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MODULE 17 - Urinary, Endocrine and Oncological Disease > PATHOLOGY - Lower Urinary Tract Disease > Flashcards

PATHOLOGY - Lower Urinary Tract Disease Flashcards

1
Q

What is gross/macroscopic haematuria?

A

Gross/macroscopic haematuria is where there is sufficient enough blood in the urine that it can be seen macroscopically. The urine will typically appear red to brownish

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2
Q

What is occlut/microscopic haematuria?

A

Occult/microscopic haematuia is where there are erythrocytes in the urine but they cannot be visualised macroscopically

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3
Q

What is pseudohaematuria?

A

Pseudohaematuria is where the urine appears red to brownish but there are no erythrocytes present in the urine

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4
Q

What can cause pseudohaematuria?

A

Haemaglobinuria
Myoglobinuria

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5
Q

How can you differentiate between true haematuria and pseudohaematuria?

A

Urine sediment examination - erythrocytes will be visible if there is true haematuria but they will not be visible if it is pseudohaematuria

Centrifuge the urine - the erythrocytes will seperate from the urine if it is true haematuria but they will not if it is pseudohaematuria

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6
Q

What are the generalised causes of haematuria?

A

Systemic disease
Renal/ureteral disease
Bladder/urethral disease
Genital tract

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7
Q

Which history questions can be useful to determine if haematuria is systemic or urogenital?

A

Has there been bleeding at other sites?
Has there been any recent trauma?
Has there been any exposure to anticoagulant rodenticides?
When does the bleeding start during urination?
Describe the appearance of the urine?

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8
Q

Which factors should you be aware of on clinical examination which could help to determine if haematuria is systemic or urogenital?

A

Determine if there are any other sites of haemorrhage
Determine if there are any signs of anaemia
Rectal examination
Palpate the kidneys
Palpate the muscles

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9
Q

What are the distinguishing factors of haematuria due to systemic disease?

A

Haematuria due to systemic disease typically presents with bleeding elsewhere and there is unlikely to be signs of a lower urinary tract disease

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10
Q

What are the systemic causes of haematuria?

A

Primary haemostasis
Secondary haemostasis
Tertiary haemostasis

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11
Q

What are the distinguishing features of haematuria due to renal/ureteral disease?

A

Bleeding can occur throughout urination, at the end of urination or intermittently
Typically there will be no signs of lower urinary tract disease
May be concurrent haemaglobinuria

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12
Q

Why can there be concurrent haemaglobinuria with haematuria due to renal/ureteral disease?

A

Renal/ureteral disease can decrease the concentrating abilities of the kidneys resulting in the production of dilute urine. Erythrocytes within dilute urine can be lysed due to osmosis resulting in haemaglobinuria

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13
Q

What are some of the causes of renal/ureteral haematuria?

A

Pyelonephritis
Neoplasia
Caliculi
Trauma
Infarction
Cysts
Glomerulonephritis
Idiopathic renal haematuria

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14
Q

What are the distinguishing features of haematuria due to bladder/urethral disease?

A

Bleeding can occur throughout urination or at the start of urination
Signs of lower urinary tract disease

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15
Q

What are some of the causes of bladder/urethral haematuria?

A

Cystitis
Neoplasia
Polyps
Caliculi
Trauma
Cyclophosphamide administration
Feline idiopathic cystitis

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16
Q

What are the distinguishing features of haematuria due to genital disease?

A

Bleeding can occur throughout urination, at the start of urination or be unrelated to urination
May or may not have signs of lower urinary tract disease

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17
Q

What are some of the causes of genital haematuria?

A

Prostatic disease
Oestrus
Infection
Neoplasia
Trauma

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18
Q

What are some of the diagnostic tests which can be done to investigate haematuria?

A

Haematology
Biochemistry
Urinalysis
Coagulation profile
Diagnostic imaging
Cystoscopy
Vaginoscopy
Vaginal cytology
Prostatic wash

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19
Q

What are the key clinical signs of lower urinary tract disease?

A

Dysuria
Stranguria
Pollakiuria

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20
Q

What is dysuria?

