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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
Q

If the urine pH is high ____ calculi are most likely

A

Struvite

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26
Q

What breed are Ca Oxalate calculi common?

A

Schnauzers (and cats on acidifying diets)

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27
Q

______ calculi cannot be medically dissolved, but alkalinizing diet can slow growth

A

Ca Oxalate

28
Q

____ calculi are almost always assoc’d with PSS in dogs and cats (exclusion of dalmations and english bulldogs)

A

Urate Calculi

29
Q

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?

A

Dx: Benign prostatic hyperplasia

Tx: Neuter or Anti-androgens

30
Q

On rectal exam, prostate is of normal size, but extremely painful, and pt is clinically ill. Dx? Tx?

A

Dx: Acute bacterial prostatitis

Tx: Neuter and ABx

31
Q

On rectal exam, prostate is bilaterally enlarged, irregular, and non-painful? Dx? Tx?

A

Dx: chronic bacterial prostatitis

Tx: neuter and Abx

32
Q

On rectal exam, prostate is unilaterally enlarged, fluid-filled, painful, and pt is clinically ill. Dx? Tx?

A

Dx: Prostatic abscess

Tx: Drain, neuter, and Abx

33
Q

Middle-age, MN dog. On rectal exam, prostate is unilaterally or bilaterally enlarged, very firm, loss of septum, fixed, and pt has stranguria

A

Dx: Prostatic neoplasia

Tx: Piroxicam

34
Q

On cytology of prepuce you find lots of cornified epithelial cells. What kind of tumor is this? what causes these? Tx?

A

Squamous metaplasia

These occur secondary to estrogen:

  1. Sertoli cell tumor
  2. Exogenous estrogen administered for incontinence

Tx: remove estrogen source

35
Q

Male dog presents with intra-abdominal mass, normal urine. On radiographs is looks like there are two bladders. Dx? Tx?

A

Dx: Periprostatic cyst

Tx: Surgically excise and neuter

36
Q

How can you dx Benign Hyperlasia of the prostate?

A
  1. Rads
  2. UA
  3. Ejaculate cytology
  4. Biopsy (definitive)
37
Q

Should you treat prostatitis with Beta-Lactams? What about Aminoglycosides?

A

NOOOO! They don’t cross the BTB (beta-lactams)

Only give aminoglycosides if the patient is dying

38
Q

What are 3 classes of Abx used to treat Gram-negative Prostatitis?

A
  1. Potentiated sulfas
  2. Quinolones
  3. Chloramphenicol
39
Q

What are 3 classes of Abx used to treat Gram-positive Prostatitis?

A
  1. Erythromycin
  2. Clindamycin
  3. Azithromycin
40
Q

____ is the #1` type of Prostatic Neoplasia

A

Adenocarcinoma

41
Q

How does incontinence happen? Explain it in terms of cmH20

A

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
Q

Name 5 major Rule-Outs for UI Workup

A
  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
Q

Causes of sphincter incompetence? Drug used to tx Sphincter Incompetence?

A

Causes:
Infection, partial obstruction, hormonal

DES! Diethylstilbesterol
- can also use PPA

44
Q

What are some benefits to using estrogen for treating sphincter incompetence?

A

Cheap, easy for client (give every 3-14 days), minimal toxicity

45
Q

So oral estrogen (DES) is okay to give to dogs; is it okay to give injectable estrogens?

A

NO! its contraindicated in dogs

46
Q

What drug would you give to tx Sphincter Hypertonicity?

A

Phenoxybenzamine (e.g. Prazosin)

Prazosin is an alpha-2 antagonist –> relaxes the urethral sphincter

47
Q

What drug would you give to treat Destrusor Hyperactivity ?

A

Propantheline

its a parasympatholytic

48
Q

What drug would you give to treat Destrusor Atony?

A

Bethanecol or Cisapride

  • parasympathomimetic
49
Q

What is ectopic ureter? Which sex is more prone?

A

Opening of the ureters anywhere other than the normal area of trigone of bladder

Females more likely to get than males

50
Q

Drug choice for uncomplicated UTI

A

Amoxicillin, trimethoprim-sulfonamide

51
Q

Drug choice for complicated UTI

A

Guided by culture and susceptibility testing, but consider amoxicillin or trimethoprim-sulfonamide initially

52
Q

Drug choice for subclinical bacteriuria

A

Antimicrobial therapy not recommended unless high risk for ascending infection. If so, tx as per complicated UTI (culture and sensitivity)

53
Q

Drug choice for pyelonephritis

A

Start with a fluoroquinolone, with a re-assessment based on culture and susceptibility testing

54
Q

Ca Oxalate, Struvite, and Silicate are Radio-____

A

Radio-dense

55
Q

Urate and Cystine are Radio-____

A

Radio-lucent

“I Cant C U”

56
Q

Ca oxalate and Silicate can be treated ____

A

Sx

57
Q

Struvite, Urate, and Cystine can be treated _____

A

Med

58
Q

All but Struvite are treated with diets that are _____

A

Alkalinizing

Only struvite is treated acidically

59
Q

Which calculi is common among Dalmations and dogs with PSS?

A

Urate!

60
Q

Predispositions for _____ calculi: Schnauzers, chronic acidification, hypercalcemia

A

Ca Oxalate

61
Q

What does infection do to pH?

A

Increases pH

62
Q

Top 3 R/O for a radiodense stone, bacterial UTI?

A
  1. Struvite
  2. Ca Oxalate
  3. Urate
63
Q

What drug is drug of choice for Lepto?

A

Doxy!

64
Q

Abortion, stillbirth, failure to conceive, bacteremia, genital tract inflammation…. what should you be thinking?

A

Brucellosis!

65
Q

CBC and Chem abnormalities of pt with Brucellosis

A

CBC:
neutrophilic leukocytosis, monocytosis

Chem:
hyperglobulinemia, polyclonal gammopathy, proteinuria

66
Q

Brucella diagnosis:

Trust a _____, confirm a _____

A

Trust a NEGATIVE, confirm a POSITIVE

*Make sure you confirm positives –> animal may be euthanized

67
Q

How do we treat Brucellosis

A

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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