K9 LUT and uroliths Flashcards
CS that localize infection to the LUT
Dysuria
Stranguria (painful, slow urination)
Pollakuria (small amounts frequently)
Other Cs associated with LUT
Hematuria, frequent urine, licking/ chewing/ biting urethra, incontenance , urine in inappropriate locations
Specific diagnostic tests for LUT
Abdominal palpation, transrectal palpation (urethra)
Urinalysis, examine penis/ vestibule, pudendal nerve reflex
What does bladder size mean?
Dysuric and not obstructed= small
Dysuric and obstructed= large
Next step after hematuria observed?
Urinalysis:
If occult blood → neg= dyes, food and drugs, positive= hemoglobin/ myoglobin →
If positive do urine sediment ( # of RBCs) → neg= Hbnemia/ myonemia , pos= hemorrhage
Hemorrhage = local (infection, inflamm and neoplasia, trauma) or general (coag, thrombocytopenia)
Timing of hematuria
Initial stream: urethra/ genital tract
Throughout urination: renal/ bladder
End of urination: Bladder
Independent of urination: urethra/ genital tract
Most common urinary problems in cats
Idiopathic cystitis (dx of exclusion)
Bladder stones
Urethral obstruction
Other (behavior/ cancer)
UTI
Most common urinary problems in dogs
Urolithiasis
UTI
Urinary incontenance
Neoplasia
Miscellaneous
Uroliths
Mineral/ non-mineral crystalloids that form in the urinary tract when urine is oversaturated with crysallogenic precursors
What are uroliths indicators of?
Marker for underlying dz
Lower** or upper urinary tract
What could cause uroliths?
Hepatic dz, vitamin/ mineral excess in diet, altered urine pH, sequela to drug administration, hypovolemic disorders, UTI, hypercalcemic disorders, genetic abnormalities
US for uroliths
Good for uroliths in bladder (NOT URETHRA)
Assess bladder and kidney to dx obstruction
Radiographs for uroliths
Most reliable way to predict urolith characteristics
Good for uroliths in bladder (if radiodense)
Differentiates uroliths (if radiodense)
Size, #, density, shape, laminations
Dx compound uroliths
Access bladder to help dx obstruction
Radiopaque stones in entire UT
Struvite
Infection (staph and proteus)- common and females
Alkalizes urine
Cx before abx selection
Calcium oxalate
Unknown cause
Hypercalcemic
Cystine
Male
Genetic mutations (adrogen dependent most common)
Prevent: ↓ testosterone and neuter
Urate
↑ levels of urate
Genetic (Dalmatians)
Portosystemic Shunt (microhepatica)
More dense (opaque) → least dense (lucent)
Ca oxalate → Ca phosphate (intact male) → silicia → struvite → cystine → urate
Tx for uroliths
Dissolving struvite stones
Surgical removal
Retrograde urohydropulsion
Voiding urohydropulsion
Dissolving struvite stones
1-3w
↑ urine acidity
Don’t if bladder obstructed
Give abx for dissolution period
Retrograde urohydropulsion
Flushing stones back to the urethra
Decompressive cytocentesis → anesthesia → RU
Voiding urohydropulsion
Anesthetize → distended bladder with fluid → position P so spine vertical → induce voiding- steady digital compression
When isn’t Voiding urohydropulsion used?
Obstructed animals
With dexmed (activates sympathetic nervous system)
