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73 Cards in this Set
- Front
- Back
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What is the common signalment for canine UTIs? What is the most common pathogen?
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beeeeeeeeeyyyyyyyyyyyaaaaaatch!!!! (females > males)
E. coli |
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What are the 2 types of UTIs in dogs?
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Recurrent (>2 in 12 months)
Persistent |
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What are the normal barriers to urinary infection?
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urethral high pressure zones (internal/external sphincter)
Urethral peristalsis Urethral length Ureterovesical flap valves Bulk flow of urine provides normograde rinsing |
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What are some anatomical disorders in females that predispose for UTIs?
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Urachal diverticulum
Ectopic ureters Vestibulovaginal stenosis Recessed vulva |
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What is the normal ratio of vestiuble to vagina?
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>0.35
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What are some disorders that suppress immunity leading to UTIs?
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Hyperadrenocorticism (exogenous or endogenous)
Diabetes mellitus Iatrogenic (chemotherapy) |
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Which of the following is NOT true regarding DM and UTIs?
a) Decreased neutrophil chemotaxis and phagocytosis b) Decreased monocyte chemotaxis and phagocytosis c) Glucosuria provides bacterial substrate for growth d) depresses cell-mediated and adaptive immunity e) allows for increased adherence of bacteria to cells |
c) Glucosuria provides bacterial substrate for growth (FALSE-O-RINO)
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What factors in urine contribute to its bacteriostatic principles?
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low pH
high urea concentration high osmolality |
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Which conditions can alter urine composition, thereby predisposing to UTIs?
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DM, DI, Cushing's, Hepatic insufficiency, CRF
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What are the 2 stages of micturation?
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passive storage
active voiding |
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What dog breeds get TCC more often?
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Scotties and Shelties
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Which bacteria can cause a primary UTI? How does it accomplish this?
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UTEC (via type I pili and intracellular biofilms)
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Which of the following are true regarding UTI diagnostics and treatments?
a) culture every animal you're treating b) begin empirical treatment of an animal with bactiuria c) use clavulinic acid due to the presence of beta lactamase in most urinary bacteria d) cranberry extract inhibits type I pili adhesion |
a) culture every animal you're treating
d) cranberry extract inhibits type I pili adhesion (no empirical treatment unless there is complicated UTI then modify after C&S) |
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T or F:
Broad spectrum antibiotics are good for UTIs. |
False! Use narrow spectrum!
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How long should uncomplicated UTIs be treated? Complicated? Renal/prostate involvement?
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Uncomplicated (7-14d)
Complicated (4-6 wks); with renal/prostate involvement (6-8wks) |
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What are ancillary therapies for UTI prevention?
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Methenamine mandelate
Cranberry extract Low dose abx |
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Where do uroliths like to lodge usually?
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proximal to os penis
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T or F:
30% of dogs w/stones also have pyonephritis. |
True!
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Blood at the beginning of urination indicates a lesion where? Blood at the end?
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Beginning (urethra, prostate, genital tract)
End (bladder) |
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Put the following in order of most common to least common sources of hematuria for dogs For cats
a) inflammation b) urolithiasis c) infection d) neoplasia |
Dogs (Infxn, stones, neoplasia, inflammation)
Cats (inflammation, stones, neoplasia, infection) |
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T or F:
There is always an underlying issue with urolith formation. |
True
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Which of the following describe a metastable supersaturation?
a) new stones don't form b) existing stones may dissolve but won't grow c) crystals aggregate when added d) existing stones may grow e) new stones form |
a) new stones don't form
d) existing stones may grow (also crystals dissolve; existing stones don't dissolve) |
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What are the 2 most common types of uroliths?
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Ca oxalate dihydrate
Struvite |
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Place these in order from most radiodense to most radiolucent:
Cysteine Oxalate Struvite Urate Silica |
Oxalate (most dense)
Silica Struvite Cysteine Urate |
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What parameters are used to identify uroliths?
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urine pH
Crystal morphology stone radiopacity breed Chemical analysis of stone |
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What are possible therapies for stone removal?
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Surgery
Medical dissolution Lithotripsy (shock or laser) Voiding urohydropropulsion |
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Which dogs get struvites? Oxalates?
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Struvites (young dogs and dogs w/infections)
Oxalate (old dogs) |
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What is the chief cause of struvites (which bacteria)?
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Staphylococcus
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NAME THAT STONE!!!!
Grows rapidly Smooth surface and large Very pH dependent... |
STRUVITE!
Also seen more in females |
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NAME THAT STONE!!!
Bichon/Yorkies/Schnauzers Laminated appearance Associated with primary hyperparathyroidism |
OXALATE!!!
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How are struvites treated/prevented?
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Treat the underlying condition!
Medical dissolution Reduced protein, Mg, and acid pH |
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How are oxalates treated?
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Surgery or uropropulsion if small enough.
No dissolution diet. Na and protein restriction; find when they recur via radiograph and have scheduled hydropropulsion. |
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NAME THAT STONE!!!
Dalmations or dogs w/liver dz!! |
URATE
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How are urates treated/prevented?
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Tx: dissoltion, urine dilution, K-citrate alkalinization, Allopurinol to prevent urate excretion
Sx: to fix PSS Prevention: Allpurinol and alkaline pH |
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NAME THAT STONE!!!!
Dissolved by 2-mercaptopropinol glycine... Corgies, Dachschunds, young female Newfies... |
Cystine!!!!
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How are cystine stones treated/prevented?
