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Small Animal Medicine 1 > 12. Examination of the urinary system > Flashcards

12. Examination of the urinary system Flashcards

1
Q

what is the parts of the urinary system?

A 
1. Upper urinary tract = examination
of the kidneys
2. Lower urinary tract
– Bladder
– Urethra
– Prostate (male dogs)
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2
Q

What are some specific signs in advanced cases?

A
  • Halitosis (foetor ex ore) → uremic breath
  • Uremic ulcers
  • Abnormal palpation of the kidneys
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3
Q

What are some signs we look for in the physical examination?

A 
• Poor body condition
• Dehydration
• Anaemia
• Periodontal, oral diseases
- Gingivitis, tooth tartar, halitosis, ulcers
• Palpation of the kidneys
- Small, firm kidneys
- Normal findings
- Enlarged kidneys
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4
Q

Are both kidneys palpable in the cat?

A

yes

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5
Q

Are both kidneys palpable in the dog?

A

only the left one

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6
Q

Description of the palpatory findings of abdominal organs:

A

Location, size, shape, relation to their neighborhood,

painfulness, surface, consistency, structure, (symmetry)

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7
Q

What can be the cause of enlarged kidneys?

A
  • renal diseases
  • kidney tumors
  • hydronephrosis
  • polycystic kidney disease (PKD)
  • perinephric pseudocyst (cats)
  • viral infections (cats)
  • PSS (dogs)
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8
Q

What can be the cause of smaller kidneys?

A
  • renal fibrosis

- renal dysplasia

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9
Q

What can be some causes of painful kidneys?

A
  • acute nephritis
  • kidney stones
  • tumor
  • pyelonephritis
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10
Q

What do we check in glomerular function?

A
  1. GFR

2. Urinary protein

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11
Q

How do you check the GFR?

A 
• Urea, creatinine
• SDMA
• Clearance techniques
Endogenous (creatinine) –
Exogenous
(creatinine, inulin, iohexol, isotopes)
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12
Q

How do you check the urinary protein?

A 
Dipstick
sulpho-salicylic acid test
Urine protein/creatinine ration (UPC)
microalbuminuria?
sediment !!!
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13
Q

Dips stick is

A

unreliable !!!

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14
Q

what are the laboratory evaluation methods of tubular function?

A

• Specific gravity

  • Hypo-1007
  • Iso-(1008-1012),
  • Hyperstenuric: dogs above1030, cats above 1035
  • Cats often able to concentrate urine despite having kidney disease

• Glycosuria, mild proteinuria, urine sediment (casts, tubular cells)

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15
Q

Diagnosing kidney disease:

4 important steps:

A
  1. Fasted, well hydrated animals (rehydrated if needed) repeated samples:
    Urea, Creatinine, SDMA
2. Urinalysis (2-3x)
– Specific gravity (refractometry)
– Presence of proteinuria
- Measure UPC (unless a hyperstenuric urine dipstick negative)
– Urine sediment
  1. Ultrasonography
  2. Cytology, biopsy in selected cases
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16
Q

Problems related to micturition (urination), urine quality, incontinence =

A
  • Dysuria
  • Stranguria
  • Hematuria
  • Pollakiuria
  • Incontinence
  • Periuria
17
Q

What are the first steps in case of lower urinary tract problems?

A

• Urinary bladder size, bladder tone, compressibility of the bladder.
• Urethral patency? (Catheterization in case of suspected obstruction)
+ complete physical exam
• Other diseases, systemic signs?
• PU/PD ?
• dehydration?

18
Q

How do you examine the urinary bladder?

A
  • inspection

- abdominal palpation

19
Q

Description of the palpatory findings of the urinary bladder:

A

location, size = degree of distension, shape, painfulness, surface, (wall thickness, bladder content)

20
Q

Abnormal findings of the urinary bladder:

A 
• Dilation
-Acute (urethral obstruction) overdistended, turgid, firm urinary bladder that cannot be expressed
• Chronic (innervation problem) flaccid
• Pain - cystitis, stones
• Abnormal surface– tumors
• Thickened wall - cystitis, tumor
21
Q

Additional examination of the lower urinary tract:

A
  • Rectal examination (to palpate the prostate in male dogs)
  • Catheterization (in case of suspected urethral obstruction)
  • Diagnostic imaging (US, Radiography)
  • Urinalysis (always needed!!!)
22
Q

what are the purpose of the different types of radiography?

A

Plain film: stone in the urethra?, in the ureters?
– Non-obstructive urethral stones may be missed during catherization

Contrast exams:
– to visualize the ureters (excretory urography)
– to detects urethral pathologies(retrograde)
– If no access to ultrasound

23
Q

How do you examine the female urethra?

A
  • vaginal examination
  • inspection (opening of the urethra)
  • palpation
  • catheterization
24
Q

How do you examine the male urethra?

A

Rectal examination (dogs)

  • palpation (pelvic part) examination of the perineum
  • inspection (perineal part)
  • palpation

Examination of the prepuce and penis

  • inspection (penile part and opening of the urethra)
  • palpation (penile part and opening of the urethra)
  • catheterisation
25
Q

How do you examine the prostate?

A

• Palpation (abdominal, rectal-digital)
– size, shape, symmetry, consistency, pain
• Imaging methods (X-ray, US)
• Urinalysis
• Examination of prostatic fluid (prostatic massage)
– Examination of semen
• Cytology, biopsy

Small Animal Medicine 1 (22 decks)

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