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SAM II > Exam 1 > Flashcards

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
Q

Struvite Therapy

A

Dietary

Hills s/d for 3 months

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26
Q

What breeds are predisposed to CaOx

A 
Schnauzer
Shih tzu
Mini poodle 
Yorkie
Bichon
Lhasa apso
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27
Q

Characteristics of CaOx

A

Spiny
Rarely cause obstruction
Very radiodense for size

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28
Q

Treatment for CaOx

A

Therapy for hypercalcemia

Surgical/lithotripsy/cytoscopy

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29
Q

Prevention for CaOx

A 
Diet + water
Hills U/D or Waltham S/O 
Thiazides diuretics- hydrochlorothiazide 
Potassium citrate (urinary alkalizer) 
Vitamins, avoid vitC and D
30
Q

Signalment for ammonium irate and xanthine stones

A

Dalmatian, Black Russian Terrier

Male dogs

31
Q

How does hepatic dx (PSS, cirrhosis) lead to urate crystals?

A

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
Q

T/F urate grows in a lower ph

A

True

33
Q

Urate therapy

A

Diet- low protein U/D
Xanthine oxidase inhibitors (only for Dalmatians), allopurinol -> decreases uric acid production
Tx hepatic dysfunction

34
Q

Cystine calculi is it common and what breeds

A

Rare, 1-8%

Australian cattle dogs, dachshunds, Newfoundland, Bulldogs

35
Q

Why do dogs get cystine calculi?

A

Tubular carrier proteins to reabsorb cystine is defective

36
Q

How do you dx cystine stones and what are the tx’s

A
  • Can see in rads but are hard to visualize in large breeds

- Thiol drugs have risks (D-penacillamin)

37
Q

How can you prevent cystine stones and what’s the risk?

A

Alkalinize the urine by feeding a low protein diet (like UD)
Risks: developing DCM in large breeds

38
Q

What are calcium phosphate uroliths usually secondary to?

A

Primary hyperparathyroidism

39
Q

What do you do if you discover a dog is having a relapse UTI?

A

Recommend MDB, rads and US of bladder

40
Q

What about cat anatomy can cause feline idiopathic cystitis?

A

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
Q

Therapy for idiopathic FLUTD

A

Make the environment stress free

42
Q

What drugs can you give for idiopathic FLUTD

A

Analgesics
Prazosin
Feliway spray

43
Q

T/F all intact male dogs with UTI have prostatitis

A

True

44
Q

Prostatitis antibiotics

A

Fluroroquinolones, doxy, trimethoprim, rifampin, erythromycin, cirpro, olfoxacin, norfloxacin, levofloxacin

45
Q

T/F Neutered dogs are less likely to have prostatic carcinoma

A

False

Not related to neuter status

46
Q

Rx for UMN bladder (detrusser areflexia with sphincter hyperreflexia)

A

Baclofen

Antispasmodic, acts as an inhibitory neurotransmitter, skeletal muscle relaxant

47
Q

Rx for LMN bladder (detrusser areflexia and sphincter areflexia)

A

Express bladder 3-4x a day, bethanecol

48
Q

Rx for Detruser-sphincter reflex dysseynergia

A

A-adrenergic blockers (phenoxybenzamine)

49
Q

What is detrusser atony and how do you tx it

A

Large flaccid bladder, from overfill, neuro exam normal

Tx: manual express

50
Q

What is urge incontinence, CS, how do you confirm and Rx

A

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
Q

What is the most common etiology for urinary incontinence

A

Urinary sphincter mechanism incompetence

52
Q

Typical signalment of urinary sphincter incompetence

A

Spayed bitch

Large breed

53
Q

What are the 2 theories about urinary sphincter incompetence

A

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
Q

Indications for urethral pressure profiles

A

Urethral sphincter mechanism incompetence
Detrusor instability
Reflex dysseynergia
Neurogenic abnormalities

55
Q

T/F Older, overweight tail docked bitches are more likely to be incontinent

A

True

56
Q

Treatment for Urinary Sphincter Incompetence

A

PPA
Ephedrine
Estriol

57
Q

How good is Urethral Bovine Cross Linked Colalgen Implation as a tx for urinary incontinence

A

68% of 40 dogs were continent for a median of 8 months and client satisfaction was 100%

Pretty good

58
Q

Accepted surgical techniques for urinary incontinence

A

Colposuspension and urethropexy

59
Q

What causes sphincter muscle incompetence?

A

Decreased estradiol (remember spayed bitches are more likely to have) -> decreased type I muscle fibers and expression of a-1 receptor

60
Q

T/f ephedrine has a similar effect to PPA but with cardiovascular side effects

A

True

61
Q

T/f dogs treated with pseudo ephedrine had a poorer outcome to dogs treated with PPA

A

True

62
Q

Clinical exam of ectopic ureter

A

Wet coat
Inflamed perineum
Excoriation X

63
Q

Tx of choice for ectopic ureters

A

Cystoscopic laser ablation

64
Q

Do you ever do a corneal grid in a cat?

A

NOOOOO

65
Q

Tell me about pannus

How would you tx it?

A 
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
Q

Corneal dystrophy is non painful except for which breed?

A

Sheltie

67
Q

What is Calcium Keratopathy?

A

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
Q

Tell me about Eosinophilic Keratitis and tx

A

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
Q

Immune Keratitis

A

Inflammatory
Potential autoimmune basis
Local immunosupression for tx
Topical steriods +/- immunomodulator (tacrolimus or cyclosporine)

70
Q

Bulbous Keratopathy

A 
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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