Urinary system Flashcards

1
Q

where are the kidneys located and how does the position of left and right vary?

A

retroperitoneal space

right more cranial

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2
Q

how does IV urography work?

A

dye collects and highlights kidneys, then moves to ureters and bladder

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3
Q

define nephron

A

functional unit of kidney

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4
Q

what is the function of the glomerulus and how does this happen?

A

filtration of blood into glomerular filtrate due to high pressure capillary bed between 2 arteries
in healthy animals proteins stay in the blood

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5
Q

what is the role of proximal convoluted tubule?

A

reabsorption of glucose, electrolyte control

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6
Q

what does the loop of henle do?

A

water reabsorption

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7
Q

what does the distal convoluted tubule do?

A

electrolyte and acid base regulation

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8
Q

where does ADH act in the kidneys?

A

distal convoluted tubule

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9
Q

what is the role of the collecting duct?

A

water reabsorption

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10
Q

define polydipsia

A

excess water intake

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11
Q

define glomerulonephritis

A

inflammation of glomeruli

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12
Q

define renal insufficiency

A

measurable reduction in kidney function

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13
Q

define renal disease

A

disease of the kidneys

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14
Q

how are free catch urine samples carried out? state advantages and disadvantages

A

caught in container midflow
adv- non-invasive
disadv- not sterile so may show bacteria not actually in sample

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15
Q

how are non-absorbable cat litter urine samples carried out? state advantages and disadvantages

A

collect after cat urinates as normal
adv- non-invasive, easy
disadv- non-sterile so may show bacteria not in sample

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16
Q

how are catheterisation urine samples carried out? state advantages and disadvantages

A

anaesthetised unless male dog
adv- more sterile, can accurately measure volume
disadv- more invasive

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17
Q

how are cystocentesis urine samples carried out? state advantages and disadvantages

A

needle inserted into bladder, blind or ultrasound guided
adv- sterile
disadv- invasive

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18
Q

what is the first sign of most kidney disease?

A

inability to concentrate urine

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19
Q

how is urine concentration measured?

A

USG with refractometer

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20
Q

what are the normal cat and dog values of USG?

A

cat- 1.035-1.060

dog- 1.015-1.045

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21
Q

define hypersthenuric USG and what values are seen for this?

A

appropriately concentrated urine

1.030

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22
Q

what is meant by sub maximally concentrated urine and what USG values are seen for cats and dogs?

A

some urine concentration taking place
cats- 1.012-1.035
dogs- 1.012-1.030

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23
Q

what is isosthenuric USG and what values are seen for this?

A

no modification of urine concentration

1.008-1.012

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24
Q

define hyposthenuric USG and what values are seen for this?

A

active dilution of urine, more dilute than filtrate

<1.008

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25
Q

what parameters are shown on dipstick analysis of urine?

A
pH
glucose
ketones
protein
blood
WBC
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26
Q

what does microscopy of urine samples show?

A

crystals and casts in urine

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27
Q

what does cytology of urine show and what should be done after cytology?

A

cells and bacteria in urine

culture of bacteria to identify

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28
Q

what is urea derived from?

A

protein breakdown

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29
Q

what is creatinine derived from?

A

breakdown of muscle creatinine

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30
Q

what is the purpose of blood tests relating to kidneys?

A

shows levels of urea and creatinine which shows function of kidneys as they are excreted by the kidneys

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31
Q

why do blood tests to look at kidney function need to be fasted?

A

protein in recent meal falsely elevates urea

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32
Q

define azotaemia

A

high urea +/- creatinine in blood

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33
Q

what does presence of azotaemia show?

A

reduced glomerular filtration of blood

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34
Q

what are the causes of azotaemia?

A

pre-renal- inadequate renal perfusion
renal- reduced functional mass of kidneys from underlying kidney disease
post-renal- lack of excretion of waste products due to obstruction or rupture

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35
Q

how can you determine cause of azotaemia?

A

pre-renal- concentrated urine as water preserved
renal- poorly concentrated urine
post-renal- imaging

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36
Q

what other findings aside from urea and creatinine can indicate kidney disease and what are they caused by?

A

hyperphosphataemia- reduced renal excretion
hypokalaemia- kidney disease
anaemia- erythropoietin synthesised by kidneys so less in disease

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37
Q

what can radiography show about the US?

A

shape and size of kidneys
ureters, urethra, bladder
stones

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38
Q

what can be seen on ultrasounds of the US?

