FIC Flashcards

1
Q

What type of patient does FIC describe?

A

a cat with clinical signs indicative of Dz associated with lower UT

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2
Q

CS of FIC

A

hematuria
dysuria
stranguira

Hx of getting in/out of litterbox frequently, straining to urinate, production of very little to no urine

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3
Q

What are the different types of categories for FIC?

A

idiopathic vs secondary to bacterial cystitis/neoplasia, uroliths
obstructive vs non-obstructive

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4
Q

Why do we see the clinical signs we see with FIC?

A

Inflamed bladder –> edema and pain within bladder wall –> irritation and contraction of detrusor muscle –> stranguria and dysuria

Inflammation and damage to local blood vessels within wall of bladder –> hematuria

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5
Q

Typical course of FIC

A

self-limiting and resolves in 10-14 days regardless of meds given

if obstructive, requires immediate intervention for survival but doesn’t change time course of Dz

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6
Q

How does urethral obstruction affect the body and how might this result in clinical signs?

A

Inability to eliminate urine –> hampers kidney’s efforts to filter blood of toxins, electrolytes, and other substances –> quick increase of urea, creatinine, phosphorus, and potassium concentrations in blood

      Increased potassium can lead to serious cardiac dysfunction & circulatory instability & hypovolemia
  Rising toxins can lead to circulatory instability and hypovolemia 

If complete obstruction, anorexia, vomiting, lethargy, weakness, collapse

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7
Q

List and describe two main therapeutic strategies for obstructive FIC.

A

IVF

  • P usually unstable and will require meds
  • P usually needs to be sedated for catheter placement
  • supports management of circulatory disturbances

Placement of Urinary Catheter
-re-establishes urine flow

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8
Q

What does the body begin to eliminate from the blood after urine flow is re-established?

A
BUN
CRE
phosphorus
potassium
other toxins
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9
Q

What condition may develop due to hyperkalemia

A

heart conditions

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10
Q

What are risk factors that are present even after reliving the obstruction?

A

acute renal failure
hypokalemia
dehydration secondary to post-obstructive diuresis

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11
Q

What does placement of an indwelling catheter allow for?

A
  • allows for time for the inflammation and urethral spasms secondary to the obstruction to subsite
  • ensure urethral patency
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12
Q

What does the use of a collection system allow?

A
  • continue evaluation of kidney function (if sudden drop in amount, may be suffering from kidney failure)
  • ability to quantify urine output (eval for kidney failure and detection of diuresis)
  • monitor for presence of blood cells, blood clots, crystals, and proteinaceous material within urine
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13
Q

How often should a CBC and biochem panel be done?

A

q24-36hr post urethral obstruction

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14
Q

What things are checked for on the CBC/Chem?

A

resolution of…

  • secondary hemoconcentration
  • azotemia
  • hyperphophatemia
  • hyperkalemia

start of…
-hypokalemia

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15
Q

When should hemoconcentration resolve?

A

as the P is rehydrated

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16
Q

when should azotemia and hyperphosphatemia resolve?

A

over 1-2 days

17
Q

When should hyperkalemia resolve?

A

within 24hrs of reliving blockage

18
Q

Why can hypokalemia develop? What can you do about it?

A

due to post-obstructive diuresis & not eating well b/c potassium is being lost from the kidneys and not being replaced thru food

supplement IVF with potassium chloride

19
Q

What are 2 things that are done after removing the urinary cathter?

A
  • monitor for signs of re-obstruction (could be urethral spasms or actual reobstruction)
  • follow up UA to make sure no bacteria was introduced to bladder
20
Q

When is a patient usually discharged?

A

able to pass urine

able to eat/drink normally

21
Q

List risk factors for FIC development

A

sedentary lifestyle
neuter status
obesity
increased crystals/protein in highly concentrated urine with acidic/basic pH

22
Q

Ways to manage increased crystals/protein in highly concentrated urine with acidic/basic pH

A
  • increase water intake (canned food, adding water/juice from tuna/salmon)
  • litterbox maintenance to prevent P from holding urine (clean it frequently, add or remove a lid, alter type of litter)
  • dietary manipulation to correct pH (won’t work if P presents with ideal pH of 6.5)
23
Q

Ways to manage sedentary lifestyle

A

interactive play/feeding

24
Q

Ways to manage obesity

A

caloric restriction

exercise

25
Q

What is the surgical option for FIC management?

A
Perineal Urethrostomy (PU)
-reroutes the urethra, bypassing the penile urethra, in a way that it becomes wider
26
Q

Pros of Perineal Urethrostomy Sx

A

decreased chance for obstruction