Intro Flashcards
What are common presentation indicating urinary problems?
PU/PD Dysuria Oliguria/anuria Abnormal colour Incontinence Inappropriate urination
Define oliguria
Less than normal urine output
What localisation is indicated by the presence of PU/PD?
Upper urinary tract
What are insensible losses?
Loss in faeces or via respiration
Define pollakiuria
Frequent passage of (small amounts of) urine.
Total daily volume same.
Define periuria
Urination at wrong time/place
Define nocturia
Urination at night
What type of urination is consistent with an irritative voiding pattern?
Give some DDx
Pollakiuria
UTI, Urolithiasis, cystitis
What abnormal clinical pathology findings may be present in a patient with urinary disease?
Azotaemia Hyperkalaemia Hyperphosphataemia Proteinuria Others
What other clinical signs may be associated with urinary tract disease?
Oedema Ascites Collapse Halitosis Depression Vomiting O report suspected constipation (O is wrong) - straining to urinate not defecate Post trauma e.g. RTA
Outline a logical approach to urinary presentations
- Hx, CS, PE
- Is it urinary tract dz
- Is it upper/lower urinary tract
- Are there other body systems involved
What is the difference between primary polyuria and primary polydipsia?
Primary Polyuria - kidneys can’t concentrate therefore drinking more
Primary polydipsia - drinking more therefore urinating more
What should be asked about the problem in the hx ?
Duration
Severity
Clinical course
Response to tx
What clinical signs are associated with upper urinary tract disease?
PU/PD Dehydration Abnormal renal palpation Halitosis Oral ulceration
What clinical signs are associated with lower urinary tract disease?
Dysuria Pollakiuria Incontinence Abnormal palpation of bladder/urethra Abnormalities of external genitalia
What clinical signs may be associated with either UUT or LUT dz?
Oliguria Anuria Haematuria Lethargy Depression
What problems commonly affect the upper urinary tract?
Acute Kidney Injury (AKI) Chronic Kidney Disease (CKD) Protein Losing Nephropathy (PLN) Neoplasia Pyelonephritis Developmental dz Nephor/uretolithiasis
What problems commonly affect the lower urinary tract?
UTI Urolithiasis Neoplasia Urethral obstruction Trauma FLUTD Functional abnormalities Developmental abnormalities
What further diagnostics may be indicated in urinary patients?
Clin path - bloods, urine, calculus analysis, aspirates, biopsies
Diagnostic imaging - Plain and contrast rads, US, CT/MRI
Others - endoscopy, urodynamics, (scintigraphy, DNA tests)
What blood work is indicated?
Routine haematology and biochem
- Electrolytes
- Urea+Createnine, (SDMA - biomarker for kidney function)
- PCV / total solids
What urinalysis would you perform?
SG Sticks Sediment analysis UPC C+S
What method of urine catching should you perform if you want to do C+S?
Cystocentesis
When would you catheterise a patient?
Closed urinary collection system - critical patients and allow healing of urethra
Relieve obstruction
Contrast studies
Urine collection (RARE)
What are the most utilised imaging modalities in urinary diagnostics?
Rads + US
When might a DNA test be used?
Feline poly cystic kidney disease
Familial/Juvenile nephropathies
Canine hyperuricouria (excessive urate secretion)
Transitional cell carcinoma