A

parenchymal detail (kidneys and prostate)
bladder wall morphology
causes of post renal azotaemia

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39
Q

what can cytology and biopsy of US show?

A

renal lymphoma
glomerular disease
commonly used on prostate

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40
Q

what is cystoscopy used for?

A

visualise LUT for collecting biopsies

laser lithotripsy of stones

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41
Q

define AKI

A

sudden onset kidney disease

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42
Q

what is the general cause of AKI and what are the effects of this?

A

sudden nephron damage

high levels of toxins present causing rapid illness

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43
Q

why does CKI present less severe illness?

A

gradual increase of toxins allows compensation

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44
Q

define anuria

A

no urine production

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45
Q

define oliguria

A

very small amounts of urine produced

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46
Q

define polyuria

A

excess urine production

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47
Q

define ischemia

A

impaired blood oxygen supply

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48
Q

what types of injury are kidneys susceptible to and why?

A

toxic and ischemic injury

highly metabolically active

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49
Q

what are causes of AKI?

A

toxic- NSAIDs, toxins
ischemia- hypoperfusion, hypovolaemia
infectious- leptospirosis, pyelonephritis
cutaneous and renal glomerular vasculopathy

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50
Q

define pyelonephritis

A

bacterial kidney infection

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51
Q

what are clinical findings of AKI?

A
acute kidney dysfunction
azotaemia, uraemia
general illness
anuria, oliguria
hyperkalaemia, cardiac arrhythmia
hyperperfusion or hypoperfusion
signs related to intoxicaton
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52
Q

define uraemia

A

clinical signs associated with azotaemia

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53
Q

how is AKI diagnosed?

A

history of short clinical illness
acute azotaemia with high phosphate and potassium
diagnosis of cause of azotaemia
urinalysis- concentration, casts, crystals, inflammatory cells, cultures`

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54
Q

what is initial treatment of AKI?

A

remove underlying cause- stop nephrotoxic drugs, treat for any ingestion of substances
supportive management- electrolytes, nutrition, analgesia
IVFT- crystalloids, correct hypovolaemia over 15 minutes, when euvolemic correct dehydration over 6 hours

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55
Q

what is ongoing treatment of AKI?

A
IVFT
treat hyperkalaemia- crystalloids for renal perfusion, calcium gluconate to stabilise heart, glucose to stimulate insulin release and glucose and potassium uptake to cells
treat cause
keep BP over 80mmHg minimum
appetite stimulants
analgesia
nutrition
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56
Q

what are complications associated with hyperkalaemia due to AKI?

A

cardiac arrhythmia or arrest

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57
Q

what is the prognosis for AKI for cats and dogs?

A

cats- 27-42%
dogs- 34-59%
up to 50% have CKD if survive

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58
Q

what are indications for euthanasia or dialysis for AKI cases?

A

persistent anuria, volume overload, unmanageable hyperkalaemia

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59
Q

define CKD

A

kidneys disease lasting over 3 months

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60
Q

what is the signalment of CKD?

A

cats

older patients

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61
Q

what is the aim of management of CKD and why?

A

protecting nephrons remaining and managing clinical consequences
damage is irreversible and progressive

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62
Q

what are causes of CKD?

A
chronic interstitial nephritis
glomerulonephropathy
untreated infection
chronic obstructive disease
congenital
neoplasia
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63
Q

what findings tend to be in history of patients with CKD?

A
PUPD
weight loss
lethargy and weakness
inappetence
vomiting, diarrhoea, haematemesis, melaena
signs associated with hypertension
can be subtle or nonspecific
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64
Q

what does clinical exam show for patients with CKD?

A
low body muscle condition
dehydration
polyuric, very dilute urine
weakness
neck ventroflexion
uraemic ulcers
uraemic halitosis
hypertensive retinopathy
small irregular kidneys
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65
Q

what are the risks for organ damage associated with different systolic BP?

A

normotensive/<140- minimal
pre-hypertensive/140-159- low
hypertensive/160-179- moderate
severely hypertensive/>180- high

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66
Q

what organs are susceptible for damage due to high BP?

A

ocular
renal
cardiac
neurology

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67
Q

how is CKD diagnosed?

A
inappropriately concentrated urine with azotaemia (only when high level of GFR lost)
SDMA test to approximate GFR
anaemia
high phosphate, low potassium
hypertension
renal ultrasound
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68
Q

what is initial management of CKD?

A

stop nephrotoxic drugs
treat underlying cause
correct fluid balance

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69
Q

what is long term treatment for CKD?

