Sx of bladder Flashcards
Describe the anatomy of the bladder, the nerve supply, and vascular supply
attached by ventral ligament & lateral ligaments (2)
apex, body, trigone region & neck
- hypogastric n. (sympathetic)*
- pelvic n. (parasympathetic)*
caudal vesicular
protatic/vaginal a.
what are the types of urachal abnormalities, which is the most common, how do you diagnose them, how we treat them
Persistent urachus
Vesicouracheal diverticulum
Urachal cyst-rare
Urachal sinus-rare
positive contrast cystography
partial cystectomy & diverticulectomy
What are the causes of bladder rupture, how do you diagnose it, and how you manage it
trauma, severe cystitis, neoplasia, urethral obstruction & iatrogenic
- may be asymptomatic, hematuria, anuria, abd pain*
- plain radiographs, u/s, positive contrast urethrocystogram, abdominocentesis*
What are the indications for a tube cystostomy, how do you perform this procedure, and what are the complications
need for urinary diversion
Inadvertent tube removal
Pet chewing on tube
Breakage of mushroom tip
Fistula formation after removal
Urine leakage around tube
What are the indications for a cystopexy and how do you perform it
Tube cystostomy
Perineal hernia
Urinary incontinence associated with pelvic bladder
Cranial traction
Bladder wall to abdominal wall
Two lines of sutures
what are the most common types of cystic calculi, what are the clinical signs, and how do you diagnose it
struvite & CaOx
Signs similar to other LUTD syndromes
Palpation of large thickened bladder
Sometimes palpate large calculi
- plain radiographs*
- pneumocystography*
- couble contrast cystography*
- u/s*
What are the nonsurgical treatment options for cystic calculi, and what are the advantages and disadvantages
hydropropulsion
transurethral cystoscopy
diet modification
electrohydraulic lithotripsy
When is surgery indicated for cystic calculi and describe the procedure from approach to closure including the appropriate suture options, patterns and closure techniques
Urinary tract obstruction
No medical options
Other retrieval methods failed
caudal ventral midline approach
stay sutures (3)
Choose avascular area
Make stab incision at apex
Extend incision with scissors
Make incision long enough to allow thorough evaluation
Evert walls to allow full inspection
Remove calculi with instrument
Pass urethra catheter and flush to ensure patency
PDS, Monocyl, Vicryl, Dexon, Prolene, Nylon
1. One or two layer inverting pattern - Cushing followed by a Lembert
2. Simple continuous in the submucosa followed by a Cushing pattern
3. One or two layer appositional pattern - Simple continuous in submucosa followed by a simple continuous in the seromuscular layer
What is polypoid cystitis, how do you diagnose it and how do you treat it
non neoplastic resembles TCC
u/d, cystoscope, bx confirmatory
sx
What is the most common bladder tumor in the dog and cat and what is the most common urinary tract tumor in the dog and cat
Bladder
dog: TCC
most common site for UT tumor in dog = bladder
cat: TCC
most common site for UT tumor in cat = kidney
most common UT tumor in cat = renal lymphoma!
How does TCC differ in the dog and cat
in dogs seen in older (11 y.o.) female patients, trigone area - Scotties
in cats seen in middle aged males, apex
What are some predisposing factors, breed predispositions, and clinical signs and physical exam findings of TCC
Obesity, Insecticide exposure, Herbicide, Cyclophosphamide
Scotties
CS: similar to LUTD
Palpable abdominal mass
Painful abdomen
Weight loss
Signs of metastatic disease:
Lymphadenopathy
Coughing\dyspnea
Lameness
How do you diagnose TCC and what are the advantages and disadvantages of the BTAT
Urine cytology
Cystoscopy
Plain radiographs, positive contrast cystography, u/s, trannsurethral bx
BTAT non invasive but high incidence of false +
best used as routine screening for older pts
How do you treat TCC medically and surgically and why
Partial cystectomy with >1cm borders
Often involves trigone so may require salvage procedure
Chemotherapy-with or without surgery
Piroxicam, Cisplatin, Mitoxantrone
MST with treatment-4-6 months
