Endoscopy and Urine sampling Flashcards
What is Urethroscopy?
Looking into the urethra with an endoscope
What is Cystoscopy?
Looking into the bladder with an endoscope
What are the two types of cystoscopy?
Transurethral cystoscopy
Prepubic percutaneous cystoscopy (Puncture the skin eg if there is a blockage)
What endoscope would you use in a bitch bladder?
Rigid or semi-rigid endoscopes with sheath
What endoscope would you use in a male dog bladder?
Flexible endoscopes
What must we do to view the detail of the urethra?
Fluid irrigation (with saline)
What will we carry out in a full urinalysis?
Macroscopic examination (colour, transparency/turbidity) Microscopic examination (preferably undertaken by experienced personnel) Chemical examination (dipstick tests and urine specific gravity) Microbiological examination by culture
How can we collect urine?
Midstream Sample Urine (MSSU) - grab urine from peeing animal
Cystocentesis
Catheterisation
What are the advantages of Midstream Sample Urine (MSSU)?
Easy (generally) and may be left to owner (naturally voided - dog)
Non-traumatic
Use of modified litter tray using glass beads can be used for initial screening of cats
How do we manually express the bladder for a MSSU?
Manually compressing the bladder may induce the micturition reflex
More effective in small dogs and cats
Bladder must contain reasonable volume of urine
Direct compression towards neck of bladder
What are the disadvantages of MSSU?
Risk of non-compliance, resentment (dog)
Need to avoid residue at end of urination, i.e. bacteriology required
Risk of haematuria and bladder rupture with manual expression
Variable volume
Risk of faecal contamination/sample unsuitable for culture
What are the advantages of cystocentesis?
Quick with no need to wait for spontaneous urination
Aseptical collection with no urethral contamination (so ideal for culture)
Easy to perform when bladder moderately distended and patient (dog or cat) adequately restrained
Lower risk of iatrogenic haematuria (cf. catheterisation)
What are the disadvantages of cystocentesis?
Requires some experience
Needs adequate volume of urine in bladder
Iatrogenic micro-/(macro-)scopic haemorrhage possible
Contraindicated if:
bladder severely diseased – risk of rupture or clotting problems
What are the advantages of catheterisation?
No need to wait for spontaneous micturition
Relatively, rather than absolutely, free of risk of bacterial contamination
Usually an ample sample volume
What are the disadvantages of catheterisation?
Some experience and a suitable speculum/light source may be needed (bitch)
Risk of iatrogenic infection, haematuria +/- mucosal damage (with some modification of urine cytology findings)
Cost of equipment and disposable catheter