Lower urinary tract disease

Question 1

What medication can aid in medical treatment of ureteroliths?

Answer 1

Alpha-adrenergic antagonists
eg Prazosin/Tamsulosin

Question 2

What are the first and second most common urolith found in the upper urinary tract in dogs?

Answer 2

1 - Calcium oxalate
2 - struvite

Question 3

Which ureter is more often affected in circumcaval ureter?

Answer 3

Right

Question 4

What gender predispositions are recognised in dogs with lower urinary urolithiasis?

Answer 4

Males - CaOx
Females - Struvite

Question 5

What medical therapies are recommended to reduce recurrence of CaOx

Answer 5

USG <1.020
Avoidance of acidic urine (diet or potassium citrate)
+/- hydrochlorothiazide diuretics

Question 6

What are the 2 mechanisms by which rate uroliths can form?

Answer 6

Abnormal urate transporter
Hepatic portovascular abnormalities

Both prevent transport of uric acid into hepatocytes for conversion to allantoin

Question 7

What gene is abnormal in inherited urate transporter abnormalities in dogs?

Answer 7

SLC2A9

Question 8

What medical treatment is available for urate urolithiasis? When is/isn’t it appropriate (and why)?

Answer 8

Allopurinol (minimised conversion of purines to uric acid)
Without liver disease
Liver function needed to convert allopurinol into oxypurinol - effective analogue

Question 9

What gene is abnormal in inherited cysteine transporter abnormalities in cats?

Answer 9

SLC3A1

Question 10

What medical treatment is available for cysteine urolithiasis?

Answer 10

Reduce USG
Alkalinise urine
Limit animal protein intake

Question 11

What non-urinary complication is described in cats with cysteine urolithiasis?

Answer 11

Neuro signs - secondary hyperammonemia
Excessive renal excretion of COLA - arginine deficiency causes hyperammonemia

Question 12

What are causes of struvite urolithiasis in cats?

Answer 12

Usually sterile
Low animal protein diet, distal RTA may promote alkaline urine

Question 13

Which breeds of cat are associated with CaOx urolithiasis?

Answer 13

Persian and Himalayan

Question 14

What is the MOA of phenylpropanolamine?

Answer 14

Alpha agonist

Question 15

What medications have been shown to improve detrusor function?

Answer 15

Bethanechol
Cisapride
Metoclopramide

Question 16

MOA prazosin

Answer 16

Alpha-1 antagonist

Question 17

MOA tamsulosin

Answer 17

Alpha 1A antagonist

Question 18

MOA phenoxybenzamine

Answer 18

Non-specific alpha antagonist

Question 19

MOA bethanechol

Answer 19

Parasympatheticomimetic

Question 20

What breed appears to be predisposed to BPH?

Answer 20

Scottish Terrier

Question 21

What influences prostatic cell growth?

Answer 21

Dihydrotestosterone, estradiol-17-beta

Question 22

What is the difference between parenchymal and paraprostatic cysts?

Answer 22

Parenchymal communicate with urethra

Question 23

MOA finasteride

Answer 23

5-alpha-reductase inhibitor
Blocks conversion of testosterone to DHT

Question 24

What are the desirable qualities for an antibiotic to reach the prostate>

Answer 24

pKa >7.0
Un-ionised
Lipophilic
Low protein binding

Question 25

Why should dogs with acute prostatitis not be castrated in the acute phase?

Answer 25

Risk of scirrhous cord formation

Question 26

What is the most common prostatic tumour in dogs?

Answer 26

Adenocarcinoma