A

renal diet
control hypertension, proteinuria, hyperphosphatemia, hypokalaemia
feed RER
monitor BW
avoid protein calorie malnutrition
phosphate binders every meal to prevent absorption as makes feel ill
potassium supplements
long term regular monitoring

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70
Q

what is prognosis for CKD?

A

cats- often years
dogs- poor if significant clinical signs
determined once reversible issues addressed

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71
Q

what is nephrotic syndrome?

A

complication of glomerular disease

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72
Q

what is meant by LUTD?

A

diseases of bladder, urethra and prostate

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73
Q

define cystitis

A

bladder inflammation

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74
Q

what are clinical signs of cystitis?

A
reflect LUT pathology, inflammation, similar signs regardless of aetiology
dysuria
stranguria
haematuria
pollakuria
periuria
vocalisation
licking prepuce
inappetance
lethargy
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75
Q

define dysuria

A

difficulty urinating

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76
Q

define stranguria

A

straining to urinate

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77
Q

define haematuria

A

blood in urine

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78
Q

define pollakuria

A

small frequent amounts of urine

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79
Q

define periuria

A

voiding in inappropriate places

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80
Q

what are causes of cystitis?

A
feline idiopathic cystitis
bacterial UTI
urolithiasis
neoplasia
drug induced
catheters
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81
Q

what is triage for cystitis?

A

find out clinical signs of LUTD

are they able to pass urine as obstructions are emergency

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82
Q

define crystals

A

microscopic mineral precipitate

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83
Q

define crystaluria

A

crystals in urine

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84
Q

define uroliths

A

macroscopic urinary stone

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85
Q

what happens to fresh urine at room temperature if crystals are present?

A

crystals precipitate

86
Q

what determines the type of crystal or urolith formed?

A

supersaturated compound

87
Q

how do crystals and stones form?

A

high saturation of compounds is precipitation risk

crystal growth and aggregation leads to uroliths

88
Q

how can you try to prevent formation of crystals and stones?

A

encourage water intake as more dilute urine the less risk of formation

89
Q

what are the treatment options for crystals?

A

as long as symptomatic no treatment needed as microscopic so wont cause damage
abnormal types may need investigating

90
Q

when are uroliths treated?

A

if symptomatic

91
Q

what are the types of symptomatic uroliths?

A

nephroliths/kidney stones- UUT
ureteroliths- UUT
urethroliths- LUT
crystoliths- LUT

92
Q

what effects do nephroliths have?

A
abdominal pain
anorexia
lethargy
haematuria from irritation to pelvis lining
pyelonephritis
93
Q

what effects do ureteroliths have?

A

ureteric obstruction

post renal azotaemia

94
Q

what affects do urethroliths have?

A

obstruction

unproductive urination

95
Q

what affects do crystoliths have?

A

pollakuria
stranguria
dysuria
haematuria

96
Q

how are symptomatic uroliths treated?

A

dissolving with diet or medication
surgical removal
treat associated infections

97
Q

how can you identify type of urolith?

A

radiolucency and opacity
crystals present
stone analysis only definite way
radiography if 2-3 mm or bigger

98
Q

what is the management for preventing uroliths?

A

encourage water intake
USG- under 1.033 for cats and 1.020 for dogs
encourage voiding
avoid obesity
dissolution diets- neutral pH to prevent formation of stones, only short term then back to normal diet

99
Q

what are nursing considerations for uroliths?

A

monitor for unproductive urination as re obstruction possible
maintain hydration and urination
catheter care
analgesia- opioids, NSAIDs when wont get blocked again

100
Q

what are potential causes of feline idiopathic cystitis/FIC?

A
young to middle aged
overweight
indoor, litter tray user
multi animal household
nervous
dry diet
stressors present
sudden change in environment
hypofunctioning GAG layer
101
Q

what is meant by the GAG layer of the bladder?

A

protective layer lining the bladder

102
Q

what tests are done if suspect FIC to rule out other causes?

A

urinalysis- exclude UTI
radiographs- look for uroliths, masses, strictures
ultrasound- assess UUT

103
Q

how do non-obstructive FIC cats present?

A

LUTD signs- pollakuria, stranguria, dysuria, haematuria

able to void

104
Q

how do obstructed FIC cats present?

A

urethral spasm or plug
unproductive urination
commonly recur

105
Q

define urethral plug

A

accumulation of mucus, debris, organic matter due to inflammation in bladder lining

106
Q

what is the consequence of obstructed UT?

