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72 Cards in this Set
- Front
- Back
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Animals with comprised host defecences (Cushing's, DM or FIV) are prone to this type of urinary tract infection (term) |
asymptomatic bacteriuria |
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How many WBC are defined as pyuria cytocentesis voiding/catherization |
3-5 WBCs/hpf 5-10 WBCs/hpf |
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What is the most common bacteria that causes UTI? |
E. coli |
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What is the second most common and third MC cause of UTI |
gram positive cocci (Staph, strep, enterococci) Proteus, Klebsiella, Pasturella, Pseudomonas |
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Why are bacteria/fungi difficult to identify with dilute urine? |
UTI maybe present with out inflammation especially if has a px with host defenses (FeLV/Cushing's) |
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What can urine be stained with to aid in detection of microbes |
Gram's stain or newmethylene blue |
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How much bacteria must be present for a UTI to be diagnosed by cystocentesis |
any bacteria, however, can get FP due to hitting a loop of intestine on aspiration. |
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How long should AB be stopped prior to re-culturing urine |
3-5 days |
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If you are unable to review the urine sediment in ___ min, it should be refrigerated |
30 min |
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Bacteria counts will ____ every 20-45 min in urine at room temperatures |
double |
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What type of plates can be used to culture urine? |
Blood agar - supports growth of aerobic bact MacConkey's agar - prevents Proteus swarming |
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What level bacteria via culture are considered significant via cystocentesis in dogs? |
>1000 |
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What level bacteria via culture are considered significant via cystocentesis in cats? |
>1000 |
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What level bacteria are considered significant via catherization in dogs? |
>10,000 |
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What level bacteria via culture are considered significant via catheritization in cats? |
>1,000 |
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What level bacteria via culture are considered contaminant via cystocentesis in dogs? |
<100 |
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What level bacteria via culture are considered contaminant via cystocentesis in cats? |
<100 |
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What level bacteria via culture are considered contaminant via cathertization in dogs? |
<1000 |
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Intact male dogs with a UTI should will generally also have this disease |
prostatitis |
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For uncomplicated UTI, how long is the AB course? |
10-14 days |
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How long after starting an AB, should C/S resolve with an uncomplicated UTI? |
48 hours |
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UTI from E.coli produce this type of urine |
aciduria g- rods |
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UTI from Staphlococci produce this type of urine with the MOA |
alkauria because they produce urease which metabolizes urea to ammonia resulting in alkaline urine pH |
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Recommended AB for E.coli UTI (3) |
TMS* cephalosporins 1st & 2 second generation fluoroquinolones |
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Recommended AB for Staph and Strep UTI (6) |
Amoxicillin* ampicillin* Clavamox* cephalosporins (1st) nitrofurantion TMS
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What animals are considered to have a complicated UTI? (3) |
intact male dogs all cats systemic diseases |
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How long should AB be used with complicated UTI? |
4-6 weeks |
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Although no studies have shown that prophylactic AB TX is helpful for recurrent UTI, what is the general protocol?
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- culture done to R/O current infection
- fluoroquinolone, cephalosporin, or B- lactam - Dose at 1/3 of the theraputic dose at night - for 6 months - cystocentesis & culture every 4-8 weeks |
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What are ancillary TX for recurrent infections (5)
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urinary acidifiers
urinary antiseptics local instillation of AB agents into bladder alteration of urine volume RX to affect storage and voiding |
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What are urinary antiseptics and what is an example. |
- Urinary antiseptics are drugs that decrease the hospitability of urine. -methenamine, which in an acidic environment is converted to formalin. - must be used in conjunction with AB
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What systemic illness is most likely to develope a fungal UTI & why |
DM Immune compromise that predisopose to infection |
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What TX can be used for fungal UTI? These animals are asymptomatic. |
- alkalinizing agents (posttium citrate or sodium bicarbonate) - diets that induce alkauria |
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If symtomatic or previous TX was not successful, what medication should be tried for a fungal UTI.
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- amphotericin B - not used - nephrotoxic
- fluconazole - itraconazole |
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What are 4 complications of bacterial UTI |
polypoid cystitis emphysematous cystitis magnesium ammonium phosphate uroliths pyelonephritis |
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What is polypoid cystitis? Where does it develope? TX? |
severe epithelial proliferation (mass like) more likely to develope at the apex of the bladder (vs. trigone for TCC) and can serve as a nidus for infection.
TX: like complicated UTI |
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What is emphysematous cystitis? Organisms involved? TX?
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accumulation of gas with in the bladder wall. Formed by E.coli but Proteus, Clostridium can cause it.
