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Exam 1 Flashcards

1
Q

Causes of LUTD

A 
Bacterial
&Roll this
Interstitial cytitis
Neuro dz
Secondary LUTD
Neoplasia
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2
Q

What is urethral profilometry?

A

Measures the pressures in all the different sides of the bladder and urethra

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3
Q

Causes of Hematuria

A

Renal
LUTD
Reproductive
Systemic (bleeding disorder, hypertension, hyperviscosity)

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4
Q

Are cats or dogs more likely to get UTIs? What sex?

A

Dogs

Females

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5
Q

Pyuria is defined as

A

> 5 WBC/hpf

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6
Q

What are normal host defenses against LUTD?

A 
Normal micturition
Anatomy 
Mucosal defenses
Urine properties
Systemic immune system
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7
Q

What are the microbial factors for LUTD?

A

Adherence
Enzymes, hemolysis, urease
Protective (capsules)
Resistance factors

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8
Q

What is the most common microbial isolate for LUTD?

A

E. coli

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9
Q

T/F most LUTD infections are two or more organisms

A

Wrong! Most are single species

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10
Q

Is hematogenous or ascending LUTD infections more common?

A

Hematogenous

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11
Q

What’s the therapy for uncomplicated UTI?

A

Empirical if the O can’t afford culture
-TMS (excreted in kidneys and concentrate in urine)
Amoxicillin
Cephalosporins
Duration: 10-14 days or high dose short duration enrofloxacin (dogs only)

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12
Q

What is a reinfection?

A

C&S positive >7 days after last tx course

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13
Q

What is a super infection?

A

C&S positive at day 7 after starting antibiotics

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14
Q

What is a relapse UTI?

A

Same organism/strain, 7 days after last treatment course

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15
Q

When do you do urine cultures for relapse UTIs?

A 
Pre therapy 
During therapy (7 days after starting therapy) 
Post therapy (7 days after done)
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16
Q

What is the last resort for recurrent UTI (reinfection)

A

Prophylactic therapy

SID bedtime admin Nitrofuratoin 30-50% or original dose

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17
Q

What are some alternative therapies for Recurrent UTIs

A

Cranberry extract (doesn’t do shit)
Probiotics
Ploysulfated glycosaminioglycans

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18
Q

What bug causes fungal UTIs and what are the underlying dz’s associated with it?

A

Candida

Diabetes and excess glucocorticoids

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19
Q

T/F Crystalluria means the urine has been supersaturated

A

False

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20
Q

What is the max urolith size when doing voiding urohydropropulsion in a female dog?

A
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21
Q

What breeds are struvites common in

A 
Schnauzer
Shih tzu
Cocker
Bichon 
Lhasa
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22
Q

What are struvites crystals and where do they normally live?

A

Magnesium ammonium phosphate hexahydrate

Mainly lower urinary tract

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23
Q

What normally causes struvites in dogs and cats?

