Investigation of Urinary Tract Disease

Question 1

What is the rate of urine production?

Answer 1

1-2ml per kg per hour

Question 2

Where do the ureters enter the bladder?

Answer 2

Caudo-dorsal section in the trigone

Question 3

Name the 3 sections of the male urethra

Answer 3

Pelvic
Membranous
Penile

Question 4

What are the 6 radiographical roentgen signs?

Answer 4

• Size
• Shape
• Location
• Number
• Margination
• Opacity

Question 5

How do normal kidneys appear on a radiograph

Answer 5

• Retroperitoneal cavity
• Right is more cranial (T13)
• Left (L1-L3)
• Length:
  Dogs = 2.5 - 3.5 x the length of L2
  Cats = 2.5 - 3 x the length of L2

Question 6

Give 3 examples of negative contrast agents

Answer 6

• Room air
• Carbon dioxide
• Nitrous oxide

Question 7

Give 2 examples of positive contrast agents

Answer 7

• Barium

- Iodine

Question 8

Increased opacity of the kidney is indicative of?

Answer 8

Cysts, Abscesses, neoplasia

Question 9

What are the indications for using intravenous urography?

Answer 9

• Evaluation of kidneys and ureters
• Indirect assessment of renal function
• Investigation of uroabdomen
• Investigation of urinary incontinence
• Investigations of upper tract haematuria

Question 10

What are the contraindications of using intravenous urography?

Answer 10

• Renal failure
• Dehydration
• Hypotension
• Hypovolaemia

Question 11

Explain how you would perform intravenous urography

Answer 11

• General anaesthesia
• Plain abdominal radiographs
• Intravenous injection of contrast medium
• Abdominal views at regular intervals

Question 12

Describe the 3 phases during intravenous urography

Answer 12

• Angiogram: contrast is seen in the great vessels
• Nephrogram: contrast is taken up and opacifies the kidneys
• Pyelogram: contrast is seen in the renal pelvis

Question 13

What are the 4 indications for using cystography?

Answer 13

• Haematuria
• Dysuria
• Urine retention
• Incontinence

Question 14

What is cystography?

Answer 14

• Involves assessment of the bladder location and integrity
• Assessment of bladder wall and mucosa
• Presence of calculi
• Negative contrast / Positive contrast / double contrast

Question 15

How would you perform pneumocystography?

Answer 15

• Urinary catheter placement to put gas into the bladder
• Room air or Carbon dioxide or Nitrous oxide
• Gently palpate bladder while injecting, radiograph when feels moderately distended
• Don’t over-distend bladder
• L lateral recumbency

Question 16

When can pneumocystography not be performed?

Answer 16

Don’t if ruptured bladder, mucosal trauma or haemorrhage

Question 17

Double contrast cystography is a combination of?

Answer 17

pneumocystography and positive contrast cystography

Question 18

What are the indications for use of retrograde urethrography?

Answer 18

Assessing the lower urinary tract

• Haematuria
• Dysuria
• Lower urinary tract obstruction
• Urethral disease
• Prostatic disease
• Penile disease

Question 19

How is a retrograde urethrography performed?

Answer 19

• Catheterise urethra and empty bladder
• Tip of the catheter (prefilled with contrast medium) in the penile urethra
• Inject 5-10ml, 150mg/ml
• Take radiographs while injecting! Advance catheter and repeat radiographs

Question 20

Name the following terms:

• Bright on ultrasound
• Dark grey on ultrasound
• Black on ultrasound (fluid)

Answer 20

• hyperechoic
• hypoechoic
• anechoic

Question 21

What are some biopsy methods for the urinary tract?

Answer 21

• Fine needle aspirate
• Catheter suction
• Surgical