Small Animal Urinary Surgery 1 and 2 Flashcards
List four pre-operative considerations you should make before renal or ureteric surgery.
Hypoproteinemia
Electrolytes and fluid statues
Haematology
Clotting abnormalities
What drugs should you avoid for renal and ureteic surgery?
Avoid CP (due to hypotension) and NSAIDs
List three sampling methods of the kidneys
FNA
Tru-cut
Incisional
What is the prognosis for dogs with renal carcinomas, sarcomas and nephroblastomas?
Carcinoma > 16 months
Sarcoma > 9 months
Nephroblastoma > 6 months
What is the prognosis for cats with renal lymphoma?
> 3-6 months
What are cystoliths?
Urinary bladder calculi
What are choleliths?
Gallbladder calculi.
Which breed of dogs and which breed of cats are over-represented with renal calculi?
Siamese
Bichon frise
What are the three situations in which you would consider surgery for renal calculi?
Obstructive
Refractory UTI
Refractory haematuria
Describe the medical management that can be used for ureteric calculi
Diuresis - 405 days may encourage the ureterolith to move into the bladder
Lithotripsy - not in cats
Ureteral relaxants - glucagon/amitiptyline
What are the three main complications of a ureterotomy?
Breakdown
Leakage/uroabdomen
Stricture formation
What are the two methods of ureteral stenting?
Open or minimally invasive procedure requiring fluoroscopy
What is a subcutaenous ureteral bypass?
Artifical catheters from renal pelvis to bladder outside the ureter.
List three ways that hydronephrosis can present.
Urine accumulation
Dilation of the renal pelvis
Progressive destruction of the renal medulla
List three causes of hydronephrosis
Pyelonephritis
Obstruction
Congenital stenosis.
What breeds are presdisposed to ectopic ureters?
Golden retriever and labrador
What is the imaging modaility of choic for ectopic ureters?
CT with contrast
What are the two types of ectopic ureters and which is more easy to treat?
Intramural and extramural.
Intramural much more common.
Why may males present with ectopic ureters later in life?
Compensate for abnormal opening fo may present later in life.
Which type of ectopic ureters can be treated by laser ablation and in which animals?
Intramural, females.
Which animals should you use open surgery to correct intramural ectopic ureters?
Males or very small females.
What procedure if performed to extramural ectopic ureters?
Ureteroneocystostomy
What is the success rate for ectopic ureters?
50-70%
What type of surgery is bladder and uretheral surgery considered to be?
Clean/contaminated
List four pre-operative considerations for bladder and urethral surgery
Renal function
Electrolytes and fluid status
Haematology
Clotting abnormalities
Where are polypoid cystitis usually found?
At the bladder apex
What is the only bladder calculi that can be dissolved?
Struvite
Which breeds are predisposed to a urethral prolapse?
Brachycephalic breeds
What is the point of retrohydropropulsion?
To avoid urethral surgery.
What urethrostomies should you use in a dog or cat for recurrent urethral obstruction?
Cat - perineal urethrostomy
Dog - scrotal urethrostomy
List three ways to treat an atonic bladder.
Keep bladder decompressed for 4-6 weeks
Detrusor stimulants - bethanecol
Urethral relaxant - phenoxybenzamine
What percentage of bladder tumours in dogs and cats are malignant?
97%
Where do transitional cell carcinomas tend to grow?
Around the bladder trigone
List three palliative measures for bladder neoplasia?
Cystostomy for urine diversion when tumour is obstructing the urethra.
Urethral stening to relieve the obstruction.
Laser debulking.
List three indications for a tube cystostomy
Obstructed bladder due to stone, atony and urethral rupture.
What are three types of catheters that can be used in a tube cystostomy?
Foley catheter
Locking-loop pigtail catheter
Low profile tube
What should you use to diagnose a urinary tract rupture?
IVU (intravenous urethrogram)
What does USMIA stand for?
Urethral sphincter mechanism incompetence
What are the types of medical management you can use with USMI?
Oestrogen
Alpha-adrenergics - phenylpropanolamine
Testosterone supplementation in males
