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120 Cards in this Set
- Front
- Back
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Why is BPH not a common condition in cats?
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Prostate is disseminated
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What is BPH?
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Benign prostatic hyperplasia- an enlargement of normal prostatic tissue
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What is the cause of squamous metaplasia?
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It is due to estrogen production (Sertoli cell tumor)
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What are some of the other diseases of the prostate?
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Prostatic & paraprostatic cysts
Prostatic abscess Prostatiitis Prostatic neoplasia- 5-7% |
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What are the clinical signs of prostatic disease?
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Straining to urinate
Voiding small amounts of urine frequently Blood tinged diarrhea Dripping blood from penis Constipation & straining to defecate Passing small ribbon shaped feces |
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A hunch gait or stance can also be in response to what condition besides prostatic disease?
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Hip Dysplasia
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How is prostate disease diagnosed?
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PE w/ digital rectal palpation
UA and Urine Culture Abdominal & chest radiographs (metaplasia) Abdominal U/S |
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What additional diagnostics can help to diagnose prostatic disease?
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Ejaculate evaluation
Prostatic massage Fluid: Cytology: culture/sensitivity Prostatic Aspiration (FNA) |
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A prostate biopsy is performed with what type of needle?
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Percutaneous- Tru-cut
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What is the most effective medical treatment for prostatic hyperplasia?
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Finasteride
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What is Finasteride?
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Synthetic steroid
Blocks action of testosterone, causes chemical castration and reduces the size of prostate. |
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Prostatic abscess is an ascending infection from where?
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LUT or testes (B.Canis)
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What is the pathophysiology of a prostatic abscess?
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Micro abscesses coalescence- rupture- peritonitis- death
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What are the clinical signs of prostatitis?
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Lethargy
Hyperthermia Anorexia Urethral discharge Abnormal way of walking |
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How is prostatitis diagnosed?
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Rectal: painful, enlarged (soft areas)
UA: hematuria, pyuria Culture & sensitivity US: hyper/hypoechoic areas Rads: +- enlarged prostate Hematology: leukocytosis |
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What types of antibiotics are used to treat prostatitis?
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Drugs that cross the prostatic-blood barrier (TMS, enrofloxacin)
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How are abscesses caused by prostatitis treated?
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Surgically
Omentalization- provides internal drainage & leads to resolution. |
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What is the difference between a prostatic cyst and a paraprostatic cyst?
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Paraprostatic cyst usually doesn't communicate with the prostate parenchyma and doesn't usually become infected.
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What is a prostatic cyst?
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squamous metaplasia- ductal occlusion that may become infected.
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How are prostatic cyst and paraprostatic cyst diagnosed?
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Signs: large abdominal mass
Rectal: cysts: large, fluctuant, non-painful Paraprostatic cyst: usually not palpated per rectum Micturation: normal or hematuria |
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What diagnostic test may help evaluate prostatic cyst and a paraprostatic cysts?
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Rads: contrast may help
U/S FNA |
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What are the surgical options for treating prostatic cysts and paraprostatic cysts?
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Resect or omentalize cyst
Omentalize Castrate |
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What technique is now used to treat canine prostate carcinoma?
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Partial prostatectomy via YAG laser to eliminate post op incontinence.
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What types of neoplasia affects the prostate of dogs?
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Adenocarcinoma
Transitional cell carcinoma |
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Where do prostatic neoplasias metastasize to?
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lymph nodes
bone bladder Rectum Muscles |
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What are the signs of prostate neoplasia?
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Tenesmus
Stranguria Hematuris Incontinence Rear limb weakness- mimcis (HD) |
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What diagnostic tests can help diagnose prostatic neoplasia?
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Rectal: firm, irregualr nodule, (pain)
xrays to check for mets U/S FNA |
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What are the indications for surgery of the spleen?
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Primary neoplasm
Splenic torsion w/ vascular thrombosis Severe trauma (rupture) Disseminated feline mastocytosis Uncontrollable IMHA |
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What type of hilus does the spleen have?
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Multipunctate
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What complications might arise if the vascular supply to the pancreas is damaged?
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Pancreatitis, necrosis
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What complications can result if the vascular supply to the greater curvature of the stomach is damaged?
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gastric necrosis
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A total splenectomy has a possible consequence of increased numbers of nucleated RBC's also called what?
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Howell Jolly bodies
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What other hematologic changes can be seen w/ a total splenectomy?
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Increased Platelet count
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Sub-clinical infections of what, might become clinical post splenectomy?
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E. Canis
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What is OPSI?
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Overwhelming post splenectomy infection
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When would you perform a partial splenectomy?
