Lower Urinary Tract

Question 1

What is the normal positioning of the canine bladder

Answer 1

Ventral to colon and uterus
often cranial to pubis
sometimes partly in the pelvic canal

Question 2

What is the normal positioning of the feline bladder

Answer 2

Ventral to colon and uterus
almost always short distance cranial to pubis

Question 3

What might interfere with the interpretation of bladder radiographs

Answer 3

superimposition of thigh muscles

Question 4

What could cause cranial displacement of the bladder

Answer 4

1) Prostatomegaly (enlarged)
-intact male and/or disease
2) Other pelvic cavity mass

Question 5

What could cause caudal displacement of the bladder

Answer 5

1) Often normal variant ( sometimes congenital abnormal with incontinence)
2) Perineal hernia
3) Mid abdominal mass displacing caudally

Question 6

What could cause increased size of the bladder

Answer 6

1) Voluntary retention (house-trained, long carride, hospitalized)
2) Urethral obstruction
3) Neurological problem- most often T3-L3

Question 7

Problems at spinal segments _______ would result in an increased bladder

Answer 7

T3-L3

Question 8

What could cause lack of bladder visualization if normal peritoneal detail

Answer 8

1) small bladder (recent urination)
2) Pelvic bladder (dog)
3) Herniated
4) ectopic ureters or another anomaly of bladder not filling (rare)

Question 9

What could cause lack of bladder visualization if poor peritoneal detail

Answer 9

1) young or underconditioned
2) Peritoneal effusion (sometimes from ruptured bladder or CHF )

Question 10

What contrast media should you never use for visualizing the bladder

Answer 10

barium

Question 11

What can give better visualization of the bladder

Answer 11

iodinated contrast
1) Urinary contrast (direct is more preferred)
2) IV

Question 12

What might cause decreased opacity of the bladder

Answer 12

1) Intraluminal gas
2) Emphysematous cystitis

Question 13

How might the bladder have intraluminal gas resulting in decreased opacity (lucency) on radiography

Answer 13

1) Iatrogenic- cysto or urinary catheter
2) Gas producing UTI

Question 14

What does emphysematous cystitis look like on radiograph

Answer 14

gas in the wall, best seen around the peripheral edges

Question 15

What might cause emphysematous cystitis

Answer 15

1) Diabetes mellitus - bacteria
2) Long term corticosteroids (Cushings or iatrogenic)
3) Chronic urinary tract infection
4) Gas producing bacteria

Question 16

What might cause increased opacity of the urinary bladder

Answer 16

1) Presence of positive (iodinated) contrast agent
2) Radiopaque uroliths (stones, calculi, cystoliths)
-Mineral opaque

Question 17

What are the most common type of radiopaque uroliths in the bladder?

Answer 17

Struvite and Calcium oxalate

Cystine and urate are less opaque but also visible but urinary stones may be a mix of different materials

Question 18

What should you do if you are having a hard time seeing the bladder and dont want to use contrast

Answer 18

Paddle Shot (compress the caudal abdomen with a lucent paddle)

Question 19

gas in wall of urinary bladder

Answer 19

Emphysematous cystitis

Question 20

if the bladder lies straight then intraluminal gas often collect

Answer 20

in the center

Question 21

Where do radiopaque uroliths typically collect within the urinary bladder

Answer 21

collect near the center

Question 22

In the female, the urethra is a

Answer 22

short tube from trigone to the vestibule

Question 23

What are the 3 parts of the male urethra

Answer 23

1) Prostatic - through the prostate
2) Membranous- through intrapelvic region
3) Penile - after intrapelvic region

Question 24

where do stones typically get lodged in the male

Answer 24

where the urethra goes through the os penis

Question 25

What often get confused for stones

Answer 25

Superimposed nipples and unimportant separate areas of ossification

Question 26

Cats can have os penis in about ____ of cases

Answer 26

1/3 of cases

do not confused with mineral blocking the urehtra

Question 27

Butt-Shot View

Answer 27

a view where the pelvic limbs are moves forward to see the rest of the urethra and stones better in the urethra

Question 28

constrast media injected into the urethra and urinary bladder

Answer 28

Cystourethrogram
good for narrowing urethra, rupture wall thickening

Question 29

When might cystourethrogram be better than ultrasound *

Answer 29

if you are concerned about lower urinary tract rupture or strictures

Question 30

What imaging technique is good for all types of uroliths and seeing most of urinary tract

Answer 30

Ultrasound
if not in pelvic canal, penile urethra is tricky

Question 31

T/F: ultrasound is not good for lower urinary tract rupture and stricture

Answer 31

True
Cystourethrogram is best
Radiographs is second best

Question 32

What is best imaging technique for Neoplasia of lower urinary tract

Answer 32

Ultrasound is great for most locations (except intrapelvic)
CT is also good

Question 33

What is best imaging technique for urinary bladder herniation

Answer 33

ultrasound or CT are good
radiographs with contrast or fluoroscopy with contrast can be good too

regular rads are not great but can give you a cause for concern