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CVNT 2 > surgical diseases of urinary tract 1+2 > Flashcards

surgical diseases of urinary tract 1+2 Flashcards

1
Q

upper urinary tract

A

kidneys and ureters

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2
Q

lower urinary tract

A

bladder and urethra

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3
Q

history questions

A
  • neuter status
  • continence? (control of bladder)
  • can patient void bladder normally?
  • unproductive urination?
  • vocalisation whilst urinating?
  • house soiling?
  • smell of urine?
  • blood in urine?
  • frequency of urination
  • drinking more than usual?
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4
Q

initial investigations

A
  • bloods (haem)
  • urinalysis (USG, dipstick, sediment, culture)
  • radiography
  • ultrasonography
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5
Q

instruments and equipment for urinary surgery

A
  • abdominal retractors
  • stay sutures/small retractors
  • tubes for cystotomy
  • urethral catheters
  • suction
  • magnification
  • sterile cotton buds
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6
Q

surgical diseases of the kidney

A
  • neoplasia
  • trauma
  • renoliths (renal stones)
  • kidney disease secondary to uretic disease
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7
Q

renal neoplasia clinical signs, contraindications

A

carcinoma- most common in dogs
lymphoma- most common in cats
clinical signs- palpable mass, haematuria
contraindications for surgical intervention:
- pulmonary metastases
- bilateral neoplasia

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8
Q

causes of renal trauma

A
  • RTA
  • dog bite
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9
Q

renal stones

A
  • similar to uroliths
  • seen in concurrent cronic renal failure
  • can be dissolved through renal diet and antibiotics
  • surgery not recommended
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10
Q

subcutaneous ureteral bypass (SUB)

A
  • indicated in patients with uni/bilateral blocked ureters
  • can be causes by calcium oxalate stones (can’t be medically dissolved)
  • tubing placed within kidney and connected to bladder
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11
Q

kidney disease secondary to ureteric disease

A

can be caused by trauma to ureters, ureteroliths (obstruction)
- managed by ureterotomy or intra-ureteral stent

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12
Q

nephrectomy indications

A
  • neoplasia
  • trauma
  • chronic pyelonephritis
  • idiopathic haematuria
  • ureteral abnormalaties
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13
Q

surgical diseases of the ureters

A
  • trauma during another surgery
  • ureteroliths
  • ureteral ectopia
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14
Q

ureteral ectopia definition

A
  • congenital abnormality (dogs)
  • ureters open into the urethra, bypassing the bladder
  • can happen in the bladder (intramural)
    treatment= neoureterostomy
  • monitor for stranguria post op
  • common for incontinence post op
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15
Q

surgical diseases of the bladder

A
  • uroliths (bladder stones)
  • neoplasia
  • trauma
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16
Q

uroliths clinical signs

A
  • haematuria
  • polyuria, urgency of urination
  • obstruction
17
Q

urolith treatment

A
  • struvite an urate uroliths can be medically dissolved
  • other uroliths and those causing obstruction are removed by cystotomy
  • urinary diet for prevention
18
Q

bladder neoplasia

A

clinical signs:
- haematuria, polyuria, obstruction
most are malignant
- partial cystectomy may be useful for palliation
- unless it affects bladder neck/trigone

19
Q

bladder trauma/rupture

A
  • leads to uroabdomen and post-renal failure
  • IVFT to stabilise patient
  • surgical repair of bladder and indwelling urinary catheter
20
Q

cystotomy

A
  • for removal of bladder stones
  • submit stones for analysis
  • monitor post-op for anuria, abdominal distension
21
Q

urethral diseases

A
  • urolithiasis
  • incontinence
  • feline lower urinary tract disease
  • trauma
  • neoplasia
22
Q

urinary incontinence

A
  • congenital or acquired
  • most common in females
  • rare in cats
23
Q

USMI= urethral sphincter mechanism incontinence risk factors

A
  • breed disposition (sheep dogs)
  • neutering, obesity, congenital, intrapelvic bladder
24
Q

USMI treatment

A
  • medically= oestrogen, phenylpropanolamine
  • surgical= colposuspension, urethropexy, hydraulic artificial urethral sphincters
25
Q

-pexy

A
  • sutured to body wall
26
Q

FLUTD

A

causes: urethral spasms, bacterial infections, neoplasia
- secondary to bladder disease
- can lead to urethral obstruction in some male cats
- some can be managed medically

27
Q

urethral neoplasia

A
  • rare cause of obstruction usually in old female cats
  • usually too advanced for surgical excision
  • by-passing the urethra may provide palliation
28
Q

2 routes into urethral surgery

A
  • urethrotomy (incision into urethra)
    • last resort for stones that can’t be flushed back into bladder
  • urethrostomy (new opening)
    • last resort for recurrent obstruction or severe trauma of urethra
29
Q

tube cystotomy

A
  • urinary diversion away from urethral surgical sites
  • catheter is passed through body wall and cystopexy is performed
  • tube must be in place for 7 days before removal
  • risk of UTI
30
Q

urethrostomy

A
  • usually males
    cats= in perineum/prepubic
    dogs= scrotal/perineal
31
Q

post op care in urinary surgery patients

A
  • indwelling urinary catheter care
  • BP monitoring to maintain renal perfusion (IVFT)
  • restriction of patient interference
  • haematuria common for 7ish days
  • monitor for dysuria, haemorrhage, analgesia
  • dressing care
32
Q

prostatic disease causes

A
  • prostate surrounds urethra in males
  • disease rare in cats
    causes in dogs:
  • benign hyperplasia (enlargement)
  • prostatitis (inflammation)
  • abscessation/cysts
  • neoplasia
33
Q

benign prostatic hyperplasia

A
  • enlargement of prostate
  • seen in older entire males
  • can cause dysuria or ischaemia
  • managed medically with anti-androgens or castration
34
Q

prostatitis

A
  • bacterial infection can occur with BPH
  • entire males
    clinical signs: dysuria, pyrexia, purulent penile discharge
  • managed medically with antibiotics/anti-androgens or castration
35
Q

prostatic abscesses

A
  • alongside prostatitis in entire males
    clinical signs: dysuria, dyschezia and systemic signs
  • managed through omentalisation following flushing of abscess, then castration
36
Q

prostatic cysts

A
  • entire males associated with BPH
  • less common are paraprostatic cysts
  • treat with flushing, omentalisation, and castration
  • occasionally due to underlying neoplasia
37
Q

prostatic neoplasia

A
  • elderly dogs
  • more common in castrated unlike other prostatic disease
  • palliation :(

CVNT 2 (33 decks)

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