Non-Obstructed LUTD Flashcards

1
Q

What are the components of the lower urinary tract?

A

Bladder, urethra, prostate

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2
Q

What are the functions of the lower urinary tract?

A

Storage and voiding of urine

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3
Q

What are some clinical signs associated with LUTD?

A
Dysuria
Pollakiuria/periuria
Stranguria
Pigmenturia
Incomplete voiding
Urinary incontinence
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4
Q

What are some causes of dys/strang/pollakiuria?

A

Irritation to the bladder, neurological disease, UTI, neoplasia

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5
Q

What are the basic diagnostics to perform when investigating LUTD?

A

Urinalysis with sedimentation/cytology and culture

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6
Q

What are additional diagnostics to perform when investigating LUTD?

A

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

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7
Q

What does dark yellow to orange urine indicate?

A

Excess bilirubin

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8
Q

What does red to port wine color urine indicatte?

A

Blood, hemoglobin, or myoglobin

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9
Q

What kind of dogs will produce more bilirubin normally?

A

Male dogs- sometimes enough to make crystals

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10
Q

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

A

Kidneys, lower urinary tract, reproductive tract, systemic disease

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11
Q

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

A

Bleeding disorders, hypertension, hyperviscosity

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12
Q

What is the incidence of UTIs in dogs?

A

Common- males predisposed

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13
Q

What is the incidence of UTIs in cats?

A

Less common although incidence increases with age and concurrent disease

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14
Q

What cell count in urine is diagnostic for a UTI?

A

> 5 WBC per HPF in cystocentesis sample

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15
Q

What are some normal host defenses against UTI?

A

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

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16
Q

What is the most common organism isolated from UTIs?

A

E.coli

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17
Q

What is the second most common organism isolated from UTIs?

A

Gram positive cocci

18
Q

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

A

True (75%)

19
Q

Which route is more common, ascending or descending infections?

A

Ascending

20
Q

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

A

FIV+ cats

21
Q

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

A

Bacterial endocarditis

22
Q

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

A

Amoxicillin and cephalosporins for 10-14 days

23
Q

What are complicated UTIs typically associated with?

A

Relapse, reinfections, or resistant organisms

24
Q

Are cultures necessary in complicated UTIs?

A

Yes

25
Q

What classifies a UTI as a reinfection or a superinfection?

A

When culture reveals a new or different/altered organism

26
Q

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

A

7 days after completion of treatment

27
Q

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

A

Reinfection

28
Q

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

A

Superinfection

29
Q

What classifies an infection as a relapse UTI?

A

The same organism or strain 7 days after the last treatment

30
Q

What is typically the reason for a relapse infection?

A

Inappropriate drug use- dosage, frequency, or duration

31
Q

What renal is often implicated with multiple relapsing UTIs?

A

Pyelonephritis

32
Q

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

A
  • Anatomical abnormalities
  • Voiding abnormalities
  • Upper UTI
  • Endocrine disease
  • Repro disease/infection
  • Immune compromise
  • Iatrogenic diuresis
33
Q

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

A

What is causing it and antimicrobial history

34
Q

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

A
  • Imaging
  • Culture
  • Underlying disease screening
  • Finding a nidus
35
Q

Why should antimicrobial history be reviewed in recurring UTI cases?

A

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

36
Q

How long should recurrent UTIs be treated for?

A

at least 4-6weeks

37
Q

When should prophylactic therapy be administered to a UTI case?

A

Once a recurrent infection has been eradicated as a last resort

38
Q

What is the typical prophylactic therapy?

A

Once daily at night at 30-50% of original dose for 6mo

Choose a drug that has high urine concentration and few side effects

39
Q

How long should animals be monitored after prophylactic therapy?

A

3 months after resolution with regular cultures

40
Q

What are some alternative therapies in recurrent UTI cases?

A

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

41
Q

What fungus do we typically find in UTIs?

A

Candida

42
Q

What kind of animals do we find fungal UTIs in?

A

Underlying disease

Diabetes or cushings most commonly