PRACTICAL ASSIGNMENT 03

QUESTION

During your secondment to a slaughterhouse, identify and collect a sample of any condition at
post-mortem.

i) Preserve the sample in such a way that you present it for practical assignment
ii) Include short but detailed notes that gives clue to the condition that you have identified

NB: Please indicate the method of preservation used

You have to include the following:

a) Identification
b) Cause
c) Transmission
d) Life Cycle
e) Ante-mortem Signs
f) Post-mortem Signs
g) Prevention and Control (25 marks)

Due Date: 12/09/16

Images of incised kidneys showing stones (left and top) & distended bladder (right)

Images of incised kidney showing stones (left) and kidney stones found in kidneys (right)
INTRODUCTION
Nephrolithiasis is a type of urolithiasis. Urolithiasis is a term used to describe stones in the urinary
tract and can be classified according to the anatomic locations of the stones as nephrolithiasis
(kidney stones) ureterolithias (ureter stones) and urethrolithiasis (urethra stones). In this case, we
are looking at Nephrolithiasis in bovine, though it can occur in any animal species including
humans. The stones are typically known as renal stones, kidney stones, urinary calculus or
nephroliths. In most cases, the stones can be formed in the kidney and can travel with urine to the
ureters, urethra or bladder and thereby producing various symptoms and signs.

In cattle, the tubes that carry urine from the kidneys to the bladder (the ureters), or from the bladder
to the penis or vagina (the urethra), can become blocked by stones (uroliths or calculi) produced
in the kidneys. This prevents the animal from passing urine and produces the condition known as
obstructive urolithiasis. Nephroliths are usually mineral stones formed by the precipitation or
crystallization of mineral salts in the urine. The condition can cause significant economic losses
due to urethral obstruction; rupture of the urethra or bladder; or death from the buildup of toxic
substances that are usually removed through the urine. The condition occurs more frequently in
feedlot situations.

IDENTIFICATION
Note: The sample under study is a silicone stone, found singly in the pelvis renalis of a right
kidney of a bovine and is very rough, irregular in shape and firm. It is also greyish in colour.
Nephroliths are stone - like body composed of urinary salts bound together by a colloid matrix of
organic materials. They are solid aggregates of minerals that precipitate out of the fluid phase of
urine to form one or more pebble-like stones in the kidneys. They consist of a nucleus around
which concentric layers of urinary salts are deposited.
Stones are usually localized in the calyx and pelvis renalis. Shapes and weights of the stones may
differ. Some of them can be solitary and big, others multiple small or sand-like. The stones can
have smooth or rough surfaces, they can be yellow, grey or brown in colour and soft or hard.
TYPES OF STONES
1. The phosphate stones are usually multiple and are smooth in character.
2. The silicone stones are usually singular in number and very rough in character and firmly than
other stones.
3. The oxalate stone also smooth in nature, is lower but still important during summer grazing
months.

CAUSES
The different types of kidney stones are identified by their mineral composition. A close
relationship exists between the composition of stones and diet. Possible predisposing factors
include:
 Inappropriate composition of the fodder. This include low roughage diets, limited water
intake, deprivation of water or dehydration, urine alkalinity, alkaline water supplies, excess
of sodium bicarbonate in the diet, vitamin imbalances
 Excessive mineral intake, which can occur from highly mineralised artesian water or from
high concentrate diets.
 Diets high in magnesium.
 Increased presence of mucoprotein (cementing agent) in the diet caused by feeding high
concentrate low roughage rations, pelleted rations, or rations high in phosphate.
 High-grain diet which has a high phosphorus content leading to the development of
smooth, surfaced, phosphate calculi.
 Grazing animals more commonly develop oxalate or silicate stones because of ingestion of
pasture plants with high oxalate content or because of ingestion of plants on acid, sandy
soils that favor the accumulation of silicone, silicate stones are usually rough surfaced.
 Concentrated urine, which is produced when there is no drinking water available or when
water is of poor quality. Water deprivation can be exacerbated by heavy fluid loss from in
hot conditions.
 An imbalance in the calcium to phosphorus ratio of the diet.
 Nephritis and cystitis results in excessive epithelial debris in the urine, and this organic
matrix binds with mineral salts to form calculi.

