Urogenital articles Flashcards
Evaluation of nafamostat mesilate as an alternative anticoagulant during intermittent hemodialysis in healthy Beagle dogs
Joon-hyuk Choi et al jvecc 2018
Nafamostat mesilate (NM) = serine protease inhibitor
0.25 mg/kg/hr maybe an alternative to UFH for IHD
Treatment of acute kidney injury associated with cyclosporine overdose in a dog using hemodialysis and charcoal hemoperfusion
Gilad Segev et al jvecc 2018
Combined hemodialysis and charcoal hemoperfusion treatment can significantly reduce blood cyclosporine concentrations following acute intoxication or overdosage
Evaluation of a prognostic scoring system for dogs managed with hemodialysis
Francesca Perondi et al jvecc 2018
Presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis.
Hemodialysis catheter-associated fibrin sheath in a dog
Langston jvecc 2018
Lumen of dialysis catheter filled w/ recombinant tPA -> 45 min dwell time -> removed tPA and then both lumens easily aspirated
Necropsy found a fibrin sheath originating from R jug into RA
- Impairs blood flow and potential incr in recirculation
Ultrasound-guided placement of pigtail cystostomy tubes in dogs with urethral obstruction.
Christine A Culler jvecc 2019
Pigtail cystotomy tubes can be placed w/ US-guidance in those where a u-cath can’t be placed
CI: inadequate chemical restraint, coagulopathies, bladder necrosis, and intestinal adhesions
complications: inadvertent penetration of the bowel or spleen, tearing of diseased bladder wall, and uroabdomen
Effect of intra-abdominal hypertension on plasma exogenous creatinine clearance in conscious and anesthetized dogs.
Min Jang et al jvecc 2019
IAP at 25 mmHg UNDER GA (not conscious) caused renal hypoperfusion and decreased Cr clearance
Plasma Cr declined rapidly and returned to basal concentrations after decompression
Incidence of bacteriuria at presentation and resulting from urinary catheterization in feline urethral obstruction.
Edward S Cooper,et al jvecc 2019
No +ve culture @ presentation
13% had +ve culture at removal
-Streptococcus and Pasteurella
Don’t rec ABX
Association of abdominal effusion with a single decompressive cystocentesis prior to catheterization in male cats with urethral obstruction
Katherine K. Gerken et al jvecc 2020
33% had abd eff pre-unblock, near bladder neck
- Transmural movement of urine across bladder wall
- 2ry to venous congestion due to incr intravesicular pressure
Single decompressive cysto didn’t cause sig. abd effusion
A prospective randomized, double-blinded clinical study evaluating the efficacy and safety of bupivacaine versus morphine-bupivacaine in caudal epidurals in cats
with urethral obstruction
Chap L. Pratt DVM, DACVECC, et al jvecc 2020
Epidural success rate 70% Less propofol used Median time to rescue longer in BUP or MOR/BUP cats Time to unblock the same No recognized epidural complications
Postmortem urinary tract changes in cats with urethral obstruction
Mauro JVECC 2020
All had bladder lesions, 79% had renal lesions; 43% had no urethral lesion, 93% had no ureteral lesion
Most common: lymphocytic cystitis and lymphoplasmacytic inflammation in kidneys
HyperK paralleled severity of bladder lesions and renal lesions
Retrospective evaluation of urinary indwelling catheter type in cats with urethral obstruction (January 2014 to December 2014): 91 cases
Davidow jvecc 2020
No diff in outcome between 3.5 Fr argyle vs red rubber u-cath
rUO 11% at 30 days
Comparison of right lateral versus left lateral versus sternal recumbence intra-abdominal pressure measurements in normal dogs
Lapa jvecc 2020
No sig. diff in IAP b/w RLAT, LLat, or sternal
Successful medical management of perinephric abscess and urosepsis following urethral obstruction in a cat
Norkus JVECC 2020
Pasteurella perinephric abscessation + urosepsis after UO
Tx w/ perinephric catheterization (22g 1.25in over the needle IVC), saline lavage until fluid is clear, then removed catheter –> CRI cefotaxmine x 72h (5mg/kg/hr) –> recovered 6 days after
Prospective, controlled, blinded, randomized crossover trial evaluating the effect of maropitant versus ondansetron on inhibiting tranexamic acid-evoked emesis
Marta E. Kantyka DVM, et al jvecc 2020
