Non-Obstructed LUTD

Question 1

What are the components of the lower urinary tract?

Answer 1

Bladder, urethra, prostate

Question 2

What are the functions of the lower urinary tract?

Answer 2

Storage and voiding of urine

Question 3

What are some clinical signs associated with LUTD?

Answer 3

Dysuria
Pollakiuria/periuria
Stranguria
Pigmenturia
Incomplete voiding
Urinary incontinence

Question 4

What are some causes of dys/strang/pollakiuria?

Answer 4

Irritation to the bladder, neurological disease, UTI, neoplasia

Question 5

What are the basic diagnostics to perform when investigating LUTD?

Answer 5

Urinalysis with sedimentation/cytology and culture

Question 6

What are additional diagnostics to perform when investigating LUTD?

Answer 6

Radiography/Ultrasound
Cystoscopy with or without biopsy
Excretory contrast studies
Urethra profilometry

Question 7

What does dark yellow to orange urine indicate?

Answer 7

Excess bilirubin

Question 8

What does red to port wine color urine indicatte?

Answer 8

Blood, hemoglobin, or myoglobin

Question 9

What kind of dogs will produce more bilirubin normally?

Answer 9

Male dogs- sometimes enough to make crystals

Question 10

Where can blood come from to end up in the urine?

Answer 10

Kidneys, lower urinary tract, reproductive tract, systemic disease

Question 11

What kinds of systemic diseases may result in blood in the urine?

Answer 11

Bleeding disorders, hypertension, hyperviscosity

Question 12

What is the incidence of UTIs in dogs?

Answer 12

Common- males predisposed

Question 13

What is the incidence of UTIs in cats?

Answer 13

Less common although incidence increases with age and concurrent disease

Question 14

What cell count in urine is diagnostic for a UTI?

Answer 14

> 5 WBC per HPF in cystocentesis sample

Question 15

What are some normal host defenses against UTI?

Answer 15

Normal micturition, anatomy, mucosal defenses, urine properties, systemic immune system

Question 16

What is the most common organism isolated from UTIs?

Answer 16

E.coli

Question 17

What is the second most common organism isolated from UTIs?

Answer 17

Gram positive cocci

Question 18

T/F: Most infections are caused by a single species

Answer 18

True (75%)

Question 19

Which route is more common, ascending or descending infections?

Answer 19

Ascending

Question 20

What kind of animals are more likely to get hematogenous UTIs?

Answer 20

FIV+ cats

Question 21

If a dog presents with a hematogenously acquired UTI, what condition should you look for?

Answer 21

Bacterial endocarditis

Question 22

What is the drug typically used when treating an uncomplicated UTI empirically?

Answer 22

Amoxicillin and cephalosporins for 10-14 days

Question 23

What are complicated UTIs typically associated with?

Answer 23

Relapse, reinfections, or resistant organisms

Question 24

Are cultures necessary in complicated UTIs?

Answer 24

Yes

Question 25

What classifies a UTI as a reinfection or a superinfection?

Answer 25

When culture reveals a new or different/altered organism

Question 26

When should a C/S be repeated in a typical UTI?

Answer 26

7 days after completion of treatment

Question 27

What kind of infection should be suspected if an animal is C/S positive >7 days after the last treatment?

Answer 27

Reinfection

Question 28

What kind of infection should be suspected if an animal is C/S positive at day 7 after STARTING antibiotics?

Answer 28

Superinfection

Question 29

What classifies an infection as a relapse UTI?

Answer 29

The same organism or strain 7 days after the last treatment

Question 30

What is typically the reason for a relapse infection?

Answer 30

Inappropriate drug use- dosage, frequency, or duration

Question 31

What renal is often implicated with multiple relapsing UTIs?

Answer 31

Pyelonephritis

Question 32

What are some things that can predispose an animal to a UTI?

Answer 32

- Anatomical abnormalities - Voiding abnormalities - Upper UTI - Endocrine disease - Repro disease/infection - Immune compromise - Iatrogenic diuresis

Question 33

What should you look at if you have a recurrent UTI?

Answer 33

What is causing it and antimicrobial history

Question 34

What can be done to determine cause of a recurrent UTI?

Answer 34

- Imaging - Culture - Underlying disease screening - Finding a nidus

Question 35

Why should antimicrobial history be reviewed in recurring UTI cases?

Answer 35

To make sure that the appropriate therapy was given and determine owner compliance

Question 36

How long should recurrent UTIs be treated for?

Answer 36

at least 4-6weeks

Question 37

When should prophylactic therapy be administered to a UTI case?

Answer 37

Once a recurrent infection has been eradicated as a last resort

Question 38

What is the typical prophylactic therapy?

Answer 38

Once daily at night at 30-50% of original dose for 6mo Choose a drug that has high urine concentration and few side effects

Question 39

How long should animals be monitored after prophylactic therapy?

Answer 39

3 months after resolution with regular cultures

Question 40

What are some alternative therapies in recurrent UTI cases?

Answer 40

Cranberry extract Probiotics Polysulfated glycosaminoglycans Fosfomycin (resistant E. coli)

Question 41

What fungus do we typically find in UTIs?

Answer 41

Candida

Question 42

What kind of animals do we find fungal UTIs in?

Answer 42

Underlying disease Diabetes or cushings most commonly