Hematuria, Pollakiuria, Stranguria

Question 1

__ is small frequent urination and __ is when its hurts to urinate and both are associated with __

Answer 1

Pollkiuria, stranguria, Hematuria

Question 2

If you spin down a Hematuria sample what will it look like?

Answer 2

Blood separates out to bottom of test tube

Question 3

Lower urinary tract common differentials

Answer 3

Bacterial UTI
Urocystoliths/urethroliths
Urinary tract neoplasia

Question 4

Sporadic bacterial cystitis

Answer 4

Uncomplicated or simple
No structural/fxn abnormalities
Normal host defenses
Fewer than 3 episodes in last 12 mths

Question 5

Recurrent bacterial cystitis

Answer 5

Complicated UTI
3 or more episodes in last 12 mths
Relapsing or persistent infection
Reinfection

Question 6

Sporadic bacterial cystitis is common in __ and is less common in __

Answer 6

Dogs

cats (typically get idiopathic cystitis or urolithiasis)

Question 7

Diagnosis of sporadic bacterial cystitis

Answer 7

Urinalysis: turbid with 50wbc/hpf

Bacti culture: preferred but can empirically treat without a culture

Question 8

Specimens should be collected by __ for aerobic bacterial urine culture

Answer 8

Cysto - AUS guidance can be helpful and id abnormalities of the bladder

Question 9

UTI’s in younger and older populations what should you evaluate?

Answer 9

Potential comorbities

Question 10

How do we treat sporadic bacterial cystitis?

Answer 10

1. Antimicrobials
2. Analgesics

Typically lasts for 3-5 days

Question 11

__ is the first choice for empirical treatment of sporadic bacterial cystitis

Answer 11

Amoxicillin

Question 12

When 1st line treatment of sporadic bacterial cystitis doesn’t work, what antimicrobials should you use?

Answer 12

Nitrofurantoin, fluoroquinolone and 3rd generation cephalosporins
- avoid if possible because of antimicrobial resistance

Question 13

Diagnosis of recurrent bacterial cystitis

Answer 13

• Urine culture by cysto
• Ultrasound, rads or contrast studies
• Biopsies of bladder may revels deep seated infections

Question 14

Treatment of recurrent bacterial cystitis

Answer 14

• may treat with analgesics solely while waiting for culture results
• reinfection may only need 3-5 days of antibiotics
• relapsing/persistent infections may need longer courses (7-14 days)

Question 15

If abdominal radiographs reveal a stone was is the treatment plan?

Answer 15

Depends on the type of stone - will likely recommend surgery but can also attempt to dissolve the stone

Needs a longer course of antibiotics (2wk)

Question 16

Pyelonephritis (upper urinary tract infx) is suspected to be due to:

Answer 16

• positive aerobic Bacti urine culture
• fever, lethargy, and/or pu/pd
• renal pain
• azotemia, cylindruria and peripheral neutrophilia
• renal pelvic dilation and/or blunting of the renal papilla on ultrasound

Question 17

Treatment of pyelonephritis

Answer 17

Treatment should be initiated immediately while waiting for culture and susceptibility
- fluoroquinolones or Cefpodoxime are reasonable first choices
10-14 days of treatment

Question 18

What should you look for in every intact male dog diagnosed with bacteriuria or bacterial cystitis?

Answer 18

Underlying bacterial prostatitis

Question 19

Dx of bacterial prostatitis

Answer 19

Full exam with rectal palpation of prostate and urinalysis
- AUS eval of prostate
- discordance between urine and prostatic fluid culture results can occur

Question 20

Treatment of bacterial prostatitis

Answer 20

• drain prostatic abscesses
• fluoroquinolones while awaiting culture and susceptibility treating
• blood-prostate barrier reduces penetration of many drugs
• 4 weeks of treatment for acute prostatitis
• castration

Question 21

How should you follow up bacterial prostatitis?

Answer 21

Monitor the prostatic size by AUS +/- rectal palpation
- culture of prostatic fluid or urine can be performed during therapy but not recommended

Question 22

T/F: you should not treat or culture the majority of subclinical bacteriuria

Answer 22

T

Question 23

What are common differentials of cats with Lower urinary tract infections?

Answer 23

Idiopathic cystitis
Behavioral
Urocystoliths/urethroliths
Mucus plugs
Bacterial UTIs

Question 24

__ is the most common cause of chronic lower urinary tract signs in cats

Answer 24

Feline idiopathic cystitis

Question 25

Treatment of FIC

Answer 25

• Goal is to reduce activation of the central stress response system
• multimodal environmental modification (focuses on environmental enrichment)

need to communicate well with owners

Question 26

MEMO

Answer 26

• Cats in general
• FIC
• Effective resource management (food and water management, litter space, etc.)
• Reduced perceived threats and reduce interact conflict

Question 27

Diets for FIC

Answer 27

Hills urinary care c/d
- changing the cats diet may just stress the cat out more

Question 28

What would be a good feeding management practice for cats prone to FIC?

Answer 28

Food puzzles and quiet locations

Question 29

Feliway

Answer 29

Combination of synthetic feline pheromone and marketed to exert a calming effect on cats

Question 30

List physical manifestations of feline idiopathic cystitis and what they lead to

Answer 30

• mucosal edema
• vascular leakage
• mucosal ulceration and hemorrhage
• intramural inflammation

leads to urgent, frequent, painful and bloody urination

Question 31

Central Stress Response System with FIC

Answer 31

natural variations in activation of neural, endocrine, and immune responses
- varied physiologic and behavioral abnormalities

Question 32

T/F: most cats with FIC resolve clinical signs in a few days without treatment

Answer 32

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