URINARY SYSTEM: 114, 115, 116, 117, 118, 119

Question 1

does renal capsular arteries arise from renal arteries?

Answer 1

no, they arise from phrenicoabdominal arttery or adrenal artery. usually are more prominent in deseased kidney

Question 2

decsribe the 3 phases of renal contrast excretion

Answer 2

1) renal angiographic phase: almost immediately, demonstrates arterial supply
2) renal phase: also known as renal blush, contrast through renal parenchima
3) excretory phase: contrast flows into collecting tubes

Question 3

policystic kidney signalment and incidence

Answer 3

persian cats and persian cat similar (himalayans, exotic shorthairs). prevalence extimated to 37-38%

Question 4

most common composition for feline kidney calculi

Answer 4

calcium oxalate

Question 5

renal cystadenocarcinoma is associated with what type of dermatological disorder?

Answer 5

nodular dermatofibrosis in german sheperd. is a inherited neoplastic syndrome

Question 6

kidney tumor and related survival expectancy

Answer 6

carcinoma - 16 M
sarcoma- 9 M
nephroblastoma - 6 M
hemangiosarcoma - 278 Days

Question 7

difference beetween renal cysts and perirenal pseudocysts

Answer 7

renal cysts are epithelial-lined
pseudocysts lacks an epithelial lining

Question 8

idiopathic renal hematuria: signalment and treatement

Answer 8

often large breeds <2 years.
treatement:
-renal pelvic infusion of povidone-iodine or silver nitrate, followed by ureteral stent placement
-ureteronephrectomy
-renal artery embolization
-ureteroscopic electrocauterization

Question 9

does nephrotomy influence renal function?

Answer 9

inconsistent findings! older studies reported decrease to 40-50% of glomerular function after partial nephrectomy. recent studies reported an increase in GFR.

Question 10

name 2 different nephrotomy techniques

Answer 10

1) bisectional nephrotomy: sharp incision
2) intersegmental nephrotomy: blunt dissection with a periosteal elevator, scalpel blade handle or similar

Question 11

luminal ureters diameter feline vs canine

Answer 11

CAT: 0,4 mm
DOG: 2-2,5 mm in dogs 20-30 kg

Question 12

anatomic curiosities of ureters

Answer 12

right ureters can be circumcaval in up to 30% of cats. left ureters have a particular bend 3 cm distal to it’s course. usually it is a common site for obstruction

Question 13

microscopic anatomy of the ureters

Answer 13

A) tunaca adventitia
B) tunaca muscolaris
-ext longitudinal
-middle circular
-int longitudinal
C) tunaca mucosa

Question 14

name some drugs that can determine ureteral relaxation

Answer 14

calcium channel blockers, glucagone, amitriptyline (tricyclic antidepressant)

Question 15

what are the 4 most important presurgical considerations before ureteral surgery?

Answer 15

1) every cat has a different amount of damage to the obstructed kidney
2) most of the cats undergoing kidneys biopsies have some degree of chronic interstitial nephritis
3) if a cat is azotemic with a unilateral obstruction it must have bilateral CKD
4) overal complication rate of more or less 30%, with mortality to 18-20%

Question 16

most common causes of ureteral strictures in cats

Answer 16

concurrent nephroureterolithiasis or previous ureteral surgery

Question 17

what is a urinoma?

Answer 17

it is a retroperitoneal collection of urine

Question 18

male dogs ureteral ectopia prevalence

Answer 18

15%

Question 19

ureteroceles embryionic development

Answer 19

failure of regression of the chwalla membrane (divide ureteral orifice from common excretory duct)

Question 20

how many ligaments does the bladder have?