cerenia 1 mg/kg IV 10 mins prior to 50 mg/kg TXA prevented vomiting
Outcomes in dogs with uroabdomen: 43 cases (2006–2015)
Janet A. Grimes javma 2018
Location: bladder > urethra > ureter
Cause: Traumatic > obstructive > iatrogenic
Hypotension most common complications
79% survived to discharge (21% mortality)
-Less likely to survive if intra- or post-op complications
Associations of patient characteristics, disease stage, and biopsy technique with the diagnostic quality of core needle renal biopsy specimens from dogs with suspected kidney disease
Leandro Z. Crivellenti javma 2018
Ultrasound-guided biopsy with a 16-gauge needle should maximize the diagnostic quality of renal biopsy specimens from dogs with suspected kidney disease
14g more bleeding
18g did not get high # glomeruli per sample
Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats
Megan Cray VMD javma 2018
Use of SUB to relieve ureteral obstruction 2ry to obstructive pyonephrosis
Pyonephrosis = infective hydronephrosis, is typically associated with renal pelvis abscess formation
Outcome of ureteral stent placement for treatment of benign ureteral obstruction in dogs: 44 cases (2010–2013)
Pavia javma 2018
Obstructive ureterolithiasis, stricture, or both
Factors associated w/ outcome: pre-op BUN, pre-op Cr, pre-op IRIS stage, and development of long-term complications
long-term complications: need for stent exchange or SUB placement d/t stent occlusion of ureter, stent migration or recurrent UTI
Evaluation for association between indwelling urethral catheter placement and risk of recurrent urethral obstruction in cats
Marc A. Seitz DVM; javma 2018
rUO: 11% inpatient and 31% outpatient
rUO high in outpatient group
Increasing abnormal urine color @ time of catheter removal was sig. associated w/ rUO
Use of a subcutaneous ureteral bypass device for treatment of benign ureteral obstruction in cats: 174 ureters in 134 cats (2009–2015)
Allyson C. Berent, javma 2018
Ureterolithiasis, stricture, or both, pyelo
Post-op complications
- Short-term: occlusion w/ blood clots, device leakage, kinking of tubing
- Long-term: catheter mineralization (463d), chronic UTI, dysuria `
High iCa sig. associated w/ SUB occlusion
94% survived to discharge
Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats
Dorsey JAVMA 2019
In-hospital rUO rate was 17%
Bladder flushing at time of catheterization did not affect rUOv
Complications and clinical utility of ultrasonographically guided pyelocentesis and antegrade pyelography in cats and dogs: 49 cases (2007–2015)
Etedali JAVMA 2019
pyelocentesis and antegrade pyelography were well-tolerated
-complications
pyelography should be considered for identification of mechanical and functional ureteral patency abnormalities
pyelocentesis didn’t provide an advantage over cystocentesis for urine culture
Factors associated with postobstructive diuresis following decompressive surgery with placement of ureteral stents or subcutaneous ureteral bypass systems for treatment of ureteral obstruction in cats: 37 cases (2010–2014)
Balsa JAVMA 2019
High Cr, K, phos and BUN correlated to duration + severity of POD
- indicated more profound + severe nephron + tubular damage
- Hydration state or acid-base status had no effect
Anuric cats had longer POD
92% survived to discharge
Retrospective multicentric study comparing durations of surgery and anesthesia and likelihoods of short- and long-term complications between cats positioned in sternal or dorsal recumbency for perineal urethrostomy
Nye et al javma 2020
Dorsal vs sternal had no effect on short- or long-term complications of a PU
Accuracy of urine dipstick tests and urine glucose-to-creatinine ratios for assessment of glucosuria in dogs and cats
Caroline F. Aldridge javma 2020
Visual reading (dipstick) was more accurate than automated reading -Helpful to rule in but not rule out
UGCR correlated to absolute urine concentration but not to dipstick – no useful info here
Regional Citrate Anticoagulation for Intermittent Hemodialysis in Dogs
T. Francey, A. Schweighauser jvim 2018
Anticoagulation efficacious
Satisfactory results in >90% of the heparin-free treatments, allowing HD treatment in dogs at risk of or with active bleeding.
