause difficulty urinating, pain, and colic. They can physically block the urinary system and can lead to a ruptured bladder, which releases urine into your horses belly, resulting in death.
- Stones are made when smaller calcium carbonate crystals get together to create larger stones. Typical horse urine contains a lot of mucus at the beginning of the urine stream to lubricate the urethra to pass the tiny crystals, which are normal. You might notice that the urine is foamy at first this is the mucus. Then, the urine becomes cloudy as it contains a whole lot of waste including those crystals.
- Horses get into trouble when the crystals band together to form stones. Stones can be formed from calcium or phosphorus, so making sure the diet is balanced is a great place to start. Dont overlook the mineralogy and pH of your horses drinking water as a factor, as well.
Equine Urinary Tract Disorders
Healthy adult horses seem to have a natural resistance to disorders of the urinary tract, but when problems in the renal system do occur, they are serious and must be dealt with promptly. Urinary tract infections are more likely to affect mares and foals. Mares are susceptible to lower urinary tract infections because their urethras are shorter than those of male horses and so can more easily transport bacteria to the bladder, resulting in cystitis. Foals, especially newborns, are also susceptible to UTIs.
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Infectious Diseases Of The Urinary System In Horses
, DVM, DACVIM, DACVECC, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University
Infections of the urinary system are often caused by bacteria. The infection may develop on its own or as the result of a problem in the urinary tract .
Several factors increase the risk of urinary system infection. These include problems with urine flow , overly dilute urine, sugar in the urine , older age, a weakened immune system, and the presence of other diseases. Healthy horses seem to be relatively resistant to urinary tract infections.
Fun Facts About The Urinary System Of The Horse:
- Your entire horses blood volume goes through the kidneys about 250 times PER DAY.
- Your horse filters about 350 gallons a day, but only urinates one or two gallons a day.
- The urethra of the mare is much shorter than that of a gelding or stallion.
- The bladder is elastic, and triggers nerves when full that tell your horse to urinate. Its the relaxation of a small muscle between bladder and urethra that lets urine flow. The muscular contractions of the bladder itself help things along.
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Bladder Inflammation In Horses
Cystitis, though typically uncommon in horses, is inflammation in the bladder. It is not often outwardly apparent that the bladder is inflamed, but there are other signs of cystitis that may be apparent. Some of the more obvious signs are excessive urination, excessive posturing to urinate, blood in the urine, or dribbling of urine without full voiding of the bladder. Cystitis tends to affect mares more so than stallions.
Urinary System Diseases In Horse
How Do You Spot Urinary Stones In Horses
You will have to notice if your horses urinary patterns start to vary. With stones, he might:
- Dribble urine. In mares, you will likely see some skin irritation under the tail
- Stand stretched out to urinate
- Have smaller volumes of urine
- Be in pain when urinating grunting, straining
- Have blood in the urine, especially after exercise
Do not wait to call the vet! Often the only remedy to stones is surgery, although there are some laser technologies that may help in some cases.
Dosage Regimens For Uti:
Currently, the duration of therapy for UTI is controversial. Although animals are routinely treated with antimicrobial drugs for 10â14 days, shorter duration antimicrobial regimens are routinely prescribed in human patients, including single-dose fluoroquinolone therapy. A clinical comparison of 3 days of therapy with a once-daily high dose of enrofloxacin with 2 wk of twice daily amoxicillin-clavulanic acid showed equivalence in the treatment of simple UTI in dogs. However, further studies are needed to determine the optimal dosage regimens for different classes of antimicrobials, and it is inappropriate to use fluoroquinolones as first-line therapy for simple UTIs. Animals with complicated UTI may require longer courses of therapy, and underlying pathology must be addressed. Chronic complicated cases of UTI, pyelonephritis, and prostatitis may require antimicrobial treatment for 4â6 wk, with the risk of selecting for antimicrobial resistance. A follow-up urine culture should be performed after 4â7 days of therapy to determine efficacy. If the same or a different pathogen is seen, then an alternative therapy should be chosen and the culture repeated again after 4â7 days. Urine should also be cultured 7â10 days after completing antimicrobial therapy to determine whether the UTI has resolved or recurred.
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