Unit 2: 7 - Urogenital 2 Flashcards
What is the most serious driving force behind renal necrosis, fibrosis, scarring, and atrophy?
Vascular damage
What is important about the left renal vein and what drains into it?
Receives blood from left ovarian/testicular v.;
This is especially important in intact animals
What ligament are the ureters associated with?
Broad ligament
The ureters enter the bladder on the _____ surface at the _____.
dorsolateral, urinary trigone
What is the median ligament?
Holds bladder in place;
Ventral midline of bladder to ventral abdominal midline
Where are the lateral ligaments and what do they contain?
Lateral surfaces of bladder to lateral pelvic wall, blend with broad ligament and contain the ureters
What is the blood supply to the bladder?
Cranial and caudal vesicular aa.
What are the 3 sources of innervation to the bladder?
- Sympathetic = hypogastric n. –> urinary retention
- Parasympathetic = pelvic n. –> urinary release
- Somatic = pudendal n. –> external urethral sphincter
What are the 3 parts of the male urethra?
Prostatic, membranous, penile
What are urethral tears and partial ruptures usually related to?
trauma
What is the treatment for urethral tears?
Primary surgical repair, healing by second intention
What should be the first thing attempted with urethral calculi?
Moved back to the bladder by retrohydropropulsion or urohydropropulsion
What is the indication for a urethrotomy?
Removal of calculi that cannot be moved
What is the biggest concern with a urethrotomy?
stricture
What is a urethrostomy?
Permanent stoma is created and urethral mucosa is sutured to skin
What are indications for a urethrostomy?
Recurrent obstruction with stone or mucus plugs, neoplasia
What type of urethrostomy is done in cats?
perineal
What type of urethrostomy is done in dogs?
scrotal
Dogs must be _____ for a scrotal urethrostomy to work.
castrated
What is the most common indication for a cystotomy?
Urinary calculi removal
What 3 areas should always be sampled with a cystotomy?
- Stone analysis
- Bladder wall histopath
- Culture of bladder wall/urine/stone
What is the preferred incision site for a cystotomy?
ventral
What urinary calculi are radiopaque?
Calcium oxalate, struvite, silicate
What urinary calculi are radiolucent?
Cysteine, urate
What stones can be dissolved?
Struvite, urate, cystine
What is the treatment for a urolith?
Cystotomy
What 3 things should always be done when doing a cystotomy for urolithiasis?
- Calculi analysis
- Bacterial culture of bladder mucosa
- Abdominal rads post-op
What is the prevalence of recurrence of urolithiasis?
12-25%
What is the most common bladder/urethral neoplasia?
TCC of the trigone
What are differentials for a bladder mass?
Polypoid cystitis, stones, prostatic dz
What type of urinary tumors can be resected?
apical
What is the prognosis for most malignant urinary neoplasias?
guarded
What is the most common source for a uroabdomen?
bladder
What acid-base and electrolyte abnormalities can be seen with a uroabdomen?
Hyperkalemia, hyponatremia, metabolic acidosis, azotemia
Immediate surgery for a uroabdomen is contraindicated in patients that are significantly _____ or _____.
hyperkalemic, uremic
What are 2 ways in which a uroabdomen can be diagnosed?
- Fluid CREA > Serum CREA (>2:1)
- Fluid K > Serum K (>1.4 : 1)
When is surgery indicated for ureteroliths?
If there is obstruction
If a ureterolith is non-obstructive, what can be done?
Stone dissolution and/or prevention of future stone formation
What is an extramural ectopic ureter?
Bypasses bladder entirely and enters urethra
What is an intramural ectopic ureter?
Enters bladder at normal location, courses submucosally, and opens into urethral lumen
What is the CS associated with an ectopic ureter?
Continuous urinary incontinence
What breed, age, and sex are ectopic ureters more common in?
Dogs, <1 year, female
What is cystoscopy good for when there is an ectopic ureter?
To determine intra- vs. extramural
What procedure is done for an intramural EU?
Neoureterostomy
What procedure is done for an extramural EU?
Ureteroneocystotomy
What is a neoureterostomy?
Creation of a new stoma in the bladder
What is an ureteroneocystotomy?
Ligation of the distal ureter and re-implantation into the bladder
Why might adjunct treatment be needed after EU correction?
30-55% of dogs continue to show some degree of urinary incontinence
Renal biopsies should be avoided unless ….. ?
Unless the results will alter the course of therapy or prognosis
What type of biopsy is preferred for the kidney?
Tru-cut
What part of the kidney is ideal for a biopsy and why?
Cortex/peripheral tissue;
Hemorrhage can occur if the arcuate vessels are entered
What is a nephrostomy tube?
Temporary ureteral bypass
What MUST be known before performing a nephrectomy?
Function of the contralateral kidney
What is the limiting factor for renal transplantation?
Immunosuppression
What spp is the only one that can have a renal transplant?
cats
