Urinary System Flashcards
Kidneys
Located in the dorsal cr. retroperitoneal space
Smooth margins, similar size and shape
R. kindey obscured by ribcage
Renal size
2.5-3.5x the length of L2- dog
2-3x the length of L2- cat
Contrast radiography
Needed to visualize the lumen and mucosal surface, assess motility or locate a structure
Cystography, excretory urogram and urethrograms
Filling defects
Space-occupying lesions in hollow organs that appear lucent when surrounded by radiopaque contrast material
Examples of filling defects
Calculi, blood clots, masses and air bubbles
Aqueous iodide
Intravasc. and urinary studies
Water soluble for GI perforation
Ionic contrast can cause pulm. edema if aspirated
Negative contrast media
Air, oxygen, CO2, nitrous oxide
Appears radiolucent on rads
Excretory urogram (EU) or Intravenous Pyelogram (IVP) phases
- Angiogram: contrast arteries (often missed on rads)
- Nephrogram
- Pyelogram
contraindicated in dehydrated pets
Nephrogram phase of EU/ IVP
Contrast in renal parenchymal “renal blush” visualized on immediate (0 minute) films
Evaluates renal size, location and intraparenchymal lesions (filing defects)
Pyelogram phase of EU/IVP
Contrast in collecting system renal pelvis, diverticuli visualized on 3-5 min films
Nephrogram should be fading
Used to evaoluate collecting system
____________ is followed by EU
Pneumocystogram
Positive contrast in ureters and negative contrast in UB
Unilateral renal pelvis dilation hydroureter
Hydronephrosis from masses and calculi in renal pelvis, ureteral obstruction, ectopic ureter
Bilateral renal pelvis dilation and hydroureter
Pyelonephritis (asc. infection from UB), mass at trigone of the UB and ectopic ureter
What causes bilateral renomegaly
Acute renal failure
Renal lymphoma*
Bilateral obstructive hydronephrosis
Polycystic kidney dz
What causes unilateral renalmegaly
Obstructive hydronephrosis
Renal mass
Polycystic kidney disease
Causes of small kidney (microrenally)
Chr. renal dz
Renal dysplasia, hypoplasia
LK <2.5 x L2
What is emphysematous cystitis associated with
UTI predisposition
Associated with DM
with glucosuria
Urothelial carcinoma (transitional cell carcinoma) etiology
Dogs: older females
Cats: rare (males > females)
Scottish terriers*, sheepdogs, beagles and collies
Where are bladder masses usually?
Most commonly in the trigone region (dogs)
Outflow obstruction with ureter, urethral or prostate involvement
+ regional LN metastasis
Other metastatic sites for Urothelial carcinoma (TCC)
Lung*, liver, kidney, spleen, uterus, GI, bone, muscle and cystocentesis needle tracts
Secondary _________________ is common with urothelial carcinoma
bacterial cystitis
CS of urothelial carcinoma
Hematuria, stranguria, pollakiruia
Tenesmus, abdominal pain/ distention, lamness and joint thickening
Dx for urothelial carcinoma
Vet bladder tumor Ag test (VBTA)
BRAF test (PCR- common mutant gene cancer)
UA: protienuria and hematuria
Cystography
What should be avoided if urothelial carcinoma (TCC) is suspected?
Cystocentesis: needle tract neoplastic cell implantation
Tx for urothelial carcinoma
Sx with rupture or if mass is operable
Tx UTI if present
Piroxicam, firocoxib alone or with chemotherapeutics
Patients with what condition should be screened for bladder masses?
Recurrent UTIs
Dogs of @-risk breeds
Uroabdomen
Accumulation of urine within the peritoneal and/ or retroperitoneal spaces and caused by leakage of urine from the kidneys, ureters, bladder or prox urethra
What causes uroabdomen
Urinary obstruction
Iatrogenic
Abdominal or pelvic trauma
CS of uroabdomen
Abdominal distention or discomfort on palpation
Lethargy, anorexia, V, depression
Trauma/ obstruction (stranguria)
Bruising and bradycardia (hyperkalemia)
Dx uroabdomen
Abdominocentesis- fluid: serum ratios for dogs
U/S: abdominal effusion (free fluid)
Positive contrast cystourethrography or IV excretory urography
Tx of uroabdomen
Intensive IV therapy
Correct hyperkalemia
Place urethral catheter (bladder decompression)
Place of peritoneal drainage catheter
Surgical exploration to repair
Radiopaque types of calculi
Struvite (magnesium, ammonium, phosphate/MAP)
Oxalates
Which stones are radiolucent (soft tissue)
Cystine or urates
Not visualized on survey rads
Most common sites for urethral obstruction in males
Proximal os
Ischiatic/ pelvic arch
Prostatic urethra
Free luminal filling defects
Air bubbles (round, smooth margins, middle or periphery)
Blood clots: irregular and indistinct borders
Calculi: various shapes, distinct edges, sink to bottom
Pelvic bladder
Cdlly positioned oblong-shaped bladder
Associated with incontinence (urethral sphincter mechanism incompetence/ USMI)
Congenital
Etiology of perineal hernia
Male, middle aged to older, intact
CS: swelling in perineal region, tenesmus, enlarged prostate (BPH)
Dx: rectal palpation
Vaginourethrogram evaluation
If vagina is mildly distended and flow is readily into bladder (USMI)
Bladder neck is rounded and in pelvic canal (pelvis bladder)
Urethra short/dilated
Filling of ureters (ectopic ureters)
