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749 - Ex 1 > Incontinence & Pollakiuria > Flashcards

Incontinence & Pollakiuria Flashcards

1
Q

Small amounts - frequently

A

Pollakiuria

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2
Q

Straining to urinate

A

Stranguria

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3
Q

Difficult urination

A

Dysuria

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4
Q

If total obstruction is occuring, clinical signs of ____ may also be present

A

Uremia

high BUN and Creatinine

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5
Q

Differentials for UTI - Dogs; most common to least

A
  1. infectious - BACTERIAL
  2. Stone
  3. Neoplasia
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6
Q

Differentials for UTI - Cats; most common to least

A
  1. Sterile - Idiopathic
  2. Infectious
  3. Stone
  4. Neoplasia
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7
Q

Differentials for pollakiuria/stranguria/dysuria

A
  1. UTI
  2. Neurological (reflex dyssynergia, spinal cord dz)
  3. Behavioral
  4. Extraluminal obstruction (prostatic dz, fractured pelvis, etc)
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8
Q

If affected dogs are intact, you should ask the O about ______ hx and ______ serological status

A

Breeding history and Brucella canis

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9
Q

In cats, determine whether the _____ and _____ serostatus are known. Why?

A

FeLV and FIV

Immunodeficiency with either virus can lead to secondary bacterial infections

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10
Q

What are you testing when doing a tail lift?

A

Cauda equina

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11
Q

What are you testing when examining for anal wink? How do you elicit an anal wink?

A

Local pudendal n

Females: pressure on vulva
Males: bulbospongiosus area

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12
Q

What are you assessing during a rectal exam?

A
  1. Anal tone
  2. Urethra
  3. Prostate
  4. Width of pelvic canal - previous fractures
  5. Pain in lumbosacral area (apply pressure dorsally)
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13
Q

The two most common vaginal anomalies are?

A
  1. 360 degree vaginal strictures
    - usually not a problem if cranial to urethral papilla
  2. dorsoventral bands
    - when palpating it seems like there are two vaginas
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14
Q

What diagnostic should ALL animals with UTI have?

A

UA! by cysto is best

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15
Q

What kind of culture is best?

A

Aerobic!

99% of bacteria found are aerobic - waste of money to do Anaerobic

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16
Q

Should you do a Mycoplasma culture?

A

No - suuuuper rare, not worth the money

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17
Q

Can you treat animals with 1st time UTIs empirically?

A

It is recommended sometimes

Gold standard would be to culture on 1st UTI so you could compare if UTI reoccurs

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18
Q

If the same bug was cultured on both initial and subsequent visit, what most likely happened?

A
  1. Wrong Abx choice
  2. Incomplete therapy - O
  3. Nidus of infection
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19
Q

If a different bug was cultured on the 2nd visit, what do you think?

A

UTIs will likely continue to occur - conformational problem?

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20
Q

Should we offer rads to Os of all animals with clinical signs of UTI? Why or why not?

A

Yes! ALWAYS have calculi on your list

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21
Q

Should we offer US to Os of all animals with clinical signs of UTI? Why or why not?

A

Yes! They are sometimes superior to rads in that they can detect radiolucent calculi, as well as intraluminal dz like urachal diverticulum and neoplasia

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22
Q

What does FLUTD stand for?

A

Feline Lower Urinary Tract Disease syndrome

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23
Q

What is the major cause of FLUTD (current theory)? Whats the best treatment?

A

Stress!

