Urinary Tract Diseases Flashcards
What are Upper Urinary Tract Diseases?
Disease affecting the kidneys and ureters.
Upper Urinary Tract Disease
What are the aetiologies?
Infection, pyelonephritis, FIP
Toxaemia, nephrotoxins
Calculi
Secondary to lower urinary tract obstruction or other systemic disease
Tumour
Polycystic kidneys (Persians)
‘Acute on chronic’ crisis
Chronic Kidney Disease / Renal failure
What is the aetiology?
Idiopathic deterioration in geriatric cat is most common.
- Previous acute renal damage eg. Injury, toxin
- Neoplasia
- Polycystic kidney disease
- Chronic infection/ pyelonephritis/ glomerulonephritis
- Concurrent conditions eg. Diabetes mellitus, hypertension
Chronic Kidney Disease / Renal Failure
What is the pathophysiology?
The kidney is unable to filter nitrogenous waste from the blood leading to uraemia.
Deterioration in renal function causes pH and electrolyte imbalance (potassium and phosphate).
Reduced production of erythropoietin leads to reduced erythrocyte formation in the bone marrow.
Chronic Kidney Disease/Renal Failure
What are the clinical signs?
Polydipsia – secondary to Polyuria
Polyuria
Vomiting
Inappetance/anorexia
Dehydration – due to increased urination
Weight loss
Depression
Oral ulcers and halitosis
Seizures
Anaemia of chronic renal disease – reduced levels of eryrthropoiton
End stage may be anuric
Chronic Kidney Disease/Renal Failure
What are the diagnostic techniques?
History and clinical signs
Physical examination
Urine testing, SG
Blood testing - elevated levels of urea and creatinine in plasma
Blood pressure
Radiography
Ultrasound
Determine cause and extent of azotaemia
SDMA testing - sensitive to early changes
Check electrolytes - phosphate levels used in prognosis, detect hypokalaemia
Lower Urinary Tract Disease
What is the aetiology?
Infection
Calculi/crystals
Neoplasia
Trauma
Iatrogenic
Neurogenic
Other concurrent disease e.g. Diabetes mellitus
Idiopathic – most common
Feline Lower Urinary Tract Disease
What is the aetiology?
Idiopathic cystitis most common
Urolithiasis (stones)
Crystals (urethral plug)
Infection - rare
Multi cat household, stress may be trigger
Underactive, overweight, neutered cats
Feline Lower Urinary Tract Disease
What is the pathophysiology?
Irritation/inflammation of the bladder wall/urethra (FIC)
May get recurrent bouts of cystitis
OR
Uroliths or urethral plugs may cause urinary obstruction – complete obstruction is an emergency!
Trauma/iatrogenic damage may result in bladder wall dysfunction or rupture of the urinary tract
Inability to void urine leads to azotaemia and signs associated with ARF (acute renal failure)
Feline Lower Urinary Tract Disease
What are the clinical signs?
Cystitis – pollakuria, dysuria, haematuria, pain
Blockage causes oliguria, anuria
Incontinence
Varying frequency/volume
Abnormal micturition (weak,interrupted)
Licking external genitalia
Depression
Vomiting
Anorexia
Dehydration
Feline Lower Urinary Tract Disease
What are the diagnostic techniques?
History and clinical signs
Physical examination
Observation of micturition
Neurological examination where indicated
Urinalysis – visual appearance, dipstick, microscopy, culture, SG
Radiography
Ultrasound
Possibly haematology/biochemistry
