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Emergencies > GU Emergencies > Flashcards

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
Q

Uterine Inertia

A

No contractions occurring
* going longer than 2 hours between puppy deliver
* uterus just stops contracting

26
Q

Which breeds do we see uterine inertia in

A
  • Large breed dogs with multiple puppies
  • Seen if mom is not healthy enough
27
Q

Screening Calls

Dystocia

A
  • 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
Q

Dystocia

Preparing Supplies

A
  • IV catheter and Fluids
  • Radiology / Ultrasound
  • Incubators
  • Surgery
  • PCV / TP
  • CBC
29
Q

Monitoring Mom

Post C-Section

A
  • 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
Q

Monitoring Puppies

Post C-Section

A
  • 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
Q

Dystocia

Signs

A
  • 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
Q

Dystocia Treatment

Prior to needing a C-Section

A
  • 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
Q

Dystocia

Oxytocin

A
  • Can be given up to 3 times IM
  • If no stimulation from uterus, C-Section required
34
Q

Pyometra

A
  • Pus in the uterus
  • Suspect in older, intact female dogs
  • Occurs less frequently in cats
35
Q

Pyometra

Common Signs

A
  • Lethargy
  • Vomiting / Anorexia
  • Polyuria / Polydypsia
  • Vaginal discharge
  • Recent heat cycle
  • Abdominal distention
36
Q

Pyometra

Preparations

A
  • IV Catheter and Fluids (LRS)
  • Radiology / Ultrasound
  • Surgery
  • Antibiotics / Analgesics
  • Blood collection supplies
37
Q

Pyometra

Blood Tests

A
  • CBC
  • BUN and Creatinine

Kidney levels elevated due to dehydration

38
Q

Length of Pregnancy

A

Also known as gestation period
* 9 weeks
* there is a range

39
Q

How many stages of labor

A

3

40
Q

First Stage of Labor

A
  • 6-24 hrs before birth of first puppy
  • Seeking seclusion
  • Nesting
  • Restless / Panting
  • Anorexia / Vomiting
  • Clear vaginal discharge
  • Temp drop, 99 or below
41
Q

Second Stage of Labor

A

Babies are born

42
Q

Third Stage of Labor

A

Delivery of the placenta

43
Q

Delivery Time

And Time Between

A

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
Q

Lochia or Uteroverdin

A

Green vaginal discharge after the first puppy is delivered
* sign that placenta has separated from uterus
* need to get a puppy soon!!

45
Q

Ultrasound for Babies
HR

A
  • Normal = 200 bpm
  • Distress = <170 bpm

Emergencies (8 decks)

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