K9 LUT and uroliths

Question 1

CS that localize infection to the LUT

Answer 1

Dysuria
Stranguria (painful, slow urination)
Pollakuria (small amounts frequently)

Question 2

Other Cs associated with LUT

Answer 2

Hematuria, frequent urine, licking/ chewing/ biting urethra, incontenance , urine in inappropriate locations

Question 3

Specific diagnostic tests for LUT

Answer 3

Abdominal palpation, transrectal palpation (urethra)
Urinalysis, examine penis/ vestibule, pudendal nerve reflex

Question 4

What does bladder size mean?

Answer 4

Dysuric and not obstructed= small
Dysuric and obstructed= large

Question 5

Next step after hematuria observed?

Answer 5

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)

Question 6

Timing of hematuria

Answer 6

Initial stream: urethra/ genital tract
Throughout urination: renal/ bladder
End of urination: Bladder
Independent of urination: urethra/ genital tract

Question 7

Most common urinary problems in cats

Answer 7

Idiopathic cystitis (dx of exclusion)
Bladder stones
Urethral obstruction
Other (behavior/ cancer)
UTI

Question 8

Most common urinary problems in dogs

Answer 8

Urolithiasis
UTI
Urinary incontenance
Neoplasia
Miscellaneous

Question 9

Uroliths

Answer 9

Mineral/ non-mineral crystalloids that form in the urinary tract when urine is oversaturated with crysallogenic precursors

Question 10

What are uroliths indicators of?

Answer 10

Marker for underlying dz
Lower** or upper urinary tract

Question 11

What could cause uroliths?

Answer 11

Hepatic dz, vitamin/ mineral excess in diet, altered urine pH, sequela to drug administration, hypovolemic disorders, UTI, hypercalcemic disorders, genetic abnormalities

Question 12

US for uroliths

Answer 12

Good for uroliths in bladder (NOT URETHRA)
Assess bladder and kidney to dx obstruction

Question 13

Radiographs for uroliths

Answer 13

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

Question 14

Struvite

Answer 14

Infection (staph and proteus)- common and females
Alkalizes urine
Cx before abx selection

Question 15

Calcium oxalate

Answer 15

Unknown cause
Hypercalcemic

Question 16

Cystine

Answer 16

Male
Genetic mutations (adrogen dependent most common)
Prevent: ↓ testosterone and neuter

Question 17

Urate

Answer 17

↑ levels of urate
Genetic (Dalmatians)
Portosystemic Shunt (microhepatica)

Question 18

More dense (opaque) → least dense (lucent)

Answer 18

Ca oxalate → Ca phosphate (intact male) → silicia → struvite → cystine → urate

Question 19

Tx for uroliths

Answer 19

Dissolving struvite stones
Surgical removal
Retrograde urohydropulsion
Voiding urohydropulsion

Question 20

Dissolving struvite stones

Answer 20

1-3w
↑ urine acidity
Don’t if bladder obstructed
Give abx for dissolution period

Question 21

Retrograde urohydropulsion

Answer 21

Flushing stones back to the urethra
Decompressive cytocentesis → anesthesia → RU

Question 22

Voiding urohydropulsion

Answer 22

Anesthetize → distended bladder with fluid → position P so spine vertical → induce voiding- steady digital compression

Question 23

When isn’t Voiding urohydropulsion used?

Answer 23

Obstructed animals
With dexmed (activates sympathetic nervous system)