A

Dysuria is difficult and/or painful urination

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21
Q

What is stranguria?

A

Stranguria is slow and painful urination or straining to urinate

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22
Q

What is pollakuria?

A

Pollakuria is the abnormally frequent passage small volumes of urine

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23
Q

What are the two general mechanisms of dysuria?

A

Mucosal irritation or inflammation of the lower urinary tract Narrowing or obstruction of the urethra or bladder neck

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24
Q

What are the differential diagnoses for dysuria involving the bladder?

A

Cystitis
Neoplasia
Polyp
Bladder rupture
Reflex dyssynergia

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25
Q

What are the differential diagnoses for dysuria involving the urethra?

A

Bladder urethritis
Granulomatous urethritis
Urethral caliculi
Urethral plugs (in cats)
Urethral stricture
Neoplasia
Urethral rupture
Reflex dyssynergia

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26
Q

What are the differential diagnoses for dysuria involving the prostate?

A

Benign prostatic hyperplasia
Prostatitis
Prostatic abscess
Prostatic cyst
Neoplasia

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27
Q

What are the differential diagnoses for dysuria involving the penis, prepuce or vagina?

A

Neoplasia

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28
Q

Which history questions are useful to ask when investigating patients with dysuria?

A

Are they passing any urine?
How much urine is being passed?
How often is urine being passed?
Is the patient painful on urination?
Describe the appearance of the urine?
Where is the animal urinating?
Is the patient licking their penis or vulva?
Has this happened before?
How long has this been going on for?
Has there been any recent trauma?

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29
Q

Which factors should you assess carefully on clinical examination in patients with dysuria?

A

Abdominal palpation
Bladder palpation
Rectal examination
Examination of the perineum and external genitalia
If possible, watch the animal urinate and take a sample

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30
Q

What are some of the diagnostic tests which can be done to investigate dysuria?

A

Haematology
Biochemistry
Urinalysis
Coagulation profile
Diagnostic imaging
Cystoscopy
Vaginoscopy
Vaginal cytology
Prostatic wash

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31
Q

Describe the physiological mechanism of urine storage

A

The sympathetic nervous system stimulates the hypogastric nerve to relax the detrusor muscle via β2 receptors and contract the internal urethral sphincter via α1 receptors

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32
Q

Describe the physiological mechanism of micturition

A

The parasympathetic nervous system stimulates the pelvic nerve to contract the detrusor muscle via M3 receptors and relax the internal urethral sphincter via the M2 receptors, allowing for the voiding of the bladder

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33
Q

What is the role of the pudendal nerve in micturition?

A

The pudendal nerve mediates the external urethral sphincter which is made up of skeletal muscle and is thus mediated under voluntary control

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34
Q

What are the potential causes of urinary retention?

A

Obstruction
Detrusor atony
Failure of relaxation of the internal urethral sphincter
Reflex dyssynergia

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35
Q

How do you approach investigation of causes of urinary retention?

A

History and clinical signs
Clinical examination
Neurological examination
Diagnostic imaging

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36
Q

What is detrusor atony?

A

Detrusor atony is where there is a loss of detrusor muscle tone resulting in incomplete bladder emptying or urinary storage

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37
Q

What are some of the causes of primary detrusor atony?

Primary detrusor atony is rare

A

Dysautonomia
Lower motor neurone disease between S1 to S3 (where the pelvic nerve arises)

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38
Q

What causes secondary detrusor atony?

Secondary detrusor atony is more common than primary

A

Secondary detrusor atony is due to chronic overstetching of the bladder

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39
Q

What are the key clinical signs of secondary detrusor atony?

A

Weak or absent urinary stream
Distended, flaccid bladder on palpation

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40
Q

How do you treat detrusor atony?

A

Bethanecol
Place an indwelling urinary catheter to rest the detrusor

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41
Q

What is reflex dyssynergia?

A

Reflex dyssynergia is where there is a loss of coordination between the detrusor muscle and the urethral sphincters resulting in delayed bladder emptying or urinary retention

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42
Q

What is the main cause of reflex dyssynergia?

