Part 5 Therapeutic options for urinary Tract infections in Farm Animals Prof Dr Hamed Attia.pdf

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1. Part 5:Therapeutic options for urinary Tract
infections in Farm Animals
(Pyelonephritis-Urolithiasis-Blood urine)

2. سماخلا ءزجلا:يف ىلوبلا زاهجلا باهتللا ةيجلاعلا تارايخلا
ةعرزملا تاناويح) ةيلكلا ضوح باهتلا-لوبلا سابتحا-ممدملا لوبلا(
ا.ةيطع دماح د
ناويحلا بط ذاتسا–ىرطيبلا بطلا ةيلك
قيزاقزلا ةعماج-رصم
ىنفلا راشتسملا
ةيرطيبلا ةيودلأل ضايرلابربخلا اجيموا ةسسؤمب

3. Post partum Diseases in Cattle
Metabolic& Digestive Disorders Inflammatory, Infectious disorders
❖fatty liver.
❖ketosis
❖Milk Fever
Displacement
of the
abomasum.
Metritis
Mastitis
Cystitis &
Pyelonephritis

4. Main Problems of Urinary Affections in Farm
Animals
Cattle & calves Camel
❖Cystitis and
pyelonephritis
Urolithiasis in
male calves
Urolithiasis in
Ram& Male goat Hematuria
Sheep

5. Introduction
❖Cystitis and pyelonephritis occur most commonly
after parturition in cattle.
❖Hematuria, pyuria, and stranguria
are common presenting clinical signs.
❖Prolonged treatment (2–4 weeks)
with administration of appropriate antimicrobials
is usually successful in acute cases.

6. Bacteriologic culture of urine is the gold standard
for diagnosis of UTI.
Indications include:
❖Clinical signs
❖Visualization of bacteria during urine sediment examination
❖Evidence of pyuria.
❖Dilute urine (urine specific gravity < 1.013).
❖ ربتعت لوبلا ةعرزمبهذلا رايعملا يهىةيلوبلا كلاسملا باهتلا صيخشتل.
❖ تارشؤم ىلوبلا زاهجلل ةباصلاالمشت:
❖ضارعلاا
❖ةيؤرلوبلا بساور صحف ءانثأ ايريتكبلا
❖ ليلدلوبلا ىف ديدص دوجو.
❖ لوبلا عييمت( لوبلل يعونلا لقثلا<1.013.(

9. 1-Main Line of Treatment of Pyelonephritis

10. 1-Main Line of Treatment of Pyelonephritis
(1) Antibiotic
(2) Urinary antiseptic
(3) Urinary lavage.
(4) Urinary diuretic
(5) Sedative
(6)Sufficient quantity of water, less nitrogenous food.

11. Line of treatment
Of
Urinary tract affections
Anti-
inflammatory
Urinary
Antiseptic
Antibiotic

12. 1-Antibiotic Used In treatment of Urinary
Affections
1-B. Lactam group 2-Fluroquinolone Group
❖Penicillin
❖Amoxicillin
❖Ampicillin
❖Amoxicillin &Clavulanic Acid.
❖Third Generation of
cephalosporin
❖Enrofloxacin
❖Marbofloxacin
❖Ciprofloxacin

13. Antibiotic Used In treatment of Urinary Affections
3-Aminoglucosides
group
4-Potentiated Sulfonamides
(Sulfonamide Combinations)
❖Gentamycin
❖Streptomycin
❖Tobramycin
❖Amikacin
❖Trimethoprim/sulfadiazine (co-
trimazine).
❖Trimethoprim/sulfamethoxazol
e (co-trimoxazole).
❖Trimethoprim/sulfadoxine
(Borgal24%)

14. Duration
of
Antibiotic
Chronic pyogenic
2-4 weeks
Chronic
7-10 D
Acute
3-5 days

15. لا تاباهتلا جلاعل مدختست ىتلا ةيويحلا تاداضملا تافصاوم زاهج
لوبلا
⚫Activity against the causal bacteria
⚫Be excreted and concentrated in the kidney and
urine
⚫Be active at the phof urine
⚫Low toxicity
يويح داضم بسنا ديدحتو لوبلل ةعرزم لمع لضفي

16. The treatment of choice for pyelonephritis
caused by Corynebacterium sppis:
R/ Procaine penicillin (22,000 IU/kg, IM, every 12 hours,
Or
R/Procaine penicillin 44,000 IU/kg, IM, every 24 hours
Or
R/Trimethoprim-sulfadoxine(16 mg combined/kg,
IM, every 12 hours) for 3–4 weeks.