NB: A change in the equilibrium of the body salts excreted in the urine maybe regarded as the
starting point of stone formation. A shift in the solubility ratio and the degree of acidity of the urine
lead to the precipitation of small crystals to which further crystals attach themselves.
TRANSMISSION
It is not transmissible from one animal to the other. It can only affect a herd of cattle which are
subjected to same type of feeding or rearing method. Although most often an occasional disease,
nephrolithiasis can occur in clusters or become a recurrent problem on a ranch, farm, or feedlot.
Dietary and environmental factors strongly influence the risk for development of urolithiasis, so
this is a disease that all sheep, goat, beef, and dairy cattle producers should understand and act to
prevent.

LIFE CYCLE
It does not have a life cycle because it is a lifeless object of chemical nature.

ANTE-MORTEM SIGNS
 Stones may remain undetected for the duration of the animal’s life, though they may be
causing physical trauma to the lining of the bladder
 The animals may stretch or occasionally kick at the abdomen, but the most characteristic
sign is frequent unsuccessful attempts to urinate. The tail will pump up and down and
contraction of the bulbo-spongiosus muscle can be seen or palpated over the ischial arch.
 In case of partial obstruction, animals will go off feed, uncomfortable, stretching, and
straining to urinate; but will only pass small amounts of urine or dribble urine which may
be blood-tinged. Blood or crystals may be adhered to the preputial hairs.
 Urethral blockage, either the bladder or urethra will rupture and signs of abdominal pain
and irritation will subside. When urethra is blocked, urine accumulates in kidney, ureters
and bladder causing distended bladder that can be felt by palpation during ante-mortem
examination
 Animal show a base- wide stance, (fore legs too forward and hind legs too behind)
 In the event of bladder rupture, abdominal enlargement is noticed, caused by urine
accumulation within the abdominal cavity (ascites also known as uroperitoneum), under
the sheath or under the tail.
 Urethral ruptures at sight of obstruction and release urine into the subcutaneous tissues of
the inguinal area (anasarca-oedema of the subcutaneous tissue occurs)
  Urea and ammonia in the urine initiate necrosis in the involved tissues, and large area may
slough. A urine or ammonia odor may be noted and the animal is usually anorectic and
quite depressed.

NB: Although stones develop in both sexes of animals, clinical signs of obstructive urinary stones
are only routinely observed in males. The urethra of female is sufficiently large and distensible
(flexible) to allow passage of stones.

POST-MORTEM SIGNS
 Spontaneous presence of renal stones in kidney is a prominent observation
 A number of nephroliths (stones), as birefringence crystals are found in the collecting and
distal uriniferous tubules in the renal medulla.
 In the uriniferous tubules epithelial cells surrounding those crystals presented such a
reaction as to form syncytia, and the surrounding connective tissue are proliferated
 Distended bladder
 Ruptured bladder, urethra or ureters leading to uroperitoneum-accumulation of urine in the
abdomen and anasarca-accumulation of urine in the subcutaneous tissue around the
inguinal area
 Medullary cysts, hyperaemia and haemorrhage in the kidneys are noticed.
 The kidneys produces a gritty sound (when incised), exhibited by small stones of various
shapes near the pelvis.
 Areas of congestion and haemorrhages are noticed in the renal pelvis.
 Urinary bladder can be ruptured by urine obstructed by the stones.
 Proliferation or hyperplasia of the pelvis renalis epithelium, cystic dilatations of the
tubules, ulcers of the pelvis mucosa and calcium deposits.
 Stones lodging in the urethra, ureters and bladder.
 Hydronephrosis
 Nephritis