A

Reflex dyssynergia is idiopathic

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43
Q

Which signalement is more prone to reflex dyssynergia?

A

Middle aged, large breed dogs

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44
Q

Which dog breed is particularly prone to reflex dyssynergia?

A

Labradors

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45
Q

What are the key clinical signs of reflex dyssynergia?

A

Urine stream intiated by not maintained
Difficult to manually express the bladder

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46
Q

What can reflex dyssynergia progress to?

A

Reflex dyssynergia can eventually cause detrusor atony

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47
Q

How do you diagnose reflex dyssynergia?

A

Reflex dyssynergia is a diagnosis based on the exclusion of all other causes of these clinical signs

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48
Q

What are the aims of treatment for reflex dyssynergia?

A

Decrease internal urethral sphincter tone
Decrease external urethral sphincter tone
Increase detrusor contraction

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49
Q

Which drugs can be used to decrease internal urethral sphincter tone?

A

Prazosin
Phenoxybenzamine

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50
Q

Which drugs can be used to decrease external urethral sphincter tone?

A

Diazepam
Dantrolene

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51
Q

Which drug can be used to increase detrusor contraction?

A

Bethanecol

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52
Q

What are the potential causes of urinary incontinence?

A

Decreased detrusor compliance
Urethral sphincter mechanism incontinence (USMI)
Overflow incontinence
Ectopic ureters

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53
Q

How do you approach investigation of causes of urinary incontinence?

A

History and clinical signs
Clinical examination
Neurological examination
Urinalysis
Diagnostic imaging

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54
Q

Which conditions can be commonly mistaken as urinary incontinence by owners?

A

Polyuria
Pollakuria
Periuria

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55
Q

What is periuria?

A

Periuria is urinating in inappropriate places

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56
Q

Which history questions are beneficial to ask to determine if an animal is truly urinary incontinent?

A

At what age did the incontinence begin?
When does the owner percieve the animal to be incontinent?
Are the able to urinate normally?
How aware are the pets of this incontinence?

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57
Q

What are the key signs of true urinary incontinence?

A

Urinary incontinence at rest
Normal urination outside of incontinence
Animal unaware of incontinence

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58
Q

Why is it important to do urine culture and sensitivity on patients with urinary incontinence?

A

It is important to do a urine culture and sensitivity on patients with urinary incontinence as there are at an increased risk of a lower urinary tract infection due to being regularly covered in urine

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59
Q

(T/F) Urethral sphincter mechanism incontinence (USMI) is more commonly congenital than acquired

A

FALSE. Urinary sphincter mechanism incontinence (USMI) is more commonly acquired

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60
Q

Which signalement typically presents with urethral sphincter mechanism incontinence (USMI)?

A

Female dogs within three years of being spayed

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61
Q

How does spaying cause urethral sphincter mechanism incontinence (USMI)?

A

Spaying causes a reduction in oestrogen which results in downregulation of the α1 adrenergic receptors at the internal urethral sphincter, resulting in decreased sphincter tone and urinary incontinence

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62
Q

What are some of the other causes of acquired urethral sphincter mechanism incontinence (USMI)?

A

Decreased urethral sphincter tone
Decreased number or responsiveness of α1 receptors
Changes in periurethral tissues
Obesity
Abnormal morphology of the bladder
Abnormal morphology of the urethra
Vaginal structural abnormalities
Breed predispositions

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63
Q

What are the clinical signs of urethral sphincter mechanism incontinence (USMI)?

A

Urinary incontinence

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64
Q

How do you diagnose urethral sphincter mechanism incontinence (USMI)?

A

Urethral sphincter mechanism incontinence is a diagnosis based on the exclusion of all other causes of these clinical signs

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65
Q

How can you medically manage urethral sphincter mechanism incontinence (USMI)?

A

Phenylpropanolamine
Ephedrine
Estriol

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66
Q

What is the mechanism of action of phenylpropanolamine?

A

Phenylpropanolamine is a sympathomimetic drug which can bind to the α1 adrenergic receptors at the internal urethral sphincter, increasing internal urethral spincter tone

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67
Q

What are the side effects of phenylpropanolamine?

