Urinary Tract Infections

Question 1

what causes most urinary tract infections?

Answer 1

bacteria

Question 2

what are the requirements for a urinary tract infection?

Answer 2

uropathogenic bacteria in sufficient numbers
epithelial receptors
flagella
iron scavenging system
breakdown in normal host defense mechanisms

Question 3

what in the urethra protects against urinary tract infections?

Answer 3

length, width, location
high-pressure zone
peristalsis

Question 4

what are some anatomic structures that help to protect against upper urinary tract infections?

Answer 4

vesicoureteral valves
ureteral peristalsis
length of ureters

Question 5

true/false: there is a normal flora/microbiome in the urinary tract that helps to protect against urinary tract infections

Answer 5

true

Question 6

what are some antimicrobial properties of urine?

Answer 6

highly acidic and alkaline environment
high urine osmolality- especially cats
high concentration of urea and weak organic acids
Tamm-Horsfall mucoprotein
prostatic secretions

Question 7

what does Tamm-Horsfall mucoprotein do?

Answer 7

impairs adhesion to uropathogenic E. coli to epithelial cells
bacteriostatic

Question 8

what does activation of toll-like receptors on luminal surface of bladder epithelium produce?

Answer 8

IL-8
neutrophil chemoattractant

Question 9

what are some contributing factors to urinary tract infections?

Answer 9

abnormal micturition
urinary catheters

Question 10

what are some anatomic defects that can make an animal predisposed to urinary tract infections?

Answer 10

vesicoureteral reflux
ectopic ureters
ureterocele
urachal diverticulum/remnant
excessive perivulvar skin folds
damage to uroepithelium

Question 11

what are some things that can cause immunosuppression or change in urine that can predispose to urinary tract infections?

Answer 11

renal failure
diabetes mellitus
hyperadrenocorticism
FeLV/FIV
chemotherapy

Question 12

in cats, who is more likely to have a UTI?

Answer 12

older cats due to concurrent disease

Question 13

what are some organisms that can cause urinary tract infections?

Answer 13

E. coli
Staphylococcus pseudointermidus
Enterococcus
Proteus
Steptococcus
Pseudomonus
Klebsiella

Question 14

how prevalent are urinary tract infections in horses?

Answer 14

uncommon

Question 15

what organisms are known to cause urinary tract infections in cattle?

Answer 15

Corynebacterium renale
E. coli
Trueperella

Question 16

when should you avoid a cystocentesis?

Answer 16

if there is a risk of a transitional cell carcinoma

Question 17

how should you confirm if you think you see cocci?

Answer 17

gram stain or wright stain

Question 18

when is it difficult to identify a urinary tract infection?

Answer 18

small bacteria
low numbers of bacteria
can have contamination if got feces in urine sample

Question 19

what are some fungi that can cause a urinary tract infection?

Answer 19

candida
cryptococcus
aspergillus

Question 20

_____________ may be used to demonstrate the characteristic capsule of Cryptococcus?

Answer 20

india ink prep

Question 21

what is cystitis?

Answer 21

inflammation of the bladder

Question 22

what is urethritis?

Answer 22

inflammation of the urethra

Question 23

what are the signs of upper urinary tract disease?

Answer 23

depression, anorexia
fever
vomiting
other signs of uremia
lumbar or abdominal pain
diary cattle: decreased milk
weight loss, pu/pd
azotemia
neutrophilia

Question 24

what are the classifications for urinary tract infections?

Answer 24

sporadic
recurrent
subclinical bacteriuria

Question 25

how do you diagnose sporadic bacterial cystitis?

Answer 25

lower urinary tract signs concurrent urinalysis abnormalities urinalysis to detect comorbidities aerobic culture, especially in cats

Question 26

what can cause relapsing urinary tract infection?

Answer 26

wrong antibiotic or dose or duration of therapy lack of owner compliance concurrent GI disease or decreased renal concentrating ability failure to eliminate predisposing factors

Question 27

what are some acute pathologic changes with lower urinary tract infection?

Answer 27

bladder thickened focal hemorrhages, erosions, ulcerations +/- emphysema exudate or blood clots

Question 28

subclinical bacteriuria is reported in _________ of healthy dogs and _________ of healthy cats

Answer 28

2-12% 1-13%

Question 29

if an animal has bacteriuria, but no clinical signs of urinary tract infection, should you treat it?

Answer 29

no

Question 30

when should you treat subclinical bacteriuria?

Answer 30

evidence of upper urinary tract infection patients have urease-producing infections patients have plaque-forming bacteria patients have signs of emphysematous cystitis

Question 31

what part of the kidney is more susceptible to infection?

Answer 31

medulla

Question 32

what are some signs of chronic pyelonephritis?