Answer 20

two lateral ligaments: contain fat and umbilical artery!

one ventral ligament attached to linea alba

Question 21

sympathetic and parasimpathetic innervation of the bladder

Answer 21

S: hypogastric nerve
- relaxation of detrusor muscle
-contraction of smooth muscle in
bladder neck and proximal urethra

P: pelvic nerve
-somatic innervation to periurethral
striated muscle (muscle contraction)
- detrusor muscle contraction for
bladder empyting

Question 22

bladder blood supply

Answer 22

enters dorsal

caudal vescical artery: from vaginal or prostatic artery (branch of internal pudendal)

cranial vescical artery: terminal ending of umbilical artery: patent in adult dogs

Question 23

struvite urolith differences beetween dogs and cats

Answer 23

in dogs 90% of the cases have a UTI (urease producing bacteria so alkalinization of pH)

in cats usually are sterile

Question 24

biggest portion of bladder that can be excised in human

Answer 24

75%. within 3 months regain a capacity of 300 ml

Question 25

possible complication of ureters diversion in colon

Answer 25

1) hyperammoniemia secondary to ammonium reabsorption in colon. this induces an hypercloremic metabolic acidosis and encephalopaty
2) pyelonefritis
3) severe colic ulcerations

Question 26

Urea, creatinine and potassium role in uroabdomen diagnosis

Answer 26

Urea: equilibrates across peritoneum, so if there is no urea in the peritoneal fluid it is defenetly NOT uroabdomen

cratinine: big molecule so it doesn’t get reabsorbed. if found in the peritoneal liquid in higher concentrations than plasma it is uroabdomen

K: also potassium concentration in uroperitoneum fluid are higher than in plasma

Question 27

percentage of cats with hidiopatic hypercalcemia that can develop uroliths

Answer 27

35%

Question 28

recurrence of struvite and CO uroliths in cats and dogs

Answer 28

struvite has been reported to recur in up to 21% of dogs and 2,7% of cats

CO has been reported to recur in up to 50% (in 3 years) for dogs and 7% in cats

Question 29

ECG abnormalities in patients with Hyperkaliemia

Answer 29

1) spiked T waves
2) depressed R, ST, P
3) prolonged QRS, QT, PR

4) ventricular arrithmias

Question 30

does calcium gluconate reduce potassium serum levels?

Answer 30

No, it only acts as a myocardial protectant (increases treshold for cardiac myocyte depolarization

Question 31

common location for urethrotomy

Answer 31

in dogs the most common location is prescrotal

Question 32

common location for urethrostomy in dogs and cats

Answer 32

dogs: scrotal
cats: perineal

Question 33

less common locations for urethrostomy in cats and dogs

Answer 33

1) transpelvic urethrostomy (caudal ischial osteotomy) in cats but also dogs: access to pelvic uretra

2) subpubic urethrotomy in cats: access to postprostatic uretra

3) prepubic urethrostomy in dogs and cats: access to preprostatic uretra

Question 34

surgical approach to perineal urethrostomy in cats

Answer 34

1) incision encircling scrotum and prepuce
2) dissection of penis and identification of ischiocavernosus muscles
3) severing of ventral ligament of the penis and both ischiocavernosus muscles
4) severing of retractor penis muscle
5) incise urethra and begin suturing from the most dorsal aspect
6) cut and ligate the distal penis

Question 35

name the 2 most important possible complication after urethrostomy

Answer 35

stricture and urine extravasation

Question 36

in the transpelvic urethrostomy, what muscles must be elevated and dissected trom the pubic symphisis?

Answer 36

gracilis and external obturator muscles

Question 37

in urethral anastomosis is it suggested to use a urine diversion technique?

Answer 37

yes, urinary diversion (catheher, cystostomy tube or both) does not provide significant difference in wound healing and prevent severe strictures

Question 38

name the 3 possible surgical treatments for urethral disruption

Answer 38

1) temprary urinary diversion and second healing
2) primary repair
3) permanent urinary diversion via urethrostomy or cystostomy tube

Question 39

signalment in urethral prolapse

Answer 39

young male brachicephalic dogs, specifically english bulldogs

Question 40

possible surgical options for urethral prolapse

Answer 40

urethropexy and urethral resection and anastomosis