A

Dogs- UTIs, breed

Cats- diet

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24
Q

Characteristics of struvites

A

Big
Smooth
Radiodense but not as dense as CaOx

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25
Struvite Therapy
Dietary | Hills s/d for 3 months
26
What breeds are predisposed to CaOx
``` Schnauzer Shih tzu Mini poodle Yorkie Bichon Lhasa apso ```
27
Characteristics of CaOx
Spiny Rarely cause obstruction Very radiodense for size
28
Treatment for CaOx
Therapy for hypercalcemia | Surgical/lithotripsy/cytoscopy
29
Prevention for CaOx
``` Diet + water Hills U/D or Waltham S/O Thiazides diuretics- hydrochlorothiazide Potassium citrate (urinary alkalizer) Vitamins, avoid vitC and D ```
30
Signalment for ammonium irate and xanthine stones
Dalmatian, Black Russian Terrier | Male dogs
31
How does hepatic dx (PSS, cirrhosis) lead to urate crystals?
Purines from the diet (xanthine, urate) are normally processed in the liver, if there's liver dz it can do that -> 86% ammonium urate crystals
32
T/F urate grows in a lower ph
True
33
Urate therapy
Diet- low protein U/D Xanthine oxidase inhibitors (only for Dalmatians), allopurinol -> decreases uric acid production Tx hepatic dysfunction
34
Cystine calculi is it common and what breeds
Rare, 1-8% | Australian cattle dogs, dachshunds, Newfoundland, Bulldogs
35
Why do dogs get cystine calculi?
Tubular carrier proteins to reabsorb cystine is defective
36
How do you dx cystine stones and what are the tx's
- Can see in rads but are hard to visualize in large breeds | - Thiol drugs have risks (D-penacillamin)
37
How can you prevent cystine stones and what's the risk?
Alkalinize the urine by feeding a low protein diet (like UD) Risks: developing DCM in large breeds
38
What are calcium phosphate uroliths usually secondary to?
Primary hyperparathyroidism
39
What do you do if you discover a dog is having a relapse UTI?
Recommend MDB, rads and US of bladder
40
What about cat anatomy can cause feline idiopathic cystitis?
Mucosa - altered gags cause increased ion leakage across urothelium Submucosa- mast cell presence SNS nervous system abnormalities and C pain fibers- substance P in these cats is higher, unregulated Capsaicin (activated C fiber vanilloid receptors) in these cats
41
Therapy for idiopathic FLUTD
Make the environment stress free
42
What drugs can you give for idiopathic FLUTD
Analgesics Prazosin Feliway spray
43
T/F all intact male dogs with UTI have prostatitis
True
44
Prostatitis antibiotics
Fluroroquinolones, doxy, trimethoprim, rifampin, erythromycin, cirpro, olfoxacin, norfloxacin, levofloxacin
45
T/F Neutered dogs are less likely to have prostatic carcinoma
False | Not related to neuter status
46
Rx for UMN bladder (detrusser areflexia with sphincter hyperreflexia)
Baclofen | Antispasmodic, acts as an inhibitory neurotransmitter, skeletal muscle relaxant
47
Rx for LMN bladder (detrusser areflexia and sphincter areflexia)
Express bladder 3-4x a day, bethanecol
48
Rx for Detruser-sphincter reflex dysseynergia
A-adrenergic blockers (phenoxybenzamine)
49
What is detrusser atony and how do you tx it
Large flaccid bladder, from overfill, neuro exam normal | Tx: manual express
50
What is urge incontinence, CS, how do you confirm and Rx
Detrusser contraction during storage of urine or Low compliance of the detrusor muscle CS: Pollakiuiria, stranguria and dysuria Confirm with cystometrography Rx: anticholinergic- oxybutynin, imipramine, or dicyclomine
51
What is the most common etiology for urinary incontinence
Urinary sphincter mechanism incompetence
52
Typical signalment of urinary sphincter incompetence
Spayed bitch | Large breed
53
What are the 2 theories about urinary sphincter incompetence
Pressure transmission theory: urethral neck not in abdominal cavity so not subjected to the same pressures and intraabdominal bladder Hammock theory: Anatomic structures maintaining the position of the bladder and urethra are abnormal
54
Indications for urethral pressure profiles
Urethral sphincter mechanism incompetence Detrusor instability Reflex dysseynergia Neurogenic abnormalities
55
T/F Older, overweight tail docked bitches are more likely to be incontinent
True
56
Treatment for Urinary Sphincter Incompetence
PPA Ephedrine Estriol
57
How good is Urethral Bovine Cross Linked Colalgen Implation as a tx for urinary incontinence
68% of 40 dogs were continent for a median of 8 months and client satisfaction was 100% Pretty good
58
Accepted surgical techniques for urinary incontinence
Colposuspension and urethropexy
59
What causes sphincter muscle incompetence?
Decreased estradiol (remember spayed bitches are more likely to have) -> decreased type I muscle fibers and expression of a-1 receptor
60
T/f ephedrine has a similar effect to PPA but with cardiovascular side effects
True
61
T/f dogs treated with pseudo ephedrine had a poorer outcome to dogs treated with PPA
True
62
Clinical exam of ectopic ureter
Wet coat Inflamed perineum Excoriation X
63
Tx of choice for ectopic ureters
Cystoscopic laser ablation
64
Do you ever do a corneal grid in a cat?
NOOOOO
65
Tell me about pannus | How would you tx it?
``` Autoimmune dz Common in GSD and greyhounds Exacerbated by UV light and altitude Both eyes are affected Tx: topical or sub conjunctival corticosteroids, tacrolimus or cyclosporin ```
66
Corneal dystrophy is non painful except for which breed?
Sheltie
67
What is Calcium Keratopathy?
Old dogs get calcium growing on their cornea. It's usually central and painful with variable vascularization. Tx: medical- lube, topical ab, contacts, EDTA Surgical- diamond bur/needle/TCA, conjunctival graft
68
Tell me about Eosinophilic Keratitis and tx
Feline, usually concurrent FHV, plaques admixed with edema and vessels, usually temporal, may or may not have ulceration, dx via cytology- eosinophils are diagnostic Tx with topical steriods, possibly antiviral or oral megasterol acetate (side effects DM, mammary enlargement)
69
Immune Keratitis
Inflammatory Potential autoimmune basis Local immunosupression for tx Topical steriods +/- immunomodulator (tacrolimus or cyclosporine)
70
Bulbous Keratopathy
``` Breakdown of endothelium results in profound edema Unknown etiology Cats Topical NaCl ointment The only time she advocates a TE flap ```

SAM II (9 decks)

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