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To preserve splenic function when part of the spleen is destroyed or severely damaged
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What surgical instrument do you use to divide the spleen for a partial splenectomy?
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Doyen clamp- use to overlap mattress sutures to avoid bleeders
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What is the first step in performing a partial splenectomy?
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Ligate vessels near hilus, close to portion of spleen to be removed.
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Most surgical diseases of the spleen cause what kind of geometric change to the spleen?
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Symmetrical or Assymmetrical (more serious) splenomegaly
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A spleen that is normal in shape but is enlarged is considered to be what?
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Symmetrical splenomegaly
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What conditions cause increased cellularity, resulting in splenomegaly?
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Extramedullary hematopoiesis
Neoplasia Intravascular disease |
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What type of tumor causes splenomegaly in cats?
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Mast cell tumor
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Give an example of an intravascular disease that can cause splenomegaly?
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Ehrlichiosis
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Asymmetric splenomegaly can be caused by which types of neoplasia?
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Hemangioma
Hemangiosarcoma |
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What are some other causes of asymmetrical splenomegaly?
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Benign splenic hypertrophy
Trauma leading to hematomas |
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What are the tests that are conducted for the clinical assessment of splenomegaly?
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Abdominal palpations
Rads & U/S- ground glass appearance CBC/platelets Biopsy |
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What are siderotic plaques?
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Deposition of minerals (iron and calcium) on the surface of the spleen
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Is siderosis in dogs a condition to be concerned with?
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No, normal change in aging dogs.
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Primary splenic neoplasia includes what?
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Hemangioma
Hemangiosarcoma Fibrosarcoma Lymphosarcoma |
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A hemangiosarcoma arises from where?
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Vascular endothelium
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What is the most common splenic neoplasm?
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Hemangiosarcoma
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What age of dogs do hemangiosarcomas tend to manifest in?
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older, 9-10 years
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What are the sites of early metastesis with hemangiosarcoma?
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Liver
Omentum Lymph nodes |
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25% of dogs w/ splenic hemangiosarcoma have a concurrent lesion where?
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Cardiac hemangiosarcoma
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What are the clinical signs associated with hemangiosarcoma?
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Weakness, fatigue
Enlarged abdomen Vague gastrointestinal signs Abdominal discomfort Sudden collapse |
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What radiographic signs might you see in a case of splenic hemangiosarcoma?
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Cranial-ventral spherical mass
Displacement of viscera Free fluid in the peritoneum (hemoperitoneum) |
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How do you auscultate the abdomen for free fluid?
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Listen on 1 side, tap on the other.
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What are the treatment options for hemangiosarcoma?
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IV Blood
Fluid replacement Splenectomy |
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What is the prognosis of an animal with hemangiosarcoma or hemangioma?
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Hemangiosarcoma- Poor
Hemangioma- guarded to poor |
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Splenic nodular hyperplasia is usually an incidental finding. What does it cause?
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Unnecessary splenectomy
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What is splenic torsion?
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Rotation on the vascular pedicle
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What causes the splenic congestion in a case of torsion?
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Venous occlusion, sequestration of RBC's.
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What breed types are susceptible to splenic torsions?
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large and giant breed dogs, male or female
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Splenic torsion may present in what two forms?
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Acute
Sub-acute |
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What are the clinical signs of an acute splenic torsion?
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-physical discomfort
-salivation, gagging, retching -tachycardia, tachypnea -cardiovascular collapse, shock |
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What DDX's must be considered when presented with acute splenic torsion?
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GDV
Rupture & hemmorrhage from neoplasm Intestinal strangulation/mesenteric torsion Pancreatis Peritonitis Torsion of uterus or intraabdominal testicle Poisoning |
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What classic posture does a dog presenting w/ pancreatitis take?
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Praying position
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What is the treatment for acute splenic torsion?
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CV resuscitation- for shock treatment
Splenic Repositioning if no thrombosis in vessels. Splenectomy & gastropexy |
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What is the presentation of a dog with sub-acute splenic torsion?
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Vague, abdominal discomfort
Lethargy, anorexia, occasional retching Tachycardia, tachyopnea, hyperthermia Variable enlargement of abdomen |
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What is the treatment for sub-acute splenic torsion?
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Repositioning of spleen
Splenectomy Gastropexy |
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Traumatic splenic injuries can include can include what?
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Severe (lacs, extensive crushing)
Moderate (lacs, vessel disruption) Mild (small hematomas) |
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What radiographic changes are seen in cases of splenic trauma?
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Loss of detail- hemoperitoneum
Visceral displacement- hematoma on spleen may be large. Small or irregular spleen |
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The severity of clinical signs in a case of splenic trauma are dependent on what?
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Rate and volume of blood loss.
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Severe blood loss could result in what condition?
