Non Obstructed LUTD Flashcards
What are the 3 components of the lower urinary tract?
- bladder
- urethra
- prostate
What are the 6 things we will with LUTD?
- Dysuria
- Pollakiuria/ periuria
- Stranguria
- Pigmenturia
- Incomplete voiding: palpate bladder after urinating and still has urine in it
- Urinary incontinence
Define dysuria
painful peeing
Define pollakuria/periuria
peeing all over the place; excessive urination
Define stranguria
straining to pee
Define pigmenturia
different color of pee than what it normally is
What causes dysuria/stranguria/pollakiuria?
- Irritation of bladder: bacterial, uroliths, interstitial cystitis
- Neurological bladder
- Secondary LUTD
- Neoplasia
How do we dx LUTD?
Use fricken everything. Collect urine free flow and cystocentesis Urinalysis including microscope exam/sedimentation Urine culture Urine cytology Rads US Contrast studies etc etc etc
One of the main things we see with LUTD is discolored urine. What color will bilirubinuria be? What about hematuria?
Bilirubin = dark yellow/orange Hematuria = red/port wine
T/F Bacterial agents tend to be the major cause behind UTIs.
True. Bacteria account for 99% of infections
What is the incidence of UTIs in dogs and cats?
Dogs: common: 14% of dogs affected: female
Cats: less common; incidence increases with advancing age
What 4 things cause LUTD?
- UTI
- pyuria (pus inside urine >5 WBC/HPF high powered field)
- Significant bacteriuria
- Inflammation (cat) vs infection (dog)
T/F Microbial factors include adherence factors, hemolysin, urease, mucosal defenses and capsules.
False, includes all of those except mucosal defenses.
Mucosal defenses, normal micturition, urine properties, immune system and anatomy are all ways in which the host protects itself.
What is the most common microbial isolate?
E. coli most common (33-50%)
What is the second most common microbial isolate?
Gram positive cocci (25-33%)
T/F Most infections contain multiple species.
False. Most infections are single species: 75%
Ascending or hematogenous is the most common route of infection?
Ascending
What is our gold standard test?
Urine culture!!!
How do we tx uncomplicated UTIs?
Drug choice: Amoxicillin and cephalosporins, TMS
Duration: 10-14 days
Are cultures necessary for complicated UTIs?
Yes!!
What is the difference btwn reinfection/superinfection and relapse?
Reinfection/superinfection is infection with new or different organism
Relapse is infection with the SAME organism/strain
Explain reinfection/superinfection UTIs
- New/different organisms
- C & S positive >7 days after last tx course (REINFECTION)
- C & S positive at day 7 after starting antibiotics (SUPER)
Explain relapse UTIs
- SAME organism/strain 7 days AFTER last tx
- have to look into inappropriate drug, dose, frequency, duration
- pyelonephritis, nidus of infection
How do we determine the cause of a RECURRENT UTI?
- Imaging: Rads and US
- CULTURE NECESSARY!
- Search for underlying dz
- Search for a nidus (stone, suture)
During tx of RECURRENT UTI, when do we culture?
Pre therapy
During therapy
Post therapy
CULTURE AT ALL 3 TIMES!
How long do we tx RECURRENT UTI?
2-4 wks
4-6 wks
6-8 wks
8-10 wks
Extended course (4-6 wks)
How do we tx a REINFECTION UTI?
Prophylactic Therapy!
- once infection is eradicated
- LAST RESORT
- drug that concentrates in urine; few side effects
- once daily, bedtime administration so it sits in der alllll night, 30-50% of original dose
- Nitrofurantoin is good choice! Urinary disinfectant
- regular microbiology (q 4 weekly)
- if negative C & S for 6 months - discontinue!
- monitor C & S for 3 months after discontinuation (q 1 monthly) then q 3 months (1 yr)
What species is primarily responsible for fungal UTIs?
Candida spp