A

Restelessness
Aggression
Hypertension

68
Q

What is the mechanism of action of ephedrine?

A

Ephedrine is a sympathomimetic drug which can bind to the α1 adrenergic receptors at the internal urethral sphincter, increasing internal urethral spincter tone

69
Q

What is the mechanism of action of estriol?

A

Estriol is a synthetic oestrogen which will upregulate the α1 adrenergic receptors at the internal urethral sphincter, increasing internal urethral spincter tone

70
Q

What are the contraindications for estriol?

A

Male animals
Intact females
PUPD patients

71
Q

What can you do if patients with urethral sphincter mechanism incontinence (USMI)?

A

Consider differential diagnoses
Try drugs in combination
Weight loss
Collagen injections into the urethra
Surgical articifical urethral sphincter

72
Q

What are ectopic ureters?

A

Ectopic ureters are a congenital conditon where the ureters bypass the trigone of the bladder and insert elsewhere

73
Q

What are intramural ectopic ureters?

A

Intramural ectopic ureters open into the bladder at a lower site than usual, usually the neck of the bladder or the urethra

74
Q

What are extramural ectopic ureters?

A

Extramural ectopic ureters bypass the bladder and open into usually either the urethra or the vagina

75
Q

What is the typical signalement for ectopic ureters?

A

Young animals (as this is a congenital condition)

76
Q

What are the clinical signs of ectopic ureters?

A

Urinary incontinence

77
Q

How can you diagnose ectopic ureters?

A

Ultrasound
Retrograde urethral contrast radiography
CT intravenous urethrogram
Cystography

78
Q

How do you treat ectopic ureters?

A

Referral surgery

79
Q

What is the main cause of lower urinary tract infections?

A

The main cause of urinary tract infections are ascending infections from the external environment (usually pathogens found in the faeces or the skin)

80
Q

Which bacteria species are usually isolated in lower urinary tract infections?

A

E. coli
Staphylococcus
Streptococcus
Proteus
Enterococcus
Klebsiella

81
Q

Which signalement is most prone to lower urinary tract infections (UTIs)?

A

Female dogs
Male dogs with prostatitis

82
Q

What are the clinical signs of lower urinary tract infections?

A

Urgency to urinate
Haematuira
Dysuria
Stranguira
Pollakiuria
Bladder small and thickened on palpation

83
Q

What can lower urinary tract infections progress to?

A

Urinary retention
Urinary incontinence

84
Q

(T/F) Pyrexia and leukocytosis are rare in lower urinary tract infections

A

TRUE. Pyrexia and leukocytosis are very rare in lower urinary tract infections however they are seen in pyelonephritis

85
Q

How do you diagnose lower urinary tract infections?

A

Urinalysis including urine culture and sensitivity

86
Q

Which is urinary culture and sensitivity indicated?

A

Animals with lower urinary tract clinical signs
Animals with renal disease
Animals with non-specific clinical signs
Animals with diseases which predispose them to urinary tract infections

87
Q

What is the best way to collect a urine sample of urinary culture and sensitivity?

A

Cystocentesis

88
Q

What is asymptomatic bacteriuria?

A

Asymptomatic bacteriuria is where patients have bacteriuria in the absence of clinical signs

89
Q

What is sporadic bacterial cystitis?

A

Sporadic bacterial cystitis is a bacterial infection of the bladder, with less than three episodes of cystitis within a twelve month period

90
Q

How do you treat sporadic bacterial cystitis?

A

3 - 5 day course of antibiotics, ideally based on urine culture and sensitivity

91
Q

Which antibiotics can you use to treat sporadic bacterial cystitis if you don’t have culture and sensitivity results?

A

Amoxycillin
Amoxycillin-clavulanate

92
Q

Which drugs, other than antibiotics, can be used to treat sporadic urinary tract infections?

A

NSAIDS

93
Q

What is a recurrent bacterial cystitis?

A

Recurrent bacterial cystitis is a bacterial infection of the bladder, with three or more episodes of cystitis in twelve months or one recurrence within three months. Recurrent bacterial cystitis can be relapsing or reinfection

94
Q

What is the difference betwen a relapsed infection and a reinfection?