A

back pressure on kidneys so cant filter blood- post renal azotaemia
hypokalaemia- bradydystrhythmia
pain

107
Q

what is initial treatment for obstructed patient?

A

catheterise to relieve pressure

108
Q

describe how to catheterise an obstructed patient

A

examine for stones, plugs, trauma
lubricate catheter
insert, can flush while doing this to aid process
suture in place
take urine sample for analysis
lavage bladder with warm 0.9% saline until clear to remove noxious secretions

109
Q

what measures should be taken if placing indwelling catheter?

A

closed system, sterile handling
change bag daily, keep off floor
slack in system so no pulling
monitor UOP- hydration, electrolytes, infection

110
Q

how do you calculate UOP?

A

weight of bag now- weight 4 hours ago= UOP over 4 hours
UOP over 4 hours/4= UOP over 1 hour
UOP over 1 hour/BW= UOP(ml/kg/hr)

111
Q

what is management for FIC?

A
analgesia
remove stress
enough resources in house for number of cats
encourage water intake
urinary diet, wet food
avoid obesity
GAG supplements
112
Q

define urinary incontinence

A

loss of normal voluntary control of micturition

113
Q

what is the normal process of urination?

A

relaxation of urethral sphincter and contraction of bladder

114
Q

what are the two types of neurogenic incontinence and how do these usually present?

A

upper motor neurone and lower motor neurone lesion

overflow incontinence

115
Q

how does upper motor neurone lesion incontinence present?

A

spastic bladder, high muscle tone

hard to express

116
Q

how does lower motor neurone lesion incontinence present?

A

flaccid bladder

easy to express

117
Q

what are the causes of non-neurogenic incontinence?

A

urethral sphincter mechanism incomplete/USMI
anatomical defects
urge incontinence
dyssynergia

118
Q

why does USMI cause incontinence?

A

sphincter function fails so leak in recumbency as bladder neck no longer compressed by pelvis which prevents leakage

119
Q

what are predispositions for USMI?

A

neutering
obesity
intrapelvic bladder
large dogs

120
Q

how is USMI treated?

A

tightening sphincter
stimulating sphincter contraction with alpha adrenergics, alpha agonists, oestrogens
urethral cuff
surgical repositioning of bladder

121
Q

why do anatomical defects cause incontinence?

A

ureter voids to urethra so no urine storage

122
Q

what is the cause of urge incontinence?

A

inflammation causing sudden contraction

123
Q

why does dyssynergia cause incontinence?

A

failure of bladder contraction to coordinate with urethral relaxation

124
Q

how is neurogenic incontinence managed?

A

treat disease

express bladder avoiding catheters where possible due to infection

125
Q

how can anatomic cause of incontinence be treated?

A

laser to reposition bladder entry

surgical re-implantation

126
Q

what history should be taken for surgical diseases of UT?

A
continence
voiding urine, any abnormal times or location
ease of urination
volume, smell, appearance of urine
frequency of urination
drinking
neuter status
127
Q

what initial investigations are done for surgical disease of UT?

A

bloods- leukocytes, anaemia, urea, creatinine
urinalysis
radiography- stones, abnormalities
ultrasound- stones, masses, lesions, inflammation

128
Q

what are general considerations when performing surgery on UT?

A

antibiotics especially if UTI present

minimise urine spilling with soaked lap pads

129
Q

what equipment is required for surgery on UT?

A
fine instruments and suture material
abdominal retractors
retractors for bladder
catheters
cystotomy tubes
suction
spoons for stones
magnification
130
Q

when is surgery for renal neoplasia contraindicated?

A

pulmonary metastasis

bilateral neoplasia

131
Q

what are clinical signs of renal neoplasia?

A

haematuria
palpable abdominal mass
other vague signs

132
Q

what are common causes of renal trauma?

A

bite

RTA

133
Q

when would subcutaneous ureteral bypass be performed?

A

ureter blocked and cant dissolve medically

134
Q

what is a subcutaneous ureteral bypass?

A

tube placed in kidney and connected to bladder via under skin to give new ureter

135
Q

what causes renal stones?

A

similar to uroliths, supersaturation of minerals

136
Q

what is the treatment for renal stones?

A

diet to dissolve
antibiotics
surgery

137
Q

what surgery be used to treat renal stones and what is a disadvantage of this?

