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GU Emergencies Flashcards

1
Q

Acute Kidney Injury
(AKI)

Causes

A
  • Ischemic or physiologic events
  • Nephrotoxins
  • Certain diseases
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2
Q

Chronic Kidney Failure
(CKF)

Causes

A
  • Progressive congenital disease
  • Renal disease acquired during life
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3
Q

FLUTD

A

Feline Lower Urinary Tract Disease

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4
Q

Physical Obstruction

Where (Urologic)

A
  • Urethra
  • Urinary bladder
  • Ureters
  • Renal pelvis
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5
Q

Uroliths

A
  • Composed of oganized crystals of phosphate, urate, cystine, and oxalate
  • Caused by congenital abnormality in metabolism or excretion of these minerals

Stones

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6
Q

Urethral Plugs

A
  • Malleable, disorganized substance
  • Composed of struvite crystals and a matrix
  • Formed from excessive bladder mucus secondary to irritation
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7
Q

Micturition

A

Action of urinating

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8
Q

Type of Obstruction Common

Dogs and Cats

A

Dogs
* often caused by organized uroliths
* urinary calculi most common

Cats
* debris less organized
* usually forms a urethral plug at tip of penis

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9
Q

Male vs Female Cat Obstructions

A

Females
* rare
* shorter urethra and wider urethral lumen

Males
* common
* lumen is small throughout entire length
* smaller lumen at the tip (where things get trapped)

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10
Q

Signs of a Blocked Cat

A
  • Alert or Depressed*
  • Stranguria
  • Pollakiuria
  • Spending longer times in the litter box
  • Urinating outside of box
  • Hematuria
  • Restless
  • Vocalization
  • Uncomfortable
  • Excessive grooming of urogenital region

*depends on duration and degree of obstruction

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11
Q

Stranguria

A

Straining to urinate

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12
Q

Pollakiuria

A

Passing small amounts of urine frequently

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13
Q

Blood Work to Run for Blocked Cats

A
  • BUN
  • Creatinine
  • Electrolytes
  • TP / PCV
  • Glucose
  • Potassium
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14
Q

Typical Treatment for Blocked Cats

A
  • Analgesics / Antibiotics
  • IV and Urinary Catheters
  • BW - renal values
  • ECG - monitor for cardiac arrhythmias cause by hyperkalemia
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15
Q

Sedations for Blocked Cats

A

Done prior to placing a urinary catheter unless patient is obtunded
* ketamine and midazolam
* Propofol

Isoflurane

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16
Q

Cystocentesis

Blocked Cats

A

Be cautious as the bladder is extremely friable and prone to injury

More accurate assessment of:
* bacteria
* cells
* crystals
* presence of blood or protein
* specific gravity
* pH of bladder

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17
Q

Hyperkalemia

Signs

A
  • Bradycardia
  • Diminished P waves
  • Widened QRS complexes
  • Increased T waves
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18
Q

Hyperkalemia

Treatment

A
  • Dextrose/Glucose +/- Insulin given IV
  • Calcium gluconate given slowly IV
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19
Q

Dextrose

A
  • Can be administered with or without insulin
  • Used to drive potassium into the cells and correct hyperkalemia and cardiac disturbances

Also called Glucose

20
Q

Urinary Catheter Goals

A
  • Record rate of urine output
  • Prevent reobstruction during the first 24 hrs after the initial obstruction has been relieved
  • Keep the bladder decompressed help bladder wall “re tighten”
21
Q

Urinary Catheter Management

with Cats

A
  • Catheter should always be connected to a collection system
  • Do not leave cats unattended
  • Measure urine output every 2-4 hours
  • E-collar may be necessary
22
Q

Diuresis Period

Obstructed Cats

What, What to Monitor, Reducing

A
  • Fluid administration must match urine output
  • Fluids exceed if cat is dehydrated
  • Monitor serum electrolytes and weight
  • Monitor K levels - supplement if dropped
  • Monitor and decrease fluid if urine output continues to match
23
Q

Dystocia

A
  • Difficult birth
  • More common in dogs
  • Occurs when there are forceful uterine contractions for 30 minutes with no deliveries
24
Q

Dystocia

Causes

A
  • Narrowing of the birth canal from a previous pelvic fracture
  • Large or malpositioned fetus
  • Physics - size/breed
  • Uterine Inertia
25
Uterine Inertia
No contractions occurring * going longer than 2 hours between puppy deliver * uterus just stops contracting
26
Which breeds do we see uterine inertia in
* Large breed dogs with multiple puppies * Seen if mom is not healthy enough
27
Screening Calls | Dystocia
* Do we know the number of fetuses? * Have any been delivered? Alive? * When was the first baby delivered? * How long has it been since the first baby? * Is mom BAR/QAR or Lethargic/Weak? * How are contractions? (forcefull, weak, none at al)
28
Dystocia | Preparing Supplies
* IV catheter and Fluids * Radiology / Ultrasound * Incubators * Surgery * PCV / TP * CBC
29
Monitoring Mom | Post C-Section
* Babies should ONLY go back to mom when she's fully awake from anesthesia - slow introduction (one at a time) * Run TP / PCV is hemorrhage from uterus significant
30
Monitoring Puppies | Post C-Section
* Place in incubator or keep warm and oxygenated until mom awake to care for them * Get weight * Be sure pups manually or nurse fed within 2 hours of delivery
31
Dystocia | Signs
* In active labor for over an hour, no deliveries * Greater than 2 hours between deliveries * Weak/Infrequent labor contractions * Depressed or Weak * Signs of toxemia * Palpable fetuses * Mammaries enlarged with milk
32
Dystocia Treatment | Prior to needing a C-Section
* Attempt to manipulate fetuses * Radiograph for head count and obstruction check * Slowly give Ca Gluconate via IV* * Give Oxytocin IM to prepare for delivery | *sensitizes uterus to oxytocin
33
Dystocia | Oxytocin
* Can be given up to 3 times IM * If no stimulation from uterus, C-Section required
34
Pyometra
* Pus in the uterus * Suspect in older, intact female dogs * Occurs less frequently in cats
35
Pyometra | Common Signs
* Lethargy * Vomiting / Anorexia * Polyuria / Polydypsia * Vaginal discharge * Recent heat cycle * Abdominal distention
36
Pyometra | Preparations
* IV Catheter and Fluids (LRS) * Radiology / Ultrasound * Surgery * Antibiotics / Analgesics * Blood collection supplies
37
Pyometra | Blood Tests
* CBC * BUN and Creatinine | Kidney levels elevated due to dehydration
38
Length of Pregnancy
Also known as gestation period * 9 weeks * there is a range
39
How many stages of labor
3
40
First Stage of Labor
* 6-24 hrs before birth of first puppy * Seeking seclusion * Nesting * Restless / Panting * Anorexia / Vomiting * Clear vaginal discharge * Temp drop, 99 or below
41
Second Stage of Labor
Babies are born
42
Third Stage of Labor
Delivery of the placenta
43
Delivery Time | And Time Between
Once active contractions have occurred, a puppy should be born within 30 minutes * normal time between babies can be minutes to 2 hours; not a concern as long as mom is not in distress
44
Lochia or Uteroverdin
Green vaginal discharge after the first puppy is delivered * sign that placenta has separated from uterus * need to get a puppy soon!!
45
Ultrasound for Babies HR
* Normal = 200 bpm * Distress = <170 bpm

Emergencies (8 decks)

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