Feline Lower Urinary Tract Dz Flashcards
What are potential etiologies of FLUTD?
Bacterial Uroliths Neoplasia Trauma Anatomical Behavioural Feline interstitial cystitis
What are risk factors for FLUTD?
Age (2-6yrs) Not enough litter boxes Mainly indoor Dry cat food Inactive Stress Obesity Seasonality Sediment Bacterial/viral infection
What changes occur in the mucosa and submucosa of the bladder that contribute to feline idiopathic cystitis?
Mucosa
- altered glycosaminoglycans excretion
- increased ion leakage across urothelium
Submucosa
-mast cells —> histamine release contributes to inflammation
What abnormalities occur with the SNS and pain fibers with feline idiopathic cystitis ??
Afferent sensory information - substance P (sesitizaiton)
C pain fibers activated by capsaicin that binds C-fiber vanilloid receptors
In what ways does stress contribute to feline idiopathic cystitis ??
Neural —> stress activates peripheral nerves (catecholamines) , hormones (cortisol), and immune complexes (pro-inflammatory cytokines)
Clinical signs of FLUTD?
Hematuria
Stranguria
Pollakiuria
Inappropriate urination
Palpate a large firm bladder
Inability to urinate (blocked) vs periuria
T/F: cytoscopy can be used to diagnosis Feline idopathic cystitis?
True
Areas of hemorrhage —> interstitial cystitis
Treatment for FLUTD??
Environmental enrichment is the only beneficial treatment
- Reduce stress (feliway/quite/dark)
- increase number of litter boxes
- water sources
- activity/ playing
Prazosin -> relaxes internal bladder sphincter (no EBM to show significant improvement)
Removal of obstruction (cath, IV fluids)
Dietary - avoid freq changes, wet food
What drugs therapy can aid in FLUTD treatment?
Analgesics-opioids
Prazosin
Questionable —> antihistamine, glycosaminoglycans, and diazepam/methocarbamol
What are potential diseases of the vagina?
Hemorrhage Vaginitis Hyperplasia Prolapse Neoplasia Persistent hymen
If you suspect a disease of the genital tract, what will your initial diagnostics include??
PE with vaginal speculum exam and rectal
Cytology
Imaging
Vaginoscopy
What effect does estrogen have on the vagina?
Hyperplasia —> can lead to prolapse
What types of neoplasia can be found within the genital tract??
Leiomyoma/leiomyosarcoma
Transmissible venereal tumor
What are diseases of the prostate?
Benign prostatic hyperplasia
Prostatic cysts (paraprostatic/prostatic)
Prostatitis
Neoplasia
Clinical signs of prostatic dz?
Fecal —> obstruction of pelvic inlet can cause blockage
Urnary —> stranguria
Systemic —> painful
Orthopedic / neurological —> pressure of sciatic nerve
What is the presenting complaint for prostatic disease?
Variable from asymptomatic to LUTD signs or difficult defecation, or systemically ill
You suspect genital disease in a male dog, what will your initial diagnosics include?
PE Rectal exam UA and culture CBC and biochem Imaging/met check Cytology -> cyst aspiration Microbial Biopsy/histopathology
What is benign prostatic hyperplasia ??
Normal aging change
Can cause constipation —> LUTD
Rectal finding
Risk of other prostatic disease
T/F: all intact male dogs with UTI have prostatitis?
True
Presentation of acute prostatitis ?
Sick animal
Painful
T/F: acute prostatitis is more common than a chronic prostatitis
False
Chronic > acute
What are usually the signs associated with chronic prostatic??
Recurrent UTI or preputial discharge
Usually non-painful
Systemically enlarged
What is the therapy for benign prostatic hyperplasia??
Surgical (orchidectomy)
Medical/chemical castrations -GnRH, gestagens
Therapy for prostatic cysts ?
Drainage
Marsupialize —> cutting a slit into cyst and suture the edge to form a continuous surface with the exterior surface
Therapy for prostatitis?
Antimicrobial —> flouroquinolones, doxycycline, TMS, rifampin, and erythromycin (penetrate prostate)
Surgery
T/F: prostatic carcinoma occurs only in intact dogs
False
Not related to neuter status
What is usually the presentation of an animal with prostatic neoplasia??
Painful git with pain in sacrum
Prostate palpable in neutered dog
Possible asymmetry
Sublumbar LN may be palpable
Local invasion
High rate of metastasis—> LN, lungs, vertebrae
Treatment for prostatic neoplasia??
Surgery not recommended
Radiation (poor success_
Chemotherapy -mitoxantrone (Topoisomerase inhibitor- disrupts DNS synthesis and repair)
COX2 inhibitors (reduce blood supply to tumors)
Urethral stent
What neoplasias can occur within the bladder/urethra?
Transitional cell carcinoma
Leiomyoma/leiomyosarcoma
Squamous cell
Adenocarcinoma
Fibrosarcoma
Hemangiosarcoma
Prostatic
What therapy can be used for a transitional cell carcinoma??
Piroxicam - NSAID anti-tumor drug
Surgical (if possible
Chemo (mitoxantrone)
Photodynamic therapy
Urine diversion (cystotomy catheter, stenting or prepubic cystotomy )