A

nephrotomy (incision thorugh kidney) with tourniquet around renal vessels to reduce blood to incisions
may reduce renal function

138
Q

how are ureters treated when damaged during spaying?

A

remove the damaged kidney and ureter

re implant ureter cutting off damaged part

139
Q

define nephrectomy

A

removal of kidney

140
Q

what are indications for nephrectomy?

A
renal neoplasia
renal trauma
chronic pyelonephritis
idiopathic haematuria
ureteral abnormalities
one normally functioning kidney
141
Q

how is nephrectomy performed?

A

midline laparotomy
kidney isolated and freed from peritoneum
renal artery and vein ligated
ureter ligated and transected adjacent to baldder

142
Q

what is ureteral ectopia?

A

ureters opening to urethra not bladder, usually bilateral

143
Q

what is signalment for ureteral ectopia?

A

congenital abnormality in dogs, normally female

144
Q

how is ureteral ectopia treated?

A

neoureterostomy with close observation post op for stranguira

145
Q

how is neoureterostomy performed?

A

incision through bladder wall and ureteral mucosa to lumen of ectopic ureter close to its entry to bladder wall
ureteral and bladder mucosa sutured to make new stoma

146
Q

what is presentation for bladder stones?

A

haematuria
frequency and urgency to urinate
complete obstruction

147
Q

how are bladder stones treated?

A

struvite and urate- medically dissolved
cystotomy for all other uroliths or any obstructing or causing clinical signs
prescription diet to prevent recurrence

148
Q

how does bladder neoplasia present?

A

elderly animals
haematuria
frequency and urgency to urinate
obstruction

149
Q

what are treatment options for bladder neoplasia?

A

most malignant
if effect trigone cant remove
partial cystectomy can aid palliative care

150
Q

what is the consequence of ruptured bladder?

A

uroabdomen

post renal failure

151
Q

how are bladder trauma treated?

A

IVFT to stabilise

surgical repair

152
Q

what are indications for cystotomy?

A

removal of bladder stones

153
Q

how is cystotomy carried out?

A

caudal midline laparotomy
exteriorise and isolate bladder with swabs
incision in ventral midline of bladder

154
Q

what equipment is needed for cystotomy?

A

urethral catheter

volkmann spoon

155
Q

what needs to be done following cystotomy for stone removal?

A

stones submitted for analysis of composition, culture and sensitivity

156
Q

what are types of urethral disease?

A
urolithiasis
incontinence
FLUTD
trauma
neoplasia
157
Q

what is the main consequence of urethral stones?

A

obstruction

158
Q

how are urethral stones managed?

A

small pass unproblematically
relive obstructions
correct hypovolaemia, electrolyte imbalance, acid base balance

159
Q

what are risk factors for USMI?

A

neutering
tail docking as affects spinal nerves
obesity
breeds- springers, mini poodles

160
Q

how is USMI managed?

A

oestrogen or phenylpropanolamine to increase smooth muscle tone of sphincters
surgery if non responsive

161
Q

what are the surgical options for USMI?

A

colposuspension
urethropexy
hydraulic artificial urethral sphincters

162
Q

define urethropexy

A

support provided to urethra

163
Q

what are risk factors for FLUTD?

A
middle aged
overweight
neutered
indoor cats
dry diet
secondary to bladder disease
164
Q

how is FLUTD managed?

A

usually medically

surgical if repeated episodes

165
Q

what are surgical options for urethral neoplasia?

A

bypass urethra for palliation

usually too advanced for excision and mets present

166
Q

define urethrotomy

A

incision into urethra

167
Q

what is urethrotomy used for?

A

stones that wont flush into bladder

168
Q

define urethrostomy

A

creation of permanent new opening

169
Q

what is urethrostomy used for?

A

last resort for recurrent obstruction, severe trauma or stricture

170
Q

where are urethrostomies mainly performed?

A

scrotal- dogs

perineal- cats

171
Q

what are indications for tube cystotomy?

A

divert urine from urethral surgical sites

palliation of obstructions due to neoplasia

172
Q

how are tube cystotomies carried out?

A

purse string suture in bladder
foley or mushroom tip catheter through stab incision in middle of suture
suture tightened
catheter passed through incision in abdominal wall
cystopexy performed
catheter sutured to skin and kept in place for 7 days

173
Q

what is post op care for urethral surgery?

A

prevent interference
monitor short term haematuria
observe dysuria if no catheter
analgesia

174
Q

what are the effects of benign prostatic hyperplasia?

