Lower urinary tract disease Flashcards
What medication can aid in medical treatment of ureteroliths?
Alpha-adrenergic antagonists
eg Prazosin/Tamsulosin
What are the first and second most common urolith found in the upper urinary tract in dogs?
1 - Calcium oxalate
2 - struvite
Which ureter is more often affected in circumcaval ureter?
Right
What gender predispositions are recognised in dogs with lower urinary urolithiasis?
Males - CaOx
Females - Struvite
What medical therapies are recommended to reduce recurrence of CaOx
USG <1.020
Avoidance of acidic urine (diet or potassium citrate)
+/- hydrochlorothiazide diuretics
What are the 2 mechanisms by which rate uroliths can form?
Abnormal urate transporter
Hepatic portovascular abnormalities
Both prevent transport of uric acid into hepatocytes for conversion to allantoin
What gene is abnormal in inherited urate transporter abnormalities in dogs?
SLC2A9
What medical treatment is available for urate urolithiasis? When is/isn’t it appropriate (and why)?
Allopurinol (minimised conversion of purines to uric acid)
Without liver disease
Liver function needed to convert allopurinol into oxypurinol - effective analogue
What gene is abnormal in inherited cysteine transporter abnormalities in cats?
SLC3A1
What medical treatment is available for cysteine urolithiasis?
Reduce USG
Alkalinise urine
Limit animal protein intake
What non-urinary complication is described in cats with cysteine urolithiasis?
Neuro signs - secondary hyperammonemia
Excessive renal excretion of COLA - arginine deficiency causes hyperammonemia
What are causes of struvite urolithiasis in cats?
Usually sterile
Low animal protein diet, distal RTA may promote alkaline urine
Which breeds of cat are associated with CaOx urolithiasis?
Persian and Himalayan
What is the MOA of phenylpropanolamine?
Alpha agonist
What medications have been shown to improve detrusor function?
Bethanechol
Cisapride
Metoclopramide
MOA prazosin
Alpha-1 antagonist
MOA tamsulosin
Alpha 1A antagonist
MOA phenoxybenzamine
Non-specific alpha antagonist
MOA bethanechol
Parasympatheticomimetic
What breed appears to be predisposed to BPH?
Scottish Terrier
What influences prostatic cell growth?
Dihydrotestosterone, estradiol-17-beta
What is the difference between parenchymal and paraprostatic cysts?
Parenchymal communicate with urethra
MOA finasteride
5-alpha-reductase inhibitor
Blocks conversion of testosterone to DHT
What are the desirable qualities for an antibiotic to reach the prostate>
pKa >7.0
Un-ionised
Lipophilic
Low protein binding
