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Small Animal Internal Medicine > Urinary Incontinence > Flashcards

Urinary Incontinence Flashcards

1
Q

What is dysuria?

A

Painful urination

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2
Q

What is stranguria?

A

Strained urination

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3
Q

What is pollakiuria?

A

Frequent urination of small amounts

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4
Q

What is polyuria?

A

Urination of large amounts

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5
Q

What is incontinence?

A

Involuntary release of urine through the urethra

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6
Q

____ ml/mg/day of urine is considered polyuric in a dog/

A

50 ml/kg/day

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7
Q

What are 3 clinical signs of incontinence?

A
  1. Wet bed
  2. Licking vulva/penis
  3. Dribbling while walking
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8
Q

With which of the following would the animal position (squat): incontinence or polyuria?

A

Polyuria

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9
Q

True or False: Incontinence and polyuria can occur simultaneously.

A

TRUE

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10
Q

What are the 3 nerves involved in micturition?

A
  1. Hypogastric
  2. Pudendal
  3. Pelvic
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11
Q

What are the 3 muscles involved in micturition?

A
  1. Detrusor
  2. Internal urethral sphincter
  3. External urethral sphincter
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12
Q

Which is smooth muscle, the internal urethral sphincter or the external urethral sphincter?

A

Internal urethral sphincter

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13
Q

Which is striated muscle, the internal urethral sphincter or the external urethral sphincter?

A

External urethral sphincter

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14
Q

What are the 2 phases of micturition?

A
  1. Filling

2. Voiding

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15
Q

What type of neurological control is filling under?

A

Sympathetic control

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16
Q

What type of neurological control is voiding under?

A

Parasympathetic control

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17
Q

What is the main neurotransmitter in filling?

A

Norepinephrine

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18
Q

What is the main neurotransmitter in voiding?

A

Acetylcholine

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19
Q

From which vertebra does the hypogastric nerve come in the dog?

A

L1-L4

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20
Q

From which vertebra does the hypogastric nerve come in the cat?

A

L2-L5

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21
Q

What effect does the hypogastric nerve have on the detrusor muscle?

A

Relaxation

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22
Q

What receptors in the detrusor muscle are targeted by the hypogastric nerve?

A

Beta-adrenergic receptors

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23
Q

What effect does the hypogastric nerve have on the internal urethral sphincter?

A

Contraction

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24
Q

What receptors in the internal urethral sphincter are targeted by the hypogastric nerve?

A

Alpha 1-adrenergic receptors

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25
Q

Is the hypogastric nerve under sympathetic or parasympathetic control?

A

Sympathetic

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26
Q

Is the hypogastric nerve involved in bladder filling or voiding?

A

Filling

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27
Q

The filling phase is also under voluntary control. What nerve is involved here?

A

Pudendal nerve

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28
Q

From which vertebra does the pudendal nerve come?

A

S1-S2

29
Q

What is the pudendal nerve’s effect on the external urethral sphincter?

A

Contraction

30
Q

Which receptors does the pudendal nerve effect at the level of the external urethral sphincter?

A

Nicotinic receptors

31
Q

The pelvic nerve is involved in the voiding phase. From which vertebra does this nerve come?

A

S1-S3

32
Q

The pelvic nerve stimulates what receptors?

A

Muscarinic

33
Q

What is the pelvic nerve’s effect on the internal urethral sphincter?

A

Relaxation

34
Q

What is the pelvic nerve’s effect on the detrusor muscle?

A

Contraction

35
Q

Are ectopic ureters more common females or males?

A

Females

36
Q

What are the 3 most common breeds predisposed to ectopic ureters?

A
  1. Siberian husky
  2. Labrador retriever
  3. Golden retriever
37
Q

Are most ectopic ureter cases unilateral or bilateral?

A

Bilateral

38
Q

Are most ectopic ureters extramural or intramural?

A

Intramural

39
Q

What are 4 abnormalities associated with ectopic ureters?

A
  1. UTIs
  2. Hydronephrosis
  3. Hydroureter
  4. Vestibulovaginal septal remnants
40
Q

What is the GOLD STANDARD for diagnosing ectopic ureters?

A

Cystoscopy

41
Q

What surgical procedure is used to treat extramural ectopic ureters?

A

Neoureterocystostomy

42
Q

What surgical procedure is used to treat intramural ectopic ureters?

A

Neoureterotomy

43
Q

Which can be treated cystoscopically with laser ablation: intramural or extramural ectopic ureter?

A

Intramural ectopic ureter

44
Q

With treatment of ectopic ureters, which tends to have the better outcome, males or females?

A

Males

45
Q

What is detrusor instability?

A

Involuntary bladder contractions at low bladder volumes

46
Q

What is the concept in treating detrusor instability?

A

Enhancing bladder relaxation

47
Q

What type of drug would you use to enhance bladder relaxation?

A

Anti-cholinergic

48
Q

What are 2 side effects of anti-cholinergic drugs?

A
  1. GI signs

2. Ptyalism

49
Q

What are 2 anticholinergic drug options for treating detrusor instability?

A
  1. Dicyclomine

2. Oxybutinin

50
Q

What are 2 tricyclic antidepressants that also work in treating detrusor instability?

A
  1. Imipramine

2. Amitryptaline

51
Q

What does USMI stand for?

A

Urethral sphincter mechanism incompetence

52
Q

What is the definition of a urethral sphincter mechanism incompetence?

A

Weak urethral pressure resulting in incontinence

53
Q

What is the most common cause of incontinence in dogs?

A

Urethral sphincter mechanism incompetence

54
Q

USMI is seen in what percentage of spayed females?

A

5-20%

55
Q

Which breeds are predisposed to USMI, small breeds or large breeds?

A

Large breeds

56
Q

Which 4 breeds, specifically, are predisposed to USMI?

A
  1. German shepherd
  2. Doberman
  3. Rottweilers
  4. Boxers
57
Q

Clinical signs associated with USMI most commonly occur within ___ months of spaying.

A

3

58
Q

What is the GOLD STANDARD for diagnosing USMI?

A

Urethral pressure profilometry

59
Q

What are your 2 general medical options for treating USMI?

A
  1. Estrogen analoques

2. Alpha-adrenergics

60
Q

What are the 2 alpha-adrenergic options for treating USMI?

A
  1. PPA - phenylpropanolamine

2. Ephedrine/pseudoephedrine

61
Q

What are the adverse effects associated with alpha-adrenergics?

A
  1. Hypertension
  2. Tachycardia
  3. Excitement
62
Q

Estrogens are another treatment option for USMI. What are the 3 mechanisms of action of estrogens?

A
  1. Increased urethral vasculature
  2. Hypertrophy of urethral epithelium
  3. Increased sensitivity of alpha1-adrenergic receptors
63
Q

What is the efficacy rate of Prion (PPA - phenylpropanolamine)?

A

85%

64
Q

What is the efficacy rate of estrogens in treating USMI?

A

18-65%

65
Q

What are the adverse effects associated with estrogen use?

A
  1. Estrus
  2. Alopecia
  3. Bone marrow suppression
66
Q

Endoscopic collagen injections are another treatment option for USMI. How long does the collagen last?

A

17-21 months

67
Q

What is a colposuspension?

A

Where the vagina is affixed to the prepubic tendon, causing lengthening and compression of the urethra.

68
Q

What is a cystourethropexy?

A

Anchoring the urethra to the ventral abdominal wall.

Small Animal Internal Medicine (36 decks)

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