urinary

Question 1

FLUTD

Answer 1

any disorder affecting urethra (male or female)

C/S- hematuria, stranguria, dysuria, pollakiuria, inappropriate urination, vocalizing, hiding

Question 2

FLUTD causes

Answer 2

FIC most common- central threat response system
uroliths- struvite w protein
urethral plugs
behavior
neoplasia

Question 3

FIC causes

Answer 3

obesity, anxiety/threat response, diet changes, indoor cats

Question 4

FLUTD dx

Answer 4

min database,
UA/culture- FIC, UTI
imaging (stones)
determine cause

Question 5

acute FLUTD tx

Answer 5

bladder stones- dissolution diet, sx

acute tx:
1. fluids
2. pain control
3. appetie stimulation
4. prazosin?
5. environment

Question 6

urethral obstruction tx

Answer 6

reduce trauma when unblocking (sm cath) for 24-36h 6-12h post cath
epidural

monitor UOP (1-2ml/kg/h)
BP q12, BW q8h, electrolytes q12, CRE q24

Question 7

FIC tx

Answer 7

MEMO
space, scents, play, food, l (wet food, urinary diet) litter box, WATER

consider amitriptyline for recurrent cases

PU after several obstructions

Question 8

urinary incontinence definition, C/S, dx

Answer 8

loss of voluntary control-> leakage
different from inappropriate urination

C/S- urinary leakage, no difficulty urinating, no PU/PD

dx- hx, PE (palpate bladder)

Question 9

causes of incontinence

Answer 9

failure of storage phase-> small bladder
(primary urethral sphincter incontinence, UTI, stones, neoplasia if spayed. young-> congenital)

voiding disorder-> incomplete emptying, residual volume, lg bladder
(flaccid-> LMN, hard-> UMN)

Question 10

USMI

Answer 10

spayed female dogs-> most common cause of incontinence
hormonal cause (low estrogen)

dx- r/o other causes
tx- PPA q12, DES (less effective, some side effects)

Question 11

ectopic ureters dx, tx

Answer 11

congenital-> ureters enter bladder at wrong location (mostly intramural)
goldens

dx- young age incontinence, rads w contrast, U/S, cystoscopy

tx- ureteral transplantation, laser ablation
medical

Question 12

sm bladder incontinence causes (other than ectopic ureters)

Answer 12

pelvic bladder
patent urachus
vesicourachal diverticula
vaginal anomalies (fistulas)
UTI
prostatic disease
infiltrative bladder disease

Question 13

lg bladder incontinence

Answer 13

LMN disease (lower spinal cord, pelvic nerves)-> no contraction of detrusor
secondary to trauma, neoplasia

sphincter is normal-> overflow incontinence (flaccid bladder)

UMN disease (higher spine)-> detrusor and sphincter work but arent synced-> firm bladder
secondary to IVDD, neoplasia, trauma

brain stem lesion

Question 14

detrusor atony

Answer 14

flaccid lg bladder
overdistension-> damages muscle
cats w UO

Question 15

detrusor-urethral dyssynergia

Answer 15

lack of coordination b/w detrusor and sphincter-> interrupted urine stream

tx- prazosin, diazepam

Question 16

lg bladder incontinence tx

Answer 16

tx primary cause
manual expression
ucath
meds to relax sphincter
tx UTI

Question 17

UTI risk factors

Answer 17

females, age, urinary incontinence, uroliths, CKD, hyperthyroidism, DM, cushings

mostly single agent (e. coli or staph)

Question 18

UTI C/S, dx

Answer 18

hematuria, stranguria, dysuria, urge incontinence
systemic signs-> pyelonephritis

dx- PE, UA (pyuria)-> active sediment, bacteria

Question 19

sporadic vs recurrent UTI

Answer 19

sporadic <3 episodes
complicated if >3 episodes
recurrent bc of relapse/refractory (recessed vulva, wrong abx, stones, overweight) or reinfection (cushings, CKD, DM, neoplasia)-> need culture

Question 20

recurrent UTI dx, tx

Answer 20

CBC/chem UA
imaging, cystoscopy

screen for endocrinopathies, CKD, prostatitis, urinary incontinence

tx- 4-6wks of abx based on culture, recheck after 1wk and after tx

Question 21

UTI complications

Answer 21

polypoid cystitis (nidus of bacteria)
emphysematous cystitis
struvites
pyelonephritis

Question 22

uroliths

Answer 22

dogs: struvite or ca oxalate (females get struvite)
cats: females 50/50, males more ca oxalate

Question 23

uroliths dx

Answer 23

C/S- hematuria, stranguria, incontinence, visible stones, FLUTD symptoms
PE, CBC/chem

rads- struvites lg smooth round
ca oxalate many small stones

Question 24

struvites causes in dogs and cats, dx

Answer 24

mg ammonium phosphate
dogs: urease producing bacteria, sm breeds
crystalluria-> abnormal

cats: sterile urine, diet, crystalluria can be normal

dx- imaging, UA, cultures

Question 25

struvite tx

Answer 25

dogs: diet (urinary) w abx-> 2-6wks
cats: dissolution diet w/o abx for 7-21d, long term urinary diet, increased water consumption

Question 26

non surgical stone removal

Answer 26

voiding urohydropropulsion

retrograde urohydropropulsion

cystoscopy

lithotripsy

Question 27

ca oxalate

Answer 27

sm breed dogs, older, males
long haired cats

dx- breed screening, UA, culture, rads (opaque)

tx- removal via cystotomy, prevent w urinary diet, recheck UA q3-6m

consider adding potassium citrate, thiazides if recurring