Urinary Obstruction and Uroabdomen

Question 1

__ is needed for complete relaxation to clear an obstruction

Answer 1

Anesthesia

Question 2

Small bladder is consistent with __ with large bladder is consistent with __

Answer 2

Pollakiuria, urethral obstruction

Question 3

Avoid anesthetics that increase urethral tone like __ for urinary obstructions

Answer 3

Dexmedotomidine

Question 4

How to relieve obstruction of a male cat

Answer 4

• urethral massage
• urethral catheter
• therapeutic cystocentesis if needed

Question 5

Summarize retrograde flushing in a cat

Answer 5

• perform de-compressive cysto if needed
• select catheter
• exteriorize penis caudally and dorsally
• insert tip of urinary catheter into the urethra and advance to obstruction
• occlude catheter
• extend urethra caudally and dorsally while assitant pressed syringe plunger to flush
• once lumen is cleared, advance a longer catheter toward urinary bladder and empty

Question 6

__ is the most common cause for male K9 urethral obstructions while __ is the most common in older females

Answer 6

Urethrolithiasis, urethral neoplasia

Question 7

Potential complication post urinary obstruction

Answer 7

• urethral swelling
• residual plug precipitates and urine debris
• urethral spasm
• pain
• pos-obstructive Diuresis
• destructor Antony
• UTI
• hypokalemia
• Anemia

Question 8

urethral catheter

Answer 8

a vehicle for flushes of fluid to dilate urethra and propel luminal contents out

Question 9

summarize retrograde flushing in a dog

Answer 9

1. perform decompressive cysto if needed
2. fill a 6ml syringe with 3 ml of saline and another with 3ml of sterile water-soluble lubricant
3. attach these 2 syringes with a 3 way stop cock and mix
4. inj mixture into urethra to lubricate around urethrolith
5. insert large bore flexible cath into distal end of urethra
6. assistant places finger into rectum and presses ventrally on the pelvic floor to occlude pelvic urethra
7. fill large syringe and catheter and empty syringe forcefulyy
8. once pelvic urethra dilates, occlusion of pelvic urethra is released

Question 10

uroperitoneums are common following __ , especially with __ fracture or __ dogs

Answer 10

trauma, pelvic, male

Question 11

Dx of uroperitoneum

Answer 11

suspected in patients with painful abdomen following trauma

RADS-> loss of detail in the peritoneal cavity or retroperitoneum
- visualization of the urinary bladder does not confirm an intact bladder or urinary tract

Question 12

in diagnosing uroperitoneum how could you compare the abd fluid and blood concentrations of potassium and creatinine in dogs and cats?

Answer 12

cats:
1.9x [K]
2 x [Cr]

Dogs:
1.6 x [K]
2 x [Cr]

Question 13

what is the most common location of disruption in uroperitoneum

Answer 13

bladder followed by urethra

Question 14

treatment of uroperitoneum

Answer 14

1. tx life threatening injuries
2. correct electrolytes -> life threatening hyperkalemia leading to bradycardia and ecg changes -> slowly give calcium gluconate and crystalloid fluids
3. if bladder rupture then abd explore and fix bladder defect
4. urethral ruptures can be treated with a catheter -> will need sx if doens’t heal/is large