Miscellaneous Genitourinary Conditions Flashcards

1
Q

What is benign Prostatic Hyperplasia?

A

Hypertrophy of the prostatic cells. It occurs in intact dogs with risk increasing with age

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2
Q

What are some complications of benign prostatic hyperplasia?

A

Symmetrical enlargement could lead to a compressed colon (making it difficult to defecate), prepucial discharge, and dysuria.

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3
Q

What is the therapy for benign prostatic hyperplasia?

A

Castration! Cells will reduce in size with time

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4
Q

What is the difference between acute and chronic bacterial Prostatitis?

A

Acute: Have systemic signs with a painful prostate

Chronic: Have recurrent UTIs and persistence of pathogens. You can treat with fluoroquinolones

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5
Q

How do you diagnose bacterial Prostatitis?

A

Prostatic wash

Urinalysis/culture

FNA of the prostate

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6
Q

How do you treat bacterial Prostatitis?

A

Prostate penetrating antibiotics like fluoroquinolones

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7
Q

How do you diagnose prostatic and para-prostatic cysts?

A

Signs of dysuria and urinary incontinence

Ultrasonography

Therapy is surgery

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8
Q

What types of prostatic neoplasia are there?

A

It is not uncommon in dogs

Common types are adenocarcinoma and transitional cell carcinomas

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9
Q

How to diagnose prostatic neoplasia?

A
  1. Hormonally independent
  2. Dysuria
  3. Imaging with prostate mineralization
  4. Prostatic fluid cytology from a FNA and prostatic wash
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10
Q

How to treat prostatic neoplasia?

A

Both local and systemic therapies using NSAIDs (COX inhibitors can reduce the size of some canine carcinomas) and other chemotherapies

Poor prognosis

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11
Q

What is the pathophysiology of urethral sphincter mechanism incompetence?

A

Post spay
-Increase in collagen and decrease in muscle in bladder/urethral wall
-Detrusor muscle responses are decreased

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12
Q

How do you diagnose urethral sphincter mechanism incompetence?

A

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.

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13
Q

How do you treat urethral sphincter mechanism incompetence?

A

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

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14
Q

What are ectopic ureters?

A

A ureteral opening located distal to the trigone

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15
Q

What other conditions are ectopic ureters associated with?

A
  1. Pyelonephritis
  2. Hydro-nephrotic/ureter
  3. Pelvic bladder
  4. Urachel remnants
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16
Q

What breeds are at risk for ectopic ureters?

A

Siberian huskies, labs, golden retrievers, newfoundlands, etc.

17
Q

How do you diagnose ectopic ureters?

A

CT and cystoscopy give the most information (95%)

18
Q

How do you treat ectopic ureters?

A

Surgery: ureteroneocystostomy that resects and re-implants

Laser ablation with cystoscopic guidance

19
Q

What is vestibulovaginal stenosis?

A

A structural abnormality that is an under-recognized cause of urinary incontinence in younger female dogs and leads to urine pooling

Causes chronic UTIs

20
Q

How do you diagnose vestibulovagnial stenosis?

A

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

21
Q

How do you treat vestibulovagnial stenosis?

A

Surgery

Balloon dilate

Abx for secondary UTIs

22
Q

What is vaginitis and what are the signs?

A

Inflammatory process that isn’t necessarily infectious

Signs include licking and vulvar discharge.

Must rule out other derm, urinary, systemic, and Anatomic causes

23
Q

What is puppy vaginitis?

A

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

24
Q

What is a common bladder neoplasia?

A

Uroepithelial cell carcinoma, formerly known as a transitional cell carcinoma

25
Q

How do you diagnose Uroepithelial cell carcinomas?

A
  1. Cystoscopy/biopsy
  2. UA
  3. CADET BRAF assay. Must send tons of urine to detect a bio marker
  4. FNA
26
Q

What is polypoid cystitis?

A

An uncommon proliferation of mucosa from chronic irritation/inflammation cycles

Must manage UTIs, resect polyp, surgical debunking/cystectomy