A

dyschezia or dysuria

175
Q

define dyschezia

A

difficult or painful defecation

176
Q

what is signalment for benign prostatic hyperplasia?

A

older entire males

177
Q

how is benign prostatic hyperplasia treated?

A

medical- anti-androgens

castration for definite treatment

178
Q

define prostatitis

A

inflammation of the prostate gland

179
Q

what are causes of prostatitis?

A

bacterial infection

often with BPH

180
Q

what are signs of prostatitis?

A

dysuria
pyrexia
purulent penile discharge

181
Q

how is prostatitis managed?

A

antibiotics
anit-androgens
castration

182
Q

what are indications for prostatic abscesses?

A

entire males

usually with prostatitis

183
Q

what are signs of prostatic abscesses?

A

male version of pyometra
dysuria
dyschezia

184
Q

what is treatment for prostatic abscesses?

A

omentalisation following re-roofing and flushing of abscess to help healing
castration
rapid surgery and castration if burst with signs of sepsis

185
Q

what are risks for prostatic neoplasia?

A

entire males
BPH
neoplasia

186
Q

how is prostatic cysts treated?

A

de-roofing
omentalisation
castration

187
Q

define catheterisation

A

inserting urinary catheter into urethra up to level of bladder

188
Q

what are the two types of catheter?

A

temporary

indwelling

189
Q

why are catheters used?

A
urine sample
empty bladder to reduce contamination during surgery
contrast insertion for radiography
maintain urethral patency
unblocking urethra
monitoring UOP
diverting urine
preventing scalding
190
Q

what are alternatives to catheterisation?

A

manual expression
free catch
cystocentesis

191
Q

what are disadvantages of manual expression of urine?

A

can rupture bladder
not possible if tense
hard if overweight
not sterile

192
Q

what are disadvantages of free catch urination?

A

time consuming

non sterile

193
Q

what are advantages of cystocentesis?

A

sterile

194
Q

what are disadvantages of cystocentesis?

A

higher risk

need to let animal void after

195
Q

describe the features of portex catheters

A

rigid so traumatic
single use
side holes to allow drainage if end blocked but low pressure so hard to unblock
not designed for indwelling

196
Q

describe the features of foley catheters

A

soft
inflatable balloon of sterile water to hold in place
preferred option for indwelling
too big for cats
multiple end ports for flushing, collection etc, externally large

197
Q

describe features of jackson/tom cat catheters

A

good for unblocking
rigid
side holes make distal obstruction harder
not used indwelling as traumatic but can leave in short term
short so wont reach bladder

198
Q

describe features of slippery sam catheters

A

open ended so good for unblocking
can be indwelling short term
atraumatic
risk hub detaching

199
Q

describe how male dogs and cats are catheterised

A

restrain, may sedate
wash hands and put on sterile gloves and apron
expose penis from prepuce and prep with dilute iodine
lubricate catheter
can give lidocaine LA
insert until see urine

200
Q

describe how to insert catheter in bitches and queens

A
sedate and place in sternal
clip and clean vulva
insert speculum in dogs to visualise urethral orifice, in cats use otoscope to visualise
feed into urethral orifice
insert until see urine
201
Q

list equipment needed for catheterisation

A
catheter
dilute iodine
swabs
lubricant
containers for sample
closed system if needed
syringes
sterile gloves and apron
speculum
202
Q

describe how to care for indwelling catheters

A
wash hands before and after
empty bag every 4 hours or as needed
measure UOP- hydration, kidney function
check for swelling or pain
check line
remove as soon as no longer needed
care for urine scalding
monitor for UTI
avoid patient interference
203
Q

what are risks associated with catheterisation?

A

urethral rupture, trauma, inflammation, stricture
infection likely
obstruction of catheter by stones or kinks

204
Q

what does cystotomy tube do?

A

urine from bladder to outside via abdominal wall

205
Q

what does nephrostomy tube do?

A

urine from kidney to outside

206
Q

what is normal UOP?

A

1-2ml/kg/hr

207
Q

how do you calculate UOP?

A

(volume of urine/hours)/BW

208
Q

how do you calculate expected normal UOP?

A

BW x normal UOP per hour x number or hours

209
Q

how often should UOP be calculated in hospitalised patients?

A

every 4 hours

210
Q

why do you need to measure UOP?

A

renal function information

211
Q

what is the purpose of renal diets and what are their compositions?

A

minimise uremic episodes, prolong survival

restricted protein, phosphorus, sodium, supplemented by omega 3, antioxidants