Canned food and stress relief

*Add in pain meds if needed

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24
Q

If the urine pH is low ___ calculi are most likely

A

Ca Oxalate

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25
If the urine pH is high ____ calculi are most likely
Struvite
26
What breed are Ca Oxalate calculi common?
Schnauzers (and cats on acidifying diets)
27
______ calculi cannot be medically dissolved, but alkalinizing diet can slow growth
Ca Oxalate
28
____ calculi are almost always assoc'd with PSS in dogs and cats (exclusion of dalmations and english bulldogs)
Urate Calculi
29
2 year-old MI dog, presents with hematuria (w/o pyuria). On rectal exam you note the prostate is bilaterally enlarged, smooth, and non-painful. Dx? Tx?
Dx: Benign prostatic hyperplasia Tx: Neuter or Anti-androgens
30
On rectal exam, prostate is of normal size, but extremely painful, and pt is clinically ill. Dx? Tx?
Dx: Acute bacterial prostatitis Tx: Neuter and ABx
31
On rectal exam, prostate is bilaterally enlarged, irregular, and non-painful? Dx? Tx?
Dx: chronic bacterial prostatitis Tx: neuter and Abx
32
On rectal exam, prostate is unilaterally enlarged, fluid-filled, painful, and pt is clinically ill. Dx? Tx?
Dx: Prostatic abscess Tx: Drain, neuter, and Abx
33
Middle-age, MN dog. On rectal exam, prostate is unilaterally or bilaterally enlarged, very firm, loss of septum, fixed, and pt has stranguria
Dx: Prostatic neoplasia Tx: Piroxicam
34
On cytology of prepuce you find lots of cornified epithelial cells. What kind of tumor is this? what causes these? Tx?
Squamous metaplasia These occur secondary to estrogen: 1. Sertoli cell tumor 2. Exogenous estrogen administered for incontinence Tx: remove estrogen source
35
Male dog presents with intra-abdominal mass, normal urine. On radiographs is looks like there are two bladders. Dx? Tx?
Dx: Periprostatic cyst Tx: Surgically excise and neuter
36
How can you dx Benign Hyperlasia of the prostate?
1. Rads 2. UA 3. Ejaculate cytology 4. Biopsy (definitive)
37
Should you treat prostatitis with Beta-Lactams? What about Aminoglycosides?
NOOOO! They don't cross the BTB (beta-lactams) Only give aminoglycosides if the patient is dying
38
What are 3 classes of Abx used to treat Gram-negative Prostatitis?
1. Potentiated sulfas 2. Quinolones 3. Chloramphenicol
39
What are 3 classes of Abx used to treat Gram-positive Prostatitis?
1. Erythromycin 2. Clindamycin 3. Azithromycin
40
____ is the #1` type of Prostatic Neoplasia
Adenocarcinoma
41
How does incontinence happen? Explain it in terms of cmH20
Urethral tone weakens with spay (lack of hormones) --> dog goes to bed with an empty bladder (urethral tone > bladder pressure) --> bladder fills overnight and the bladder pressure becomes greater than the urethral tone --> urine begins leaking and dog finally wakes up in puddle of urine
42
Name 5 major Rule-Outs for UI Workup
1. R/O infection 2. R/O stones/masses 3. R/O PU/PD 4. R/O prostate diseases 5. R/O ectopic ureters
43
Causes of sphincter incompetence? Drug used to tx Sphincter Incompetence?
Causes: Infection, partial obstruction, hormonal DES! Diethylstilbesterol - can also use PPA
44
What are some benefits to using estrogen for treating sphincter incompetence?
Cheap, easy for client (give every 3-14 days), minimal toxicity
45
So oral estrogen (DES) is okay to give to dogs; is it okay to give injectable estrogens?
NO! its contraindicated in dogs
46
What drug would you give to tx Sphincter Hypertonicity?
Phenoxybenzamine (e.g. Prazosin) Prazosin is an alpha-2 antagonist --> relaxes the urethral sphincter
47
What drug would you give to treat Destrusor Hyperactivity ?
Propantheline its a parasympatholytic
48
What drug would you give to treat Destrusor Atony?
Bethanecol or Cisapride - parasympathomimetic
49
What is ectopic ureter? Which sex is more prone?
Opening of the ureters anywhere other than the normal area of trigone of bladder Females more likely to get than males
50
Drug choice for uncomplicated UTI
Amoxicillin, trimethoprim-sulfonamide
51
Drug choice for complicated UTI
Guided by culture and susceptibility testing, but consider amoxicillin or trimethoprim-sulfonamide initially
52
Drug choice for subclinical bacteriuria
Antimicrobial therapy not recommended unless high risk for ascending infection. If so, tx as per complicated UTI (culture and sensitivity)
53
Drug choice for pyelonephritis
Start with a fluoroquinolone, with a re-assessment based on culture and susceptibility testing
54
Ca Oxalate, Struvite, and Silicate are Radio-____
Radio-dense
55
Urate and Cystine are Radio-____
Radio-lucent | "I Cant C U"
56
Ca oxalate and Silicate can be treated ____
Sx
57
Struvite, Urate, and Cystine can be treated _____
Med
58
All but Struvite are treated with diets that are _____
Alkalinizing Only struvite is treated acidically
59
Which calculi is common among Dalmations and dogs with PSS?
Urate!
60
Predispositions for _____ calculi: Schnauzers, chronic acidification, hypercalcemia
Ca Oxalate
61
What does infection do to pH?
Increases pH
62
Top 3 R/O for a radiodense stone, bacterial UTI?
1. Struvite 2. Ca Oxalate 3. Urate
63
What drug is drug of choice for Lepto?
Doxy!
64
Abortion, stillbirth, failure to conceive, bacteremia, genital tract inflammation.... what should you be thinking?
Brucellosis!
65
CBC and Chem abnormalities of pt with Brucellosis
CBC: neutrophilic leukocytosis, monocytosis Chem: hyperglobulinemia, polyclonal gammopathy, proteinuria
66
Brucella diagnosis: Trust a _____, confirm a _____
Trust a NEGATIVE, confirm a POSITIVE *Make sure you confirm positives --> animal may be euthanized
67
How do we treat Brucellosis
Discuss zoonotic risk - may euthanize If tx is chosen: - carefully! spay or neuter if intact - Quinolone, PO, SID 14 days - Doxy, PO, SID for 14 days * repeat until seronegative

749 - Ex 1 (21 decks)

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