A

A relapsed infection is the persistence of the original bacteria which caused the infection, whereas a reinfection is where there is a new infection with a different bacteria

95
Q

What can cause bacterial cystitis to relapse?

A

Inappropriate antibiotic
Inappropriate antibiotic dose
Inappropriate frequency or duration of treatment
Lack of owner compliance
Presence of a nidus of infection
Anatomical or funtional abnormalities

96
Q

What can cause a bacterial cystitis reinfection?

A

Presence of a nidus of infection
Anatomical or functional abnormalities

97
Q

How do you treat a recurrent bacterial cystitis?

A

Identify and treat the underlying causes
3 - 5 day course of antibiotics based on culture and sensitivity if a reinfection
7 - 14 day course of antibiotics if relapsed infection

98
Q

(T/F) Recurrent bacterial cystitis should always be prescribed antibiotics based on urine culture and sensitivity

A

TRUE.

99
Q

What are the potential complications of lower urinary tract infections?

A

Polypoid cystitis
Emphysematous cystitis

100
Q

What is polypoid cystitis?

A

Polypoid cystitis is the formation of polyp-like growths on the bladder wall which cause inflammation and can be a nidus (focus) for infection

101
Q

Which treatment option should you consider for polypoid cystitis?

A

Partial cystectomy

102
Q

What is emphysematous cystitis?

A

Emphysematous cystis is the accumulation of gas in the bladder lumen and wall

103
Q

What causes emphysematous cystitis?

A

Emphysematous cystitis is caused by certain types of bacteria, most commonly E. coli, which are capable of fermenting glucose and producing gas as a byproduct resulting in emphysema

104
Q

Which disease can increase the risk of emphysematous cystitis?

A

Diabetes mellitus

105
Q

What is the most common iatrogenic cause of lower urinary tract infections?

A

Urinary catheterisation

106
Q

How can you reduce the risk of lower urinary tract infections secondary to urinary catheterisation?

A

Minimise trauma during catheter placement
Aseptic technique
Closed urinary collection systems
Reduce duration of catheter placement

107
Q

What are the most common benign bladder masses seen in small animals?

A

Polypoid cystitis
Leiomyoma

108
Q

What is the most common malignant bladder neoplasia seen in small animals?

A

Transitional cell carcinoma

109
Q

Which dog breed is predisposed to bladder transitional cell carcinoma?

A

Scottish Terrier

110
Q

What are the clinical signs of a bladder transitional cell carcinoma?

A

Haematuira
Dysuria
Stranguira
Pollakiuria
Urinary retention
Urinary incontinence (rare)

111
Q

How can a bladder transitional cell carcinoma cause urinary retention?

A

A bladder transitional cell carcinoma can extend into the bladder neck and urethra, resulting in a physical obstruction in urine outflow

112
Q

How do you diagnose a bladder transitional cell carcinoma?

A

Diagnostic imaging
Cystoscopy
Bladder biopsy
BRAF mutation test

113
Q

How do you treat a bladder transitional cell carcinoma?

A

Surgical resection
Chemotherapy
NSAIDS

114
Q

Why is surgical resection often impossible for bladder transitional cell carcinomas?

A

Transitional cell carcinomas mostly occur at the trigone region of the bladder which is the small triangular region of the bladder formed by the openings of the ureters and the internal urethral sphincter, which can make surgical resection challenging due to the close proximity and risk of damage to vital structures

115
Q

Which chemotherpy drug is usually used for bladder transitional cell carcinomas?

A

Carboplatin

116
Q

What is the risk of chemotherapy in urinary incontinent patients?

A

Patients with transitional cell carcinomas can develop urinary incontinence, and since chemotherapy drugs are excreted renally into the urine this can result in chemotherpay drugs being distributed around the owner’s house

117
Q

What are the benefits of NSAIDS in the treatment of bladder transitional cell carcinomas?

A

NSAIDS have both anti-neoplastic effects against transitional cell carcinomas and anti-inflammatory effects

118
Q

What are the general clinical signs of prostatic disease?