Need glucose to ferment, generally occurs with DM
TX: as complicated UTI |
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How are magnesium ammonium phosphate urothilasis a complication to a bacterial UTI? (how struvite crystals form) |
Staph and Proteus produce urease (hydrolizes urea to ammonium) which butter urine pH forming ammonium ions and increasing the pH and dissolves phosphate. It will precipitate around a nidus. |
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What is special about struvite stones in cats? |
sterile |
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prostatic fluid makes up this fraction of the ejaculate.
What % of the total ejaculate is prostatic fluid? |
first and third and accounts for 97% of the ejaculate |
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On rectal exam, the prostate should feel |
bilobed symmetric smooth movable pain free |
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What size must a prostate be radiographically to be enlarged? |
70% of the pubic-promontory distance on later or 50% of the weight of the pelvic inlet on VD |
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On radiographs, if prostatomegaly is noted, what else should be evaluated on the radiograph? |
enlargment of the sublumbar LN and lytic bone lesion s of the lumbar vertebral bodies and pelvic bones. |
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Although US is the best to evaluate prostate, what other diagnostic test is used to evaluate the prostate? |
distention retrograde contrast urethrocytography |
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Any dog with a suspected prostitic disease, the prostatic fluid should be evaluated for __ and ___ |
cytologic evaulation culture |
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How can prostatic fluid be obtained? |
ejaculation (collection of the third fraction) or by prostatic wash FNA - US |
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How is a prostatic wash performed? |
- catheterize the bladder and remove urine - flush 5 mL of saline and removed - pull back catheter to distal to prostate, massage prostate for about 1 min and collected into the catheter - sterile saline expressed into bladder - occlude distal urethra - collect sample from bladder |
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Why would AB be administered prior to a prostatic wash? |
UTI |
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How is BPH diagnosed |
PE R/O other dz histopathology (very invasive) prostatic cytology & culture ** |
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With BPH, how long after castration should it take for prostate to decrease in size? |
7-10 days |
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How does finasteride work? |
prevents conversion of testosterone to DHT |
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What is a down fall of finasteride |
effects are reversible within less than 8 weeks of discontinuation of therapy. |
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Besides finasteride and castration for BPH has been used, but is not recommended because it can affect gonadal function |
antiandrogenic (chloradionone acetate, osaterone acetate, delmadionane acetate, flutamide, and megestrol acetate) |
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These can cause chronic bacterial prostatitis |
common to lower UTI (E.coli**, Pseudomonas, Proteus) Brucella canis |
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What is a common sign of chronic bacterial prostatitis? |
recurrent UTI continuous or intermittent dripping of fluid from penis independent of urination (continue discharge of prostatic fluid esp due to inflammation) |
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If chronic bacterial prostatitis is not treated, what can result? |
rupture and cause peritonitis |
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What allows a drug to penetrate the prostate(2)?
What type of ionization can RX cross the epithelial membrane? |
- pKa ( PH at which the drug exists as ionized and nonionized forms) - lipid solubility
Only non-ionized forms cross the epithelial membranes. |
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What drugs reach the prostatic fluid (5)?
What medication crosses the epithelial membrane, but not penetrate the prostate? |
TMS erythromycin clindamycin chloramphenicol enroflaxicin (ciprofloxacin - dosen't penetrate well) |
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How long with chronic bacterial prostatis should AB be used?
What should be done when the ABs are finished? |
4-6 weeks
culture fluids 3-7 days afterwards |
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What is the most common prostatic disorder in castrated dogs? |
prostatic carcinoma |
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Does castration help prevent prostatic carcinoma? |
No |
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Where dose prostatic carcinoma metastasize to? |
Metastasis common sublumbar LN lumbar vetebral bodies lungs |
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In castrated dogs, palpation of prostatomegaly should be suspicious of this disease |
prostatic carcinoma |
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Prognosis for prostatic neoplasia |
poor |
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TX options for prostatic neoplasia |
castration if intact radiation therapy piroxicam (+ cisplatin)
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These two prostatitis diseases are uncommon in dogs |
acute bacterial prostatitis prostatic abscesses |
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Prostatic abscesses have been associated with this disease and RX administration |
BPH estrogen administration |
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TX of acute bacterial prostatitis? |
AB - culture and sensitivity (blood/prostate barrier has been breached)
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TX of prostatic abscesses |
Do not resolve with AB TX alone
marsupialiation penrose drain technique drainage via US and alcoholization of the cavity? |
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What maybe the etiology of paraprostatic cysts? |
Maybe from dilated paramesonephric duct remnants or from retention cyts |
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Compared to the bladder, where are paraprostatic cysts located? |
cranial or dorsal to the prostate and bladder |
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On radiographs this looks like a second bladder |
paraprostatic cyst |
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TX for paraprostatic cysts |
SX removal |