PREVENTION AND CONTROL


 Encouraging increased water consumption is an important preventive measure.
 Water palatability is vital – animals drink more when the water is clean than when it is
dirty (they have taste buds, just like us). Water containers should be cleaned and filled
with fresh water on a regular basis – the water should be so clean that the owner would
be tempted to drink it on a hot day. Providing water in white containers can help the
owner recognize when water has become soiled with dirt, feed, and/or manure.
 If automatic waterers are used, stagnation of water can be limited by using shallow
tubs with spigots adjusted for rapid refill.
 Provision of shade over the water in the summer and heating the water during cold
weather makes the water more attractive.
 Regardless of the calculus (kidney stone) type involved, dilution of calculogenic ions
in the urine is of primary importance in prevention of nephrolithiasis in ruminants. The
salt content of the diet should be gradually increased to promote water intake and
formation of large volumes of dilute urine. Mixing lick salt directly into the feed is the
most effective means of delivery. Salt can be mixed in moistened feed or sprayed as a
saturated solution directly onto hay.
 Ammonium chloride to be added to dry feed as it induce modest reduction in urine pH
(acidification) The salt is unpalatable. Table sugar works well for covering up the
flavor of ammonium chloride. However, the type of stone present should be determined
first because some types of stones will actually form in acidic urine. Also, care needs
to be taken when adding ammonium chloride to the diet as too much of it will cause
acidosis.
 Ensuring adequate intake of vitamin A, especially during drought periods.
 Removing cattle, especially steers, from paddocks containing plants which predispose
cattle to stones formation.
 Flavoring the water with sugar-free drink mixes has resulted in increased water intake
 For large groups of animals, provision of multiple watering sites allows for more
frequent water intake. This is particularly important for sheep, as individuals are
usually reluctant to separate from the flock to travel to distant watering sites.
CONCLUSION
A presumptive diagnosis can be made based on history and physical examination. A definitive
diagnosis is generally based on post-mortem findings when stones are found in the kidneys and
bladder or obstructing the urethra or ureters. In steers, stones are typically lodged in the urethra
where it narrows before it goes into the penis. Numerous additional stones are frequently found in
the bladder. Sometimes stones are not found and more samples are required to confirm the
diagnosis. Stones need to be sent to a veterinary laboratory to determine their mineral composition
to assist with options of treatment and prevention in future. If nephrolithiasis is diagnosed in one
animal in a mob, all animals in that mob are at risk. Animals at risk should be managed
appropriately to prevent more clinical cases. Surgical treatment may be considered in valuable
animals. However, most affected cattle showing clinical signs will need to be humanely destroyed.

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REFERENCES
1.Jubb KVF, Kennedy PC and Palmer N. (1993) Pathology of Domestic Animals, 4th Edition,
Academic Press Inc. New York, USA

2.Van Metre DC, Smith BP. (1995) Surgical Treatment of Nephrolithiasis in Food Animals. In:
Proceedings, Fall Symposium on Advances in Veterinary Clinical Medicine, University of
California at Irvine, USA

3. Van Metre DC, House JK, Smith BP, George LW, et al. (1996), Obstructive urolithiasis in
ruminants: Medical treatment and urethral surgery. Comp Cont Ed Pract Vet18: University Of
California, USA

4.Ubrahim D, Savab Z.T, Murat K et al (2003),Transrectal Ultrasonographic Examination of the

Urinary System in Holstein Cows, Faculty of Vet Medicine, University of Ankara, Turkey.

5.Divers, T.J., Reef, V.B., Roby, K.A.(1989) : Nephrolithiasis resulting in intermittent ureteral
obstruction in a cow. Cornell Vet, London

6. Ahmad B,Shahrzad Azizi, and Mohammad Reza H, (2012), Nephrolithiasis among Slaughtered
Cow in Iran: Pathology Findings and Mineral Compositions, Iran

7.Almond S, Kiman P et al (2014), Veterinary Pathology, School of Veterinary Medicine, Shiraz,

University, Shiraz, Iran

8. Moe OW (2006) Kidney Stones: Pathophysiology and Medical Management. Lancet Press,
London

9. Hesse AT, Tiselius HG, Siener R, (2009), Urinary Stones, Diagnosis, Treatment and
Prevention of Recurrence, Vet World, USA.