Lower Urinary Tract Flashcards
What is the normal positioning of the canine bladder
Ventral to colon and uterus
often cranial to pubis
sometimes partly in the pelvic canal
What is the normal positioning of the feline bladder
Ventral to colon and uterus
almost always short distance cranial to pubis
What might interfere with the interpretation of bladder radiographs
superimposition of thigh muscles
What could cause cranial displacement of the bladder
1) Prostatomegaly (enlarged)
-intact male and/or disease
2) Other pelvic cavity mass
What could cause caudal displacement of the bladder
1) Often normal variant ( sometimes congenital abnormal with incontinence)
2) Perineal hernia
3) Mid abdominal mass displacing caudally
What could cause increased size of the bladder
1) Voluntary retention (house-trained, long carride, hospitalized)
2) Urethral obstruction
3) Neurological problem- most often T3-L3
Problems at spinal segments _______ would result in an increased bladder
T3-L3
What could cause lack of bladder visualization if normal peritoneal detail
1) small bladder (recent urination)
2) Pelvic bladder (dog)
3) Herniated
4) ectopic ureters or another anomaly of bladder not filling (rare)
What could cause lack of bladder visualization if poor peritoneal detail
1) young or underconditioned
2) Peritoneal effusion (sometimes from ruptured bladder or CHF )
What contrast media should you never use for visualizing the bladder
barium
What can give better visualization of the bladder
iodinated contrast
1) Urinary contrast (direct is more preferred)
2) IV
What might cause decreased opacity of the bladder
1) Intraluminal gas
2) Emphysematous cystitis
How might the bladder have intraluminal gas resulting in decreased opacity (lucency) on radiography
1) Iatrogenic- cysto or urinary catheter
2) Gas producing UTI
What does emphysematous cystitis look like on radiograph
gas in the wall, best seen around the peripheral edges
What might cause emphysematous cystitis
1) Diabetes mellitus - bacteria
2) Long term corticosteroids (Cushings or iatrogenic)
3) Chronic urinary tract infection
4) Gas producing bacteria
What might cause increased opacity of the urinary bladder
1) Presence of positive (iodinated) contrast agent
2) Radiopaque uroliths (stones, calculi, cystoliths)
-Mineral opaque
What are the most common type of radiopaque uroliths in the bladder?
Struvite and Calcium oxalate
Cystine and urate are less opaque but also visible but urinary stones may be a mix of different materials
What should you do if you are having a hard time seeing the bladder and dont want to use contrast
Paddle Shot (compress the caudal abdomen with a lucent paddle)
gas in wall of urinary bladder
Emphysematous cystitis
if the bladder lies straight then intraluminal gas often collect
in the center
Where do radiopaque uroliths typically collect within the urinary bladder
collect near the center
In the female, the urethra is a
short tube from trigone to the vestibule
What are the 3 parts of the male urethra
1) Prostatic - through the prostate
2) Membranous- through intrapelvic region
3) Penile - after intrapelvic region
where do stones typically get lodged in the male
where the urethra goes through the os penis
What often get confused for stones
Superimposed nipples and unimportant separate areas of ossification
Cats can have os penis in about ____ of cases
1/3 of cases
do not confused with mineral blocking the urehtra
Butt-Shot View
a view where the pelvic limbs are moves forward to see the rest of the urethra and stones better in the urethra
constrast media injected into the urethra and urinary bladder
Cystourethrogram
good for narrowing urethra, rupture wall thickening
When might cystourethrogram be better than ultrasound *
if you are concerned about lower urinary tract rupture or strictures
What imaging technique is good for all types of uroliths and seeing most of urinary tract
Ultrasound
if not in pelvic canal, penile urethra is tricky
T/F: ultrasound is not good for lower urinary tract rupture and stricture
True
Cystourethrogram is best
Radiographs is second best
What is best imaging technique for Neoplasia of lower urinary tract
Ultrasound is great for most locations (except intrapelvic)
CT is also good
What is best imaging technique for urinary bladder herniation
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