17. ❖Advantages of Penicillin& Cephalosporins
❖Penicillin traditionally has been considered the first-line
antibiotic in cases of pyelonephritis caused by
Corynebacterium sp. because renal excretion of the drug
leads to high concentrations of active drug in renal tissues.
❖Other beta-lactam antibiotics such as ampicillin and
cephalosporins also undergo urinary excretion, making them
additional options for treatment.

18. 2-The treatment of choice for pyelonephritis
(E coli infections)
R/Ceftiofur (1.1–2.2 mg/kg, IM or SC,
every 24 hours for 2–3 weeks) .
Or
R/Gentamicin (5–6 mg/kg, IM, every 24 hours
for 5–7 days).
has been used successfully in some cases

19. Name of the drug
Name of antibiotic used for treatment of urinary affections in
dog &cat

20. 2-Urinary
Antiseptic
Urinary lavage
IV glucose
Systemic
Local
use of
catheters

21. 3-Urinary acidifiers
Manipulation of urine pH may theoretically be of value
because E coli grow best in acidic urine (pH < 7), whereas
Corynebacterium sppgrow best in alkaline urine (pH >7)
R/Sodium acid phosphate (125 gm dissolved in drinking
water daily for several days to acidify urine).

22. جلاعلا ىف دعاست ةمهم باشعا
سفركلاو سنودقبلا ىلغم
ريعشلا ىلغم
رعرعلا تابن
ةيرمرملا ىلغم
بدلا بنع
ناصحلا ليذ تابن
بنعلا رذج نوغيروأ
يربلا توتلا
موثلا

23. 2-Main Line of Treatment of Hematuria in Camel

24. Causes
Acute or chronic urogenital inflammations (Salmonella)
Traumatic calculous injuries.
Cancers, corrosive poisonings.
Blood Parasites(Theileria)

25. Main Line of Treatment of Hematuria
Blood transfusion in case of sever blood loss for long time
Antibiotic.
Vit K
Urinary antiseptic
Fluid therapy
Kidney wash (Nephro-cleaner)

26. The Best Antibiotic used in Treatment of
Hematuria in Camel
R/Amoxicillin& clavounic acid.
R/Amoxicillin& gentamycin.
R/Gentamycin.
R/Cephalosporine
( Third generation)or Penicillin & streptomycin
R/Sulpha& Trimethoprim

27. 2-Hematinics
A-Blood transfusion
(In sever cases)
Iron & VitB12.

28. ❖لمكميئاذغيوتحيىلعديدحلا
يفاصلاضيوعتلصقنديدحلاروعف
ةبسننيبولجوميهلامدلاف.
❖لمعيىلععفرةيهشلاديزيونم
ةيويحلاطاشنلاوناويحلل.
دعملا لاةةملااو تاةةنيماتيفلا نةةم ةةلماكتم ةةةبيكرت ةةةين
ةةيلاع تازةةيكرت ىةةلع يوةةتحتو ةةينيملاا ضاةةمحلااو
حلا رةةةصنع نةةةمدةةةيد نيوةةةكت يةةةف نيةةةمهملا ساةةةحنلاو
وةلجوميهلا ةبةسن عةفر ىلع دعاسي امك مدلا ايلاخ نيب
ةيعيبطلا تايوتسملا ىلا مدلا يف

29. مدلا لقن متي
نوكت امدنع
مدلا تارك
لقا ءارمحلا
نم5
نم لقا7
نم لقا
20
؟مدلا لقن بجي ىتم

30. ةلاح جلاعل تشور
ةقان ىف ممدم لوب

31. لبلاا ىف ممدملا لوبلا جلاعل تشور
R/Antibiotic:Amoxicillin& clavounic acid.
R/ Fluid therapy 6 liter Na cl per day نيترم ىلع
R/ Blood cell (Hematincs)50 ml orally for 15 days
R/ Nephro-cleaner for 5 days
R/Vit K for 5 days

