diagnostic techniques Flashcards
causes of intraurethral obstruction
- calculi
- tumours
- inflammatory disease
- foreign bodies
extraurethral causes of obstruction cause
urethral compression
neurogenic causes of urinary obstruction can be (2)
- lover motor neurone (after L5)
- upper motor neurone
lower motor neurone cause of urinary abstruction cause bladder to be (3)
- flaccid
- overdistended
- easy to express
upper motor neurone disease cause bladder to be (3)
- firm
- tense
- difficult to express
functional urethral obstruction also known as
reflex dysynergia
define reflex dysynergia
- rare condition seen mainly in dogs
- dysfunction with urethral relaxation not occurring as not receiving sense to urinate
3 clinical signs reflex dysynergia
- dysuria
- pass small spurts urine
- large residual volume
managment reflex dysynergia
medical
how obstructive uropathy causes azotemia (4)
- increase pressure in bowman’s space
- GFR falls
- decreased renal blood flow
- protein enters filtrate
bladder enlargment due to overdistension can cause (4)
- ischaemia
- oedema
- haemorrhage
- mucosal sloughing
obstruction and progression times
- 48 hours - CNS depression, vomiting and decreased food and water intake
- 72 hours - death
treatment obstruction (3)
- IV fluids to dilute potassium
- calcium gluconate
- relieve obstruction
cystocentesis dog with obstruction urinary
- avoid as can cause septic peritonitis
- if have to do then empty bladder completly
post unblocking urinary obstruction care
- keep up with ins and outs using IV fluids
- may get hypokalaemia so supplement
define retrograde hydropulsion
pushing calculi from urethra back into bladder
how to retrograde hydropulsion (3)
- get a person to block urethra with a finger through the anus
- fill urethra with saline while blocking distal urethra
- get person to let go and pressure of fluid should push stones into bladder
define cystotomy tube
tube placed across the body wall and into bladder to drain into a bag
define urethrostomy
permanent surgical opening into the urethra to divert urine flow
urinary incontinence can be (2)
- neurogenic
- non-neurogenic
common cause of incontinence dogs
urethral sphincter mechanism incompetence
urethral sphincter mechanism incompetence can be
- acquired
- congenital
urethral sphincter mechanism incompetence clinical signs
usually urinary leaking when recumbent
ureteral ectopica can be (cause)
- congenital
- aquired
ureteral ectopica appearance (3)
- unilateral or bilateral
- single, double or elongated opening
- intramural or extramural
define intramural ectopic ureters
ureter attaches in normal place then runs through the bladder wall to open elsewhere
define extramural ectopic ureter
ureter attaches and opens in same funny place
extramural ectopic ureter seen more in
cats
intramural ectopic ureter seen more in
dogs
ureteral ectopica 4 clinical signs
- continuous dribbling of urine
- severe scalding
- associated with urinary tract infections
- may have concomitant sphincter mechanism incompetence
genitourinary dysplasia is
congenital abnormality affecting vaguba abd urethra
bladder atony is usually secondary to
bladder distansion
L1-4 nerves supply
sympathetic stimulation along hypogastric nerve to beat and alpha receptors
where beta receptors in bladder
in bladder main body cause relaxation
where alpha receptors in bladder
in bladder neck cause constriction
S1-3 nerves supply
- somatic stimulation via the pudendal nerve
- parasympathetic stimulation via pelvic nerve
action phenoxylenzamine and diazepam
reduce urethral tone
bethanecol actions
improves bladder tone and contractility
main clinical signs hypersomatotrophism
acromegaly
steps of hypersomatotrophism
uncontrolled production of growth hormone results in increased IGF1
IGF1 causes
tissue proliferation and hyperplasia
cat main cause hypersomatotrophism
pituitary tumour
dogs cause of hypersomatotrophism
increased GH secretion from mammary tissue
juvenile hypersomatotrophism clinical signs
- increased length of long bones untill growth plate fuse
- once growth plates have fused changes are restricted to soft tissues and flat bones
hypersomatotrophism and diabetes
growth hormone is an insulin antagonist so you can get insulin intolerance and diabetes mellitus
5 clinical signs hypersomatotrophism
- PU/PD
- weight gain
- thick set facial features
- increased intradermal spaces
- hepatomegaly and cataracts due to poorly controlled diabetes mellitus
4 diagnosis hypersomatotrophism
- serum GH estimation - but not widely available
- serum IGF1 estimation - more useful in dogs
- serum progesterone levels and abdominal ultrasound in dogs
- CAT or MRI scan for cats
tx hypersomatotrophism dogs
remove progesterone influence
4 tx hypersomatotrophism cats
- dopamine agonists
- local irradiation
- somatostatin analogues
- hypophysectomy and replacement hormones
hyposomatotorophism main signs
dwarfism
hyposomatotrophism pathogenesis
decreased GH secretion anlso possibly decreased TSH and gonadotrophin secretion
4 clinical signs hyposomatotrophism
- small stature
- immature hair coat
- non chondrodystrophic dwarfism
- persistent oestrus or infertile males
3 diagnosis hyposomatotrophism
- serum GH estimation - relatively unavailable
- serum IGF1 estimation in dogs
- delayed growth plate closure
3 things that cause primary PD
- hyperadrenocorticism
- hyperthyroidism
- hepatic encephalopathy
diabetes insipidus can be (2)
- central
- nephrogenic
central diabetes insipidus due to
decreased ADH secretion
3 causes of decreased ADH secretion
- idiopathic (common)
- secondary to expanding mass lesion in brain
