Miscellaneous Genitourinary Conditions Flashcards
What is benign Prostatic Hyperplasia?
Hypertrophy of the prostatic cells. It occurs in intact dogs with risk increasing with age
What are some complications of benign prostatic hyperplasia?
Symmetrical enlargement could lead to a compressed colon (making it difficult to defecate), prepucial discharge, and dysuria.
What is the therapy for benign prostatic hyperplasia?
Castration! Cells will reduce in size with time
What is the difference between acute and chronic bacterial Prostatitis?
Acute: Have systemic signs with a painful prostate
Chronic: Have recurrent UTIs and persistence of pathogens. You can treat with fluoroquinolones
How do you diagnose bacterial Prostatitis?
Prostatic wash
Urinalysis/culture
FNA of the prostate
How do you treat bacterial Prostatitis?
Prostate penetrating antibiotics like fluoroquinolones
How do you diagnose prostatic and para-prostatic cysts?
Signs of dysuria and urinary incontinence
Ultrasonography
Therapy is surgery
What types of prostatic neoplasia are there?
It is not uncommon in dogs
Common types are adenocarcinoma and transitional cell carcinomas
How to diagnose prostatic neoplasia?
- Hormonally independent
- Dysuria
- Imaging with prostate mineralization
- Prostatic fluid cytology from a FNA and prostatic wash
How to treat prostatic neoplasia?
Both local and systemic therapies using NSAIDs (COX inhibitors can reduce the size of some canine carcinomas) and other chemotherapies
Poor prognosis
What is the pathophysiology of urethral sphincter mechanism incompetence?
Post spay
-Increase in collagen and decrease in muscle in bladder/urethral wall
-Detrusor muscle responses are decreased
How do you diagnose urethral sphincter mechanism incompetence?
Urethral pressure profiling that helps document if urethral pressure is greater than Intra-vesicular pressure
Rule out other causes like musculoskeletal, neurologic, congenital, infectious, etc.
How do you treat urethral sphincter mechanism incompetence?
Alpha adrenergic agonists like phenylpropanolamine (proin) but does cause hypertension
Estrogens that help increase response to alpha adrenergic receptors. Example is estriol (incurin). Side effects include bone marrow suppression
Per-urethral injections of collagen that can be very effective with medical management
Other surgeries
What are ectopic ureters?
A ureteral opening located distal to the trigone
What other conditions are ectopic ureters associated with?
- Pyelonephritis
- Hydro-nephrotic/ureter
- Pelvic bladder
- Urachel remnants
What breeds are at risk for ectopic ureters?
Siberian huskies, labs, golden retrievers, newfoundlands, etc.
How do you diagnose ectopic ureters?
CT and cystoscopy give the most information (95%)
How do you treat ectopic ureters?
Surgery: ureteroneocystostomy that resects and re-implants
Laser ablation with cystoscopic guidance
What is vestibulovaginal stenosis?
A structural abnormality that is an under-recognized cause of urinary incontinence in younger female dogs and leads to urine pooling
Causes chronic UTIs
How do you diagnose vestibulovagnial stenosis?
Digital vaginal exam with lidocaine jelly. If your finger feels like it hits the cervix, its not. It is a stenosis. Finger should not hit the cervix
How do you treat vestibulovagnial stenosis?
Surgery
Balloon dilate
Abx for secondary UTIs
What is vaginitis and what are the signs?
Inflammatory process that isn’t necessarily infectious
Signs include licking and vulvar discharge.
Must rule out other derm, urinary, systemic, and Anatomic causes
What is puppy vaginitis?
A pre-pubertal occurrence in females. Presentation is commonly purulent vulvar discharge seen post micturition. It self-resolves as they mature
Need pain meds and possible topical pain therapy
What is a common bladder neoplasia?
Uroepithelial cell carcinoma, formerly known as a transitional cell carcinoma
How do you diagnose Uroepithelial cell carcinomas?
- Cystoscopy/biopsy
- UA
- CADET BRAF assay. Must send tons of urine to detect a bio marker
- FNA
What is polypoid cystitis?
An uncommon proliferation of mucosa from chronic irritation/inflammation cycles
Must manage UTIs, resect polyp, surgical debunking/cystectomy
