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Dr. Guess’s Kidneys > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

Define the terms pyuria, hematuria, pollakiuria, and polyuria.

A

Pyuria: WBC in urine
Hematuria: RBC in urine
Pollakiuria: Frequent but small amounts of urination
Polyuria: Urinating large amounts

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2
Q

What do most UTIs develop from?

A

A breach in host defenses. Usually bacterial in nature but could be viral, parasitic, fungal, or other

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3
Q

UTIs in dogs

A

More common in females than males. But 14% of dogs will get a UTI

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4
Q

UTIs in cats

A

Healthy cats RARELY get a UTI. It is usually a mucus crystalline plug and don’t need ABX. If they do get one it is concurrent with something else

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5
Q

What are some host defenses against UTIs

A

A. Normal micturition: frequent voiding of bladder
B. Anatomical features: urethral/ureteral peristalsis, renal blood supply/flow, ureteral vesicular glands
C. Mucosal defense: Pathogen associated molecular patterns or PAMPS activate innate immune responses
D. Properties of urine: pH, hyper-osmolarity
E. Systemic immune-competence

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6
Q

What are some clinical findings of a UTI?

A
  1. Variable depending on pathogen, site, and duration
  2. Pollakiuria
  3. Stranguria
  4. Polyuria
  5. Abdominal/kidney pain
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7
Q

What are some causes of polyuria from a UTI?

A
  1. Pyonephritis
  2. E. Coli UTI
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8
Q

What’s an important thing to do if there is a UTI present?

A

Look for an underlying cause

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9
Q

What should you examine on a reproductive exam?

A
  1. Anatomic like the vulva (hooded?), dermatitis, or vaginal stenosis/PU sites?
  2. Discharge or hair?
  3. Prostate enlargement
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10
Q

What two parts of the urinary tract are UTIs localized into?

A

Lower and upper

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11
Q

What structures are included in a lower UTI?

A

Bladder, Urethra, and Prostate

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12
Q

What structures are included in an upper UTI?

A

Ureter and Kidney

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13
Q

What signs or abnormality are present on a lower UTI?

A

A. Stranguria and pollakiuria
B. Gross hematuria at the end of micturition
C. Normal CBC
D. Urine will show pyuria, hematuria, proteinuria, and bactiuria

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14
Q

What signs or abnormality are present on an upper UTI?

A

A. Polyuria and polydipsia
B. Systemic infection signs
C. May have a leukocytosis on CBC
D. Urine will show pyuria, hematuria, proteinuria, bactiuria, and granular casts; get those out. Save the nehpron

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15
Q

How is urine collected for a UTI?

A

Cystocentesis is the gold standard but you could get it from catheterization or mid stream catch while voiding

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16
Q

Why is cyctocentesis the best method to collect urine for a sample?

A

It is the most sterile and will decrease the likelihood of a false positive bactiuria

17
Q

What are the parts of a urinalysis?

A

USG
Dipstick - invalid leukocyte method for vets
Urine sediment - may still be quiet with bacteria
Urine culture - MUST do

18
Q

How to diagnose based on a culture?

A

Qualitative - isolation or visualization of bacteria which is not recommended

Quantitative - determine the CFU per unit volume of urine to see how significant the bacteria are

19
Q

CFU interpretation

A

Greater than 1000 CFUs from a cystocentesis is significant and warrants treatment.

20
Q

What are the most common bacteria isolated from Dogs and Cats?

A

E. Coli and Staph

21
Q

Which bacteria is found in the dog and is non-pathogenic/inherently resistant to most ABX?

A

Enterococcus

22
Q

What are some predisposing causes of UTIs?

A
  1. Abnormal micturition
  2. Damage to mucosal barriers
  3. Underlying systemic disease
  4. Anatomic abnormalities
  5. Iatrogenic - indwelling catheters
23
Q

What is the difference between a complicated and uncomplicated UTI?

A
  1. Uncomplicated UTI is where no structure, neurologic, or functional abnormality is identified
  2. Complicated UTI
    - Sexually intact
    - A predisposing cause
    - An upper UTI
    - Anything involving the kidneys
24
Q

How do you treat an uncomplicated UTI?

A
  1. Amoxicillin is a first line
  2. Trimethoprim-sulfonamide but has side affects
  3. Treat for 7-14 days traditionally but may be 3-5 days with a high dose
25
Q

How do you treat a complicated UTI?

A

Guide ABX choice by culture and sensitivity

26
Q

How do you treat a sub clinical bacteriuria?

A

Unless they are immunocompromised, do not treat and let them resolve it on their own

27
Q

When can you use a fluoroquinolone?

A
  1. The C+S says the bug is resistant to everything else
  2. There is a known pyelonephritis
28
Q

What do you do with a complicated or recurrent UTI?

A

-Usually they are due to an underlying cause. Try to identify and fix
-If there is a continued re-infection or relapse, a 4-6 week therapy may be indicated

29
Q

What does ultrasound do in a UTI case?

A

Assessment of tissue architecture

  • Asses bladder thickness
  • Radiolucent uroliths
  • Neoplasia
  • Dilated renal pelvises and other renal tissue
  • Prostate
  • Adrenal gland size (hyperadrenocorticism)
30
Q

What is the definition of reinfection?

A

Recurrent UTI in 6 months after a successful treatment with a different organism. An underlying cause was likely not addressed

31
Q

What is the definition of relapse?

A

Recurrent UTI in 6 months after a successful treatment with the same organism. Could be from:

Wrong ABX therapy, dose, resistance, bacterial sequestration

32
Q

What are some reasons for poor response to therapy?

A
  1. Resistance
  2. Ineffective drug or inadequate treatment interval
  3. Lack of compliance
  4. Decreases drug absorption
  5. Bacterial sequestration
  6. Mixed infection
  7. Iatrogenic
  8. Underlying cause not addressed
33
Q

What is subclinical bactiuria?

A

Urine positive with culture but does not have clinical or cytological evidence of UTI

Most likely don’t need to treat!

Dr. Guess’s Kidneys (7 decks)

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