- secondary to congenital abnormality
urine in central diabetes insipidus
persistently and unremittingly hyposthenuric
define nephrogenic diabetes insipidus
nephrons are ADH resistant
clinical signs diabetes insipidus
- PD - usually over 200ml/kg/24hrs
- PU
6 diagnosis procedures diabetes insipidus
- specific gravity lower than 1.008
- routine biochemical screen to rule out any other cause
- hospitalise and observe water intake, if it decreases then it is primary PD
- water deprivation test shows inability to concentrate urine when dehydrated
- increase of specific gravity after desmopressin administration
- low dose dexamethasone suppression test to rule out hyperadrenocorticism
tx diabetes insipidus
desmopressin
parathyroid hormone secreted by
chief cells of parathyroid gland
why PTH releasd
low serum ionised calcium
5 PTH actions
increases calcium by
- decreaseing excretion
- ionising calcitriol production
- increasing calcium bone reabsorption
- increaseing calcium absorption in GIT
- increase phosphate excretion in urine
define PTHrP
- parathyroid hormone related peptide
- secreted by some neoplastic cells
calcitriol also known as (2)
- vit D
- 1,25 dihydroxychole calciferol
3 actions of calcitriol
- increase calcium absorption in GIT
- renal reabsorption of calcium
- mobilising calcium and phosphorus from bone
calcitonin when secreted
response to hypercalcaemia
where calcitonin from
C cells in thyroid gland
significant increases in ionised calcium can cause
small changes in total calcium
12 clinical signs hypercalcaemia
- PU/PD
- anorexia
- dehydration
- weakness/lethargy
- vomiting
- facial pruritis
- oral discomfort
- cardiac arrhythmias
- seizures
- twitching
- acute renal failure
- death
what is biologically active form of calcium
ionised calcium
high calcium and GFR
causes vasoconstriction of afferent arterioles so decreasing GFR and predisposing it to azotemia
dogs most common cause of hypocalcaemia
neoplasia
hypocalcaemia commonly associated with
low serum albumin
9 clinical signs hypocalcaemia
- tremors
- cramps
- stiff gait
- behavioural change
- panting
- hyperthermia
- tachycardia
- hypotension
- death
who most likely to develop urolith obstruction LA
early castrated males
what diet predisposes to urolith formation LA (4)
- high concentrate low rouphage as increases phosphate in blodd (by not recycling through git slaiva)
- high phosphate low calcium diest
- high Mg diest
- alkaline urine
most common urolith LA
struvite
where urolith obstruction occur in ruminants (2)
- urethral process small ruminents
- distal to sigmoid flexure of cattle
6 early clinical signs obstruction LA
- haematuria
- dysuria
- crystals on prepuce
- urine dribbling
- tail flagging
- colic signs
7 later clinical signs LA obstruction
- annorexia
- depresion
- preputial swelling
- abdominal distension
- recumbent
- seizures
- death
6 diagnosis urolith obsruction
- history
- azotemia
- hyperkalaemia
- hyponatraemia
- acidosis
- imaging
3 complications obstruction
- bladder rupture
- urethral rupture
- hydronephrosis
amyloidosis cattle accosiated with
- metritis
- mastitis
- pneumonia
enzootic haematuria define
chronic toxicity with ptaquiloside carcinogens found in bracken
3 clinical signs enzootic haematuria
- haematuria
- haemorrhagic cystitis
- anaemia
7 clinical signs umbilical infection
- fever
- malaise
- lethargy
- heat
- pain
- swelling
- discharge from umbilicus
umbilical arteries should be (size)
less than 1cm diameter
tx small (under 2cm) umbilical hernia
usually resolve around 2 months
difference bewteen umbilical infection and hernia
hernias arent painful
tx large umbilical hernias (over 2cm)
surgery
umbilical hernia bad if
strangulating
define patent urachus
where its been closed and then opened again
define persistne urachs
open from birth
LA specifica gravity in renal failure
1.008-1.014 as cant concentrate urine
8 clinical signs of bladder rupture
- azotemia
- hyperkalaemia
- hyponatraemia
- metabolic acidosis
- respiratory acidosis due to pressure on diaphragm
- straining to urinate
- abdominal distension
- ventral and preputial oedema
proteinuria is considered a
hallmark of glomerular disease
how much protein in urine is considered normal
trace or 1+
4 causes of proteinuria
- infection
- inflammation
- neoplasia
- haemorrhage
common quantification of proteinuria
- protein:creatinine ratio
- protein measurement divided by creatinine in urine
how detect bence jones proteins in urine
electrophoresis
what are bence-jones proteins
immunoglobulin light chains
4 categories of proteinuria
- pre-glomerular
- glomerular
- tubular
- post-glomerular
how pre-glomerular proteinuria
excess proteins getting through glomerulus so cant reabsorb
how glomerular proteinuria
increased glomerular capillary pressure causes more proteins shoved through
- relatively mild proteinuria
how tubular proteinuria
- mild proteinuria
- tubules do not reabsorb protein filtered by glomeruli
how post-glomerular proteinuria
- caused by inflammatory conditions of lower urinary tract or repro system
- most common cause is infection and urolithiasis
nephrotic syndrome presents with (4)
- significant proteinuria
- hypoalbuminaemia
- hypercholesterolemia
- oedema, ascites or pleural effusion
6 tx protein losing nephropathy
- identify and treat underlying disease process
- diet modification
- immunosuppressive drug therapy
- tx amyloidosis
- ACE inhibitors
- antithrombotic drugs
- antihypertensive drugs to decrease blood pressure
dietary modifications tx protein losing nephropathy (3)
- high quality but low quantity protein
- low sodium
- omega 3 fatty acid supplements