A

Haematuria
Urethral discharge
Faecal tenesmus
Dysuria
Urinary incontinence
Hindlimb lameness
Systemic clinical signs (sometimes)

119
Q

How can prostatic disease cause faecal tenesmus?

A

Prostatic disease can cause prostatic enlargement which can compress the rectum and cause faecal tenesmus

120
Q

How can prostatic disease cause dysuria?

A

Prostatic disease can compress the urethra and cause dysuria

121
Q

Which diagnostic tests can be done to investigate prostatic disease?

A

Rectal examination
Haematology and biochemistry
Urinalysis (including culture and sensitivity)
Prostatic wash
Diagnostic imagine
Fine needl aspirate (FNA)

122
Q

How should a normal prostate feel on rectal examination?

A

On rectal examination you should be able to feel the prostate ventrally and it should feel smooth, bilobed and non-painful

123
Q

How do you carry out a prostatic wash?

A
  1. Sedate your patient
  2. Pass a urinary catheter into the bladder and drain the bladder
  3. Flush the bladder with sterile saline
  4. Move the urinary catheter back to the level of the prostate. An assistant will have to feel the prostate per rectum and tell you when they can feel the tip of the catheter
  5. Inject a small volume (2 - 5ml) of sterile saline into the urinary catheter and have your assistant massage the prostate per rectum for approximately one minute to encourage sloughing of prostatic cells into the saline
  6. Aspirate the fluid
  7. Submit the sample for cytology and culture
124
Q

What is benign prostatic hyperplasia?

A

Benign prostatic hyperplasia is an age-related change seen in entire male dogs. Persistent hormonal stimulation of the prostate can result in hyperplasia of the prostate parenchyma, along with the formation of prostatic cysts and increased prostatic vascularity (which can cause bleeding)

125
Q

What are the clinical signs of benign prostatic hyperplasia?

A

Asymptomatic
Haematuria
Haemorrhagic urethral discharge
Haematospermia
Faecal tenesmus

126
Q

How do you diagnose benign prostatic hyperplasia?

A

Rectal examination
Ultrasound
Prostatic wash

127
Q

How does benign prostatic hyperplasia feel on rectal examination?

A

On rectal examination, benign prostatic hyperplasia will be a symmetrically enlarged, non-painful prostate

128
Q

Why should you do a prostatic wash if you suspect benign prostatic hyperplasia?

A

A prostatic wash should be done if you suspect benign prostatic hyperplasia as it can rule out inflammatory and neoplastic conditons

129
Q

What is required for a definitive diagnosis of benign prostatic hyperplasia?

A

Biopsy and histopathology

130
Q

How can you treat benign prostatic hyperplasia?

A

Surgical castration
Chemical castration

131
Q

How long does it take surgical castration to begin to correct benign prostatic hyperplasia?

A

4 weeks

132
Q

What are the main options for chemical castration?

A

Osaterone
Deslorelin

133
Q

What is osaterone?

A

Osaterone is a tablet form of a testosterone receptor antagonist and thus prevents the persistent stimulation of testosterone on the prostate

134
Q

How long does it take osaterone to begin to correct benign prostatic hyperplasia?

A

2 weeks

135
Q

What is deslorelin?

A

Deslorelin is an implant GnRH agonist

136
Q

How long does it take deslorelin to begin to correct benign prostatic hyperplasia?

A

At least a month

137
Q

What are the contraindications for deslorelin to treat benign prostatic hyperplasia?

A

Deslorelin can cause initial swelling of the prostate which can worsen faecal tenesmus, so if patients are already presenting with faecal tenesmus, this form of treatment is contraindicated

138
Q

What is bacterial prostatitis?

A

Bacterial prostatitis is the inflammation of the prostate due to a bacterial infection

139
Q

What are the causes of bacterial prostatitis?

A

Ascending bacterial infection from the urethra
Haematogenous bacterial infection

140
Q

Which signalement typically presents with bacterial prostatitis?

A

Entire male dogs

141
Q

What are the clinical signs of acute bacterial prostatitis?