32. 3-Treatment of urolithiasis

33. Treatment of urolithiasis
1-Medical
Treatment
2-Surgical
Treatment

34. 1-MedicalTreatment

35. Main Line of Treatment of Urolithiasis
1-Analgesia,
2-Correct fluid and electrolyte imbalances
3-Decrease urethral inflammation
4-Prevent infection.
5-Acidification of urine

36. لوبلل سابتحا ةلاح جلاعل تشور(ناثملل راجفنا ثودح لبقة(
1) Urinary antiseptic (Antibiotic, sulphonamideor others)
to prevent secondary infection.
2) Analgesic (Novalgin10ml/100KgBW, IV) to relief pain.
3) Smooth muscle relaxants (Depropanxor Prostagmineor
Neurazineor Neuril) to relax the urethral muscle and permit
passage of the obstructing calculus.
4) IV glucose 5% (After or with muscle relaxant) as
diuretic, increase urine flow and facilitate calculi passage.

37. سابتحلاا ةلاح ىف ليلاحملا مادختسا دنع ةمهم تاظحلام
Fluid therapy should be instituted based on clinical
findings and the results of serum biochemistry testing.
After or during the relief of the obstruction, diuresis is
important to replace hydration deficits, manage azotemia,
and flush urolith components from the urinary tract.
 راجفنا ثودح نم افوخ لوبلا ىرجمل لماكلا داددسنلاا ءانثأ ليلاحم ءاطعا مدع بجي
ةناثملل.
تنو ةيريرسلا جئاتنلا ىلع ًءانب لوبلا لوزن دعب لئاوسلاب جلاعلا ءدب بجي رابتخا جئا
مدلا يف ةيويحلا ءايميكلا .
 ىرجم تانوكم درطو ، ايميتوزأ ةرادإو ، ءاملا صقن ضيوعتل اًمهم لوبلا راردإ دعي
ةيلوبلا كلاسملا نم لوبلا.

38. مدختسملا لولحملا عون
Normal (0.9%) saline makes an appropriate empiric first
fluid for these cases.
Additives should be used as indicated by serum
biochemistry findings. Initial rates of fluid therapy should
be slow until the obstruction is relieved and then increased
to 80–100 mL/kg/day until the patient stabilizes.
 يداعلا يحلملا لولحملا(0.9٪ (تلااحلا هذهل بسانملا يبيرجتلا لولأا لئاسلا عنصي.
مدلا يف ةيويحلا ءايميكلا جئاتن يف نيبم وه امك ةفاضملا داوملا مادختسا بجي. نأ بجي
دعب دادزت مث دادسنلاا لوزي ىتح ةئيطب لئاوسلاب جلاعلل ةيلولأا تلادعملا نوكت ىلإ كلذ
80-100 لم / مجك
رنيلكورفينلا لثم ةيلكلل ليسغ مادختسا

39. لوجعلا ىف لوبلا سابتحا جلاعل ةديدج ةقيرط

40. لخلا نقحب ةبرجت لمع مت ريتسجام ةلاسر ىف(ضمح ( للاخ نم
ةوصحلا تانوكم عم لعافتي ىذلاو ةيجراخلا لوبلا ةحتف (ىولق (
لوبلا لوزنو تاوصحلا نابوذ ىلا لعافتلا اذه ىدؤيو

41. لوبلا لوزنو ةوصحلا نابوذل لوبلا ىرجم ىف لخلا نقح تاوطخ
?????? كيتسلاب ةجنريس ( ةربإ نودب (20للم
?????? بحس20ماعطلا لخ نم للمacetic acid
??????لوبلا ىرجمل ةيجراخلا ةحتفلا ىف ةجنريسلا مسبم لاخدإ
لوبلا ةانق ىف لخلا نقح.
??????ةمكارتملا تاوصحلا كيكفتل نيترم لخلا دعب ةجنريسلاب ءاوه لاخدا نكمم
?????? ضمحلا لعافت ثدحي(لخلا( ىولقلا عم (ةوصحلا (وبلا لزنيو ةوصحلا ككفتول
??????لوبلا ةانق عاستا ىلع دعاست نقح ءاطعإ نم عناملا (muscle relaxant) لثم
لخلا نقح لبق نيزلايزلا