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Hypovolemia & shock
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Splenic hemorrhage may have what appearance radiographically?
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Ground glass
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What method is used to confirm splenic traumas that are 97% accurate?
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DPL- diagnostic peritoneal lavage
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What are the treatment options for splenic trauma?
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Blood or fluid replacement
Partial splenectomy Total splenectomy |
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Why are different surgical techniques needed for the liver?
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Tissues are friable
Difficult hemostatis Biliary leaks |
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Which system supplies 4/5 of the blood flow to the liver?
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Portal system, under low pressure
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Is the arterial system of the liver under high or low pressure and what artery does this system branch off of?
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High
Hepatic artery |
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When do clinical signs of liver disease manifest?
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When the disease is in advanced stages.
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Hepatic failure can affect many other body systems such as what?
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CNS
Kidney Liver Intestines Heart Coagulation Wound Healing |
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In giant breeds, what structure is sometimes mistaken for the liver?
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Falciform ligament
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Biliary obstruction alters the absorption of what ion?
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Potassium
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Which anaerobic flora is a natural inhabitant of the liver?
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Clostridium sp.
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What type of antibiotics is suggested when dealing the liver?
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Prophalactic Abs.
Ampicillian Metronidazol- specific for clostridium Cephalosporins |
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What is the surgical approach to the liver?
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Ventral midline & paracostal
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What is the Pringle Maneuver?
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Used to treat hepatic hemorrhage:
occludes the portal triad (portal vein, hepatic artery, common bile duct) for up to 20 mins. |
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What are the approaches to hepatic biopsy?
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Percutaneous
Transthoracic Transabdominal Laporroscopy Otoscope Celiotomy |
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What is the term for a closed cavity that is filled w/ pus within the hepatic parenchyma?
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Hepatic abscess
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What is a hepatic cyst?
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A closed cavity covered by secretory epithelium (filled w/ fluid)
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What are the clinical signs of hepatic abscess?
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Anorexia
Lethargy Weight Loss Intermittent Abdominal pain |
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What are the clinical signs of a hepatic cyst?
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Asymptomatic
Abdominal distension Secondary infection behave like an abscess. |
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What is the best method to demonstrate cavitary lesions of the liver?
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U/S
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Why must you be careful in performing U/S guided biopsy lesions?
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Diffuse peritonitis
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What are the surgical treatments for cavitary lesions of the liver?
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Partial hepatectomy
Ab's for 7-10 days |
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In performing a total hepatic lobectomy, what type of tourniquet is used?
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Rummel tourniquet
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How much of the livercan be removed and still have function?
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80%
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What type of post op care is needed after hepatic surgery?
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Antibiotics
Pain control Enteral nutrition thorough monitoring Slow metabolism Slow recovery |
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What complications can be encountered post hepatic surgery?
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Hemorrhage
Bacti proliferation biliary proliferation sepsis portal hypertension Ascites coagulopathy |
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Neoplasias make up what % of hepatic tumors?
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1%
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What are the primaryhepatocellular tumors?
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adenomas
carcinomas |
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What is the primary type of cholangiocellular tumors?
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carcinomas
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The liver is not a common site for primary tumors but is a common site for what?
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Metastasis
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What are the clinical signs of primary neoplasia?
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Lethargy
Weakness Anorexia Weight loss Vomits |
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What are the signs of secondary neoplasia/
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Variable
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What is the main cause of extrahepatic biliary obstruction in cats?
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Pancreatic pathology
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When would surgery be indicated for the extrahepatic system?
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Obstruction
Trauma |
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What is a type I, II and III obstruction?
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I- Emphysematous (Necrotizing)
II- Acute III- Chronic |
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What is the mortality rate of cholecystitis?
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39%
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What are the clinical signs of cholecysitis?
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Vomiting
Anorexia Fever Abd pain jaundice |
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What are the consequences of cholelithiasis?
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bacterial infection
Biliary stasis Excessive mucinous production by the gallbladder |
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Which dog signalment are most susceptible to cholelithiasis?
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Female, adult, small breeds
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What classical sign of cholelithiasis can be seen on U/S?
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Kiwi sign- gallbladder mucocele
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When is cholelithiasis treated?
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Only when clinical signs are seen.
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What is the term for an opening into the gallbladder?
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Cholecystotomy
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What is the term for the removal of the gallbladder?
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cholecystectomy
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What is the term for creating an opening in the common bile duct?
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Choledochtomy
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Biliary salts are a mild irritant and are sterile unless associated with what disease?
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Hepatic disease
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What is the survival rate of biliary peritonitis and septic biliary peritonitis?
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Biliary Peritonitis- 46%
Septic- 27% |