A

Haematuria
Haemorrhagic/purulent urethral discharge
Faecal tenesmus
Dysuria
Abdominal pain
Lethargy
Pyrexia
Anorexia
Vomiting

142
Q

What are the clinical signs of chronic bacterial prostatitis?

A

Mild haematuria
Haemorrhagic/purulent urethral discharge
Recurrent lower urinary tract infections
Infertility

143
Q

How do you diagnose bacterial prostatitis?

A

Rectal examination
Haematology and biochemistry
Urinalysis and culture
Ultrasound
Prostatic wash

144
Q

How does bacterial prostatitis feel on rectal examination?

A

On rectal examination, the prostate can feel normal with bacterial prostatitis however it is likely to be painful with acute bacteria prostatitis but not with chronic bacterial prostatitis

145
Q

How do you treat bacterial prostatitis?

A

It is important to check for bacteria prostatitis in entire male dogs presenting with bacteruria or bacterial cystitis as the treatment for bacterial prostatitis is quite different due to the blood prostate barrier - because of this you have to choose very specific antibiotics and adminsiter them for a longer duration

146
Q

Which antibiotics can be used to treat bacterial prostatitis?

A

Trimethroprim (first line)
Fluoroquinolones (second line)

147
Q

How long should you treat acute bacterial prostatitis with antibiotics?

A

4 week course of antibiotics

148
Q

How long should you treat chronic bacterial prostatitis with antibiotics?

A

4 -6 week course of antibiotics

149
Q

Which treatment method is recommended to prevent recurrence of bacterial prostatitis?

A

Castration following antibiotic treatment

150
Q

What are the clinical signs of prostatic abscesses?

A

Haematuria
Haemorrhagic/purulent urethral discharge
Faecal tenesmus
Dysuria
Abdominal pain
Lethargy
Pyrexia
Anorexia
Vomiting

151
Q

What is one of the main potential complications of prostatic abscesses?

A

Prostatic abscesses can cause septic shock if they rupture

152
Q

How do you diagnose prostatic abscesses?

A

Rectal examination
Ultrasound

153
Q

How does a prostatic abscess feel on rectal examination?

A

On rectal examination, the prostate will feel enlarged and asymmetrical if there is a prostatic abscess

154
Q

How do you treat a prostatic abscess?

A

Surgical drainage and omentalisation
Percutaneous drainage
Castration (to prevent recurrence)

These are referral procedures

155
Q

What are paraprostatic cysts?

A

Paraprostatic cysts are large cysts adjacent to but attached to the prostate via a stalk

156
Q

What are the clinical signs of paraprostatic cysts?

A

Faecal tenesmus
Dysuria
Perineal mass

Clinical signs don’t usually arise until the cyst is very large

157
Q

How do you diagnose a paraprostatic cyst?

A

Radiography
Ultrasound

158
Q

How do you treat a paraprostatic cysts?

A

Percutaneous drainage
Castration (to prevent recurrence)

159
Q

What is the most common form of prostatic neoplasia?

A

Prostatic carcinoma

160
Q

Which signalement can present with prostatic neoplasia?

A

Entire or neutered male dogs

161
Q

What are the clinical signs of prostatic neoplasia?

A

Haematuria
Haemorrhagic urethral discharge
Faecal tenesmus
Dysuria
Hindlimb lameness
Weight loss
Anorexia

162
Q

How do you diagnose prostatic neoplasia?

A

Rectal examination
Radiography
Ultrasound
BRAF test
Prostatic wash

163
Q

How does prostatic neoplasia feel on rectal examination?

A

Enlarged, firm, ± painful prostate with firm, irregular nodules
May be able to palpate enlarged sublumbar lymph nodes

164
Q

How do you treat prostatic neoplasia?

A

Chemotherapy
NSAIDS

There is no curative treatment for prostatic neoplasia

165
Q

Which referral treatment can you recommend to owners for prostatic neoplasia?

A

Coil embolisation which reduces blood flow to the tumour to attempt to reduce the rate of growth

MODULE 17 - Urinary, Endocrine and Oncological Disease (12 decks)

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