Answer 32

poor doer weight loss pu/pd may be asymptomatic cattle: poor weight gain, diarrhea

Question 33

how does leptosporosis do in the environment?

Answer 33

survives weeks to months

Question 34

what is the most common manifestation of leptosporosis?

Answer 34

acute kidney injury often hepatic involvement

Question 35

in dogs, _______________ is the most common cause of a hematogenous bacterial infection

Answer 35

leptosporosis

Question 36

when should you consider leptosporosis?

Answer 36

fever and unspecified illness signs of renal disease especially if renal disease is accompanied by signs of liver disease

Question 37

what do calves and lambs get with leptosporosis?

Answer 37

severe, acute illness fever intravascular hemolysis, anemia, icterus acute kidney injury (uncommon)

Question 38

what do adult cattle get with leptosporosis?

Answer 38

mastitis decreased milk production abortion acute kidney injury and hemolysis (uncommon)

Question 39

what species of leptsporosis is most common in swine?

Answer 39

L. bratislava

Question 40

what does leptosporosis cause in swine?

Answer 40

abortions stillbirths or neonatal deaths decreased fertility in sows

Question 41

what does leptosporosis cause in equine?

Answer 41

recurrent uveitis abortion kidney failure in foals

Question 42

what are the routes of infection for UTIs?

Answer 42

usually ascending infection from perineum catheterization hematogenous: uncommon direct extension from infected site near urinary tract: uncommon

Question 43

how do vesicoureteral valves prevent infection?

Answer 43

pressure of urination closes opening prevents reflux and permits removal of all urine

Question 44

how do bacteria in the host interfere with pathogenic bacteria?

Answer 44

occupy receptors for bacterial P-fimbriae bacteriocidins

Question 45

what are the mucosal defense barriers?

Answer 45

distal urethra has normal flora proximal urethra: microplicae entrap bacteria exfoliation of urothelial cells production of antimicrobial molecules antibody production

Question 46

what does lipocalin and lactoferrin do as defense?

Answer 46

sequester iron from bacteria produced by renal tubular epithelial cells

Question 47

what cells produce antimicrobial proteins?

Answer 47

macrophages and epithelial cells

Question 48

what antimicrobial protein does the bladder produce?

Answer 48

cathelecidins

Question 49

what antimicrobial protein do the kidneys produce?

Answer 49

beta-defensins

Question 50

what does activation of toll-like receptors on the luminal surface of bladder epithelium lead to?

Answer 50

production of IL-8

Question 51

neutrophils help clear bacteria, in acute UTI, but ____________________

Answer 51

cause tissue damage

Question 52

what is a vesicoureteral reflux?

Answer 52

valve remains open: puppies or acquired

Question 53

what bacteria are most common in hematogenous infections of foals?

Answer 53

gram negatives

Question 54

when do cattle get UTIs?

Answer 54

pyelonephritis after parturition

Question 55

who is pyelonephritis most common in in swine?

Answer 55

farrowing sows

Question 56

what are some parasites that infect the urinary tract?

Answer 56

Capillaria plica Dioctophyme renale Stephanurus dentatus

Question 57

what makes a UTI recurrent?

Answer 57

three or more episodes of clinical cystitis within preceding 12 months two or more within 6 months

Question 58

what can cause recurrent bacterial cystitis?

Answer 58

alterations in host defenses development of resistant bacteria

Question 59

what are some chronic changes with lower urinary tract infection?

Answer 59

thickened bladder wall can lead to polyploid cystitis

Question 60

who has higher rates of subclinical bacteriuria?

Answer 60

diabetes mellitus, obesity, parvovirus, acute disc herniation, paralyzed dogs, dogs treated with cyclosporine or glucocorticoids

Question 61

what bacteria causes plaques?

Answer 61

Corynebacterium urealyticum

Question 62

what are some urease-producing bacteria?

Answer 62

Proteus spp Klebsiella Staphylococcus aureus Staphylococcus pseudintermedius

Question 63

how can you diagnose pyelonephritis?

Answer 63

isosthenuric urine white blood cell casts confirm radiographs and sonograms

Question 64

why is the medulla more susceptible to infection?

Answer 64

poor inflammatory response decreased blood flow hyperosmolarity inhibits immune low pH hypoxic environment

Question 65

what should you evaluate a patient with acute pyelonephritis for?

Answer 65

leptospirosis

Question 66

what cells does leptospirosis have an affinity for?

Answer 66

renal proximal tubules, biliary tract, and vascular endothelium

Question 67

what are the abnormalities on a chemistry profile associated with leptospirosis?

Answer 67

elevated BUN and creatinine elevated ALT elevated alkaline phosphatase elevated bilirubin

Question 68

what is leptospirosis like in cats?

Answer 68

inherently resistant develop antibodies