42. ةحتفلا ىف لخلا نقح
لوبلا ىرجمل ةيجراخلا

43. 2-Surgical
Treatment

44. Surgical Treatment
•Urethral process amputation ةيدودلا ةدئازلا رتب(Ram)
•Tube cystotomy يبوبنلأا ةناثملا ةرطسق
•Urinary bladder marsupialization ىف اهتيبثتو ةناثملا ىف ةحتف
دلجلا
•Perineal prescrotalurethrostomy يناجعلا لوبلا ىرجم ةحتف

45. Urethral process amputation
مانغلأاروكذ ىف ةيدودلا ةدئازلا عطق

46. مانغلاا ركذ ىف ةيدودلا ةدئازلا صق
If the blockage is in the urethral process in sheep and
goats, amputation of the blocked tip of the process with
scissors may resolve the condition.
Care should be taken to ensure there are not additional
stones further back along the urethra or in the bladder.
دسملا فرطلا رتب نإف ، زعاملاو مانغلأا يف لوبلا ىرجم ةيلمع يف دادسنلاا ناك اذإ دو
ةلاحلا لحي دق صقملاب ةيلمعلل.
 ىرجم لوط ىلع فلخلا يف ةيفاضإ تاوصح دوجو مدع نامضل رذحلا يخوت بجي
ةناثملا يف وأ لوبلا.

49. perineal urethrostomy
If there is a complete obstruction and the bladder is still
intact, perineal urethrostomy may be lifesaving.
This can be performed under caudal epidural anaesthesia
while the animal is standing, if skills and resources are
available.
يناجعلا ليلحلإا رغف نوكي دقف ، ةميلس لازت لا ةناثملاو لماك دادسنا كانه ناك اذإ اًذقنم
ةايحلل.
ت اذإ ، ناويحلا فوقو ءانثأ ةيليذلاو ةيفاجلا قوف ريدختلا تحت كلذ ءارجإ نكمي ترفو
دراوملاو تاراهملا.

50. ةناثملا راجفنا دعب ايحارج لماعتلا
Animals with a ruptured bladder and urine accumulation in
the abdomen may be salvaged with a perineal urethrostomy
and drainage of urine from the abdomen using a trocar or
teat cannula.
This may allow the bladder to heal spontaneously.
دختساب نطبلا يف لوبلا مكارتو ةناثملا قزمتب ةباصملا تاناويحلا ذاقنإ نكمي رغف ما
ةينق ةملح وأ لزبم مادختساب نطبلا نم لوبلا فيرصتو يناجعلا ليلحلإا.
اًيئاقلت ءافشلاب ةناثملل اذه حمسي دق.

51. ةيحارجلا ةيلمعلا ءارجا دعب ةيئاود ةتشور
ةحارج نودب ةلاحلا نسحت دعب وا
R/Antibiotic (Pen&Strep®, 1 mL/25 kg) for successive 5 days
R/Anti-inflammatory (flunixin meglumine 2.2 mg/kg) for
successive 3 days was performed.
R/10 g of ammonium chloride dissolved in 40 mL of water
for 20 days postoperatively.

52. ةياقولا قرط

53. Prevention
Analysis of the uroliths is essential before adjustments to
dietary mineral balance are made in order to ensure that
appropriate changes are made.
Prevention of formation of urethral calculi is mainly
dependent on providing a calcium to phosphorus ratio of
2:1 in the complete ration, and ensuring animals have ready
access to good quality water supply.
 نوكت نا بجي ةقيلعلا ىف روفسوفلا ىلا مويسلاكلا ةبسن1:2

54. Prevention
Additional measures may be useful in some cases, such as
supplemental sodium chloride (up to 4 % of the total ration)
to increase urine output, and urinary acidifiers that may
prevent formation of some crystals.
Where a small number of cases have occurred, it is
important to implement dietary changes and check water
quality as soon as possible to try and prevent further cases
from occurring.
 ةبسنب ةقيلعلا ىف ماعطلا حلم ةفاضا4%

55. Questions?