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Tx:
Sx, medical dissolution w/mercaptopropionol (MPG), low protein (low Na and alkaline pH) Prevent: Diet, high pH, K-citrate, maybe MPG |
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What is the common presentation of FLUTD?
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Pollakuria, dysuria, hematuria
Maybe stones, or obstruction |
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What are the 3 populations of FLUTD? Which is an EMERGENCY?
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Hematuria w/obstruction (EMERGENCY)
Hematuria w/dysuria and no obstruction Hematuria w/inappropriate urination |
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What pharmaceuticals can be used to manage a cat w/hematuria and inappropriate urination?
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Fluoxetine
Buspirone Pheromones |
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Which tests should be performed on a cat with hematuria, dysuria, and no obstruction?
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UA (look for pyuria, hematuria, bacteriuria)
Rads/US of urinary tract C&S Maybe contrast rads |
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What are the most common uroliths in cats?
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Struvites and oxalates!
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T or F:
Struvites in cats are usually sterile. |
True (they're metabolic stones)
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What is the age/sex distribution for stones in cats?
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<2yo males/<5yo females get struvites
>7yo males and >11yo females get oxalates |
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Kidney stones in kitties are commonly which type?
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Oxalate
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How do you get rid of struvites in cats?
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Surgery
Hydropropulsion (females) Diet dissolution (need pH 6.1-6.5) |
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Which cat breeds are predisposed to oxalates?
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Himalayan, Persians, Ragdoll, Burmese
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Which of the following are true?
a) hypercalcemia is a risk factor for oxalates in cats b) hypercalcemia in cats is due to primary hyperparathyroidism c) K-citrate can be used to treat feline oxalates d) oxalates form in acidic urine |
a) hypercalcemia is a risk factor for oxalates in cats
c) K-citrate can be used to treat feline oxalates (Hyper Ca is IDIOPATHIC; oxalates form in ALKALINE urine) |
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How are oxalates treated/prevented in cats?
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Surgery only!
Correct hyper calcemia Keep urine pH between 7 and 7.5 use appropriate diet |
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What is the new name for idiopathic feline cystitis?
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Interstitial cystitis
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Which are NOT true regarding idiopathic feline (interstitial) cystitis?
a) common in older cats b) diagnosis of attrition c) stress is a major factor d) more common in fall/summer e) hematuria, pyuria, and crystalluria are commonly the only signs |
a) common in older cats (NO, common in indoor, obese 2-6yo cats)
d) more common in fall/summer (NO, more common in spring/winter) |
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When is crystalluria treated?
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When xanthine, cystine, or ammonium urate crystals are found
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What is the ONLY thing that makes a difference in idiopathic feline (interstitial) cystitis?
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Increased water consumption (wet food)
Amitriptyline (pain control, bladder/urethra relax, anxiolytic) may increase interval between crises |
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What effect does sympathetic tone have on the urinary system?
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Detrusor relaxation (filling)
Internal sphincter contraction |
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What effect does parasympathetic tone have on the urinary system?
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Detrusor contraction
Overrides sympathetic tone |
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What innervates the external urinary sphincter?
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Pudendal nerve
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T or F:
Normally, ALL urine is voided with micturation. |
True!
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What is going on if an animal only leaks with a full bladder?
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Paradoxical (obstructive) incontinence; full bladder forces urine around a stone
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Where is the lesion in an animal with a difficult to express bladder with no attempts to void?
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Brain stem to L7
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What are the signs of an UMN bladder?
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REALLY FULL bladder
Hypertonic sphincter Cannot feel that bladder is full and cannot contract bladder. |
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Where is the lesion in an animal with a really full, difficult to express bladder that is experiencing signs of pain?
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L4 to L7 (still UMN) but pain fibers work
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Where is the lesion in an animal with an easy to express bladder, no attempts to void, residual urine, and possible incontinence?
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Sacral lesion (LMN)
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What are the signs of a LMN bladder?
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Flabby bladder
Easy to express Residual urine |
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Where is the lesion in an animal with normal voiding but with leakage during stress, coughing, and is easy to express?
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ONLY in pudendal nerve (no control over external sphincter);
More commonly urethral sphincter mechanism incompetence |
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What are the 3 scenarios of incontinence?
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Normal voiding + incontinence
Unfruitful voiding attempts Don't even try to void |
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What is the common signalment for urethral sphincter mechanism incompetence?
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middle-aged spayed females
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How is urethral sphincter mechanism incompetence diagnosed?
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Clinical signs and history; rule-out UTIs!!!
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How is urethral sphincter mechanism incompetence treated?
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Phenylpropanolamine
Diethylstilbestrol Imipramine (maybe surgery w/collagen or hydraulic occluder) |
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What is the #1 and #2 reason for incontinence in young dogs? Spayed female dogs?
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Young (ectopic ureters and UTI)
Spayed female (UTI and urethral sphincter mechanism incompetence) |
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What is the most common cause for urge incontinence (normal voiding with increased frequency)?
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UTI
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If urination starts then stops suddenly, what should you suspect?
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Obstruction!
stones, prostatitis, urethritis, or neoplasia (maybe reflex dyssynergia) |
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If you see an animal with constant leakage and an empty bladder, what should you suspect?
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Anatomical defect (ectopic ureters & etc)
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How should an animal with an overdistended bladder be treated? What is a possible sequel to overdistention?
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EMERGENCY!!! Unblock w/o manual expression (indwelling catheter for 7 days);
Rupture and separation of tight junctions (loss of coordinated contraction) |
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What are the two main causes of detrusor arreflexia?
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Normal or increased sphincter tone (UMN bladder)
Decreased sphincter tone (LMN lesion) |