Pyelonephritis in Dogs: Retrospective Study of 47 Histologically Diagnosed Cases (2005–2015)
J. Bouillon, jvim 2018
E. coli most common
Most common predisposing factor =cancer unrelated to urogenital tract
80% culture positive; equal # of g+ve and g-ve
Fever sig. associated w/ histopath subacute pyelo
Effects of 6% Tetrastarch and Lactated Ringer’s Solution on Extravascular Lung Water and Markers of Acute Renal Injury in Hemorrhaged, Isoflurane-Anesthetized Healthy Dogs
M.S. Diniz jvim 2018
Neither fluid caused pulmonary edema and did not cause AKI (measured by NGAL and plasma Cr)
Both induced hyperdyanmic state (incr CI and decr SVRI)
Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications
Roberta Troìa jvim 2018
Intrinsic AKI had higher FE of electrolytes compared to VR-AKI (FeNA 2.39% vs 0.24%)
-Increased FENa detected in non survivor
Mortality 41%
Nonsurvivors had significantly higher AKI grade, sCr, urea, K, Phos, Mg, Tbil, AG, FE of electrolytes, UPC, and APPLEfast and significantly lower Hgb, iCa, BE, pH, and uCr/sCr values than survivors
Factors associated with survival in dogs with chronic kidney disease
Adam J. Rudinsky jvim 2018
Investigate relationship b/w FGF-23, PTH, vit D metabolites, and clinical variables w/ survival time in CKD
Associated w/ death: BCS <4/9, muscle atrophy, increased Cr, hyperphosphatemia, increased UPC, total hypocalcemia, hypoaAlb, increased CaPP, and incr FGF-23
Incr FGF-23 associated w/ incr risk of premature death in azotemic CKD
Associations between increased body condition score, bodyweight, age and breed with urethral obstruction in male castrated cats
A Jukes VET J 2019
Incidence rate unrelated to BW or BCS
Lower in Burmese cat compared to DSH and higher in non-pedigree cats.
Incidence rate increased from 2 to 4 yo, then declined.
Comparison of clinicopathological patterns of renal tubular damage in dogs with acute kidney injury caused by leptospirosis and other etiologies
Zamagni et al vet j 2020
Lepto dogs had higher FE K, glucosuria, and +ve dipstick glucose
uNGAL similar in lepto vs other AKI causes
NEJM 2020
STARRT-AKI: Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury
Accelerated RRT strategy (ASAP, w/in 12h) did not lower risk of death at 90 days
Risk factors for positive urine cultures in cats with subcutaneous ureteral bypass and ureteral stents (2010-2016).
Lucy Kopecny jvim 2019
- Enterococcus spp most common
- Cats received ABX post-op less likely to have +ve urine culture.
- had LURT, pyelo signs, or both
Risk factors for Candida urinary tract infections in dogs and cats.
Krystle L Reagan JVIM 2019
Admin of ABX 30 days prior to dx (dogs + cats), immunosuppressant (dogs), LURT dz (cats).
Diabetes or hospitalization not factors
Urinary neutrophil gelatinase-associated lipocalin (NGAL) in dogs with stable or progressive kidney disease.
Yoojin M Kim, jvim 2019
Used urinary NGAL:crreatnine ratio UNCR
UNCR higher in dogs w/ progressive CKD
UNCR lowest in pre-renal azotemia
No diff b/w stable and pre-renal azotemia
Epidemiologic evaluation of calcium oxalate urolithiasis in dogs in the United States: 2010-2015.
Vachira Hunprasit jvim 2019
should start screening @ 5-6 yo, 2-3 y before developing clinical urolithiasis
All high-risk breeds were small dog breeds, and all low-risk breeds were medium to large dog breeds
High risk breeds: Bichon, Brussels giffon, cairn terrier, chihuahua, JRt, jap chin, lhasa, maltese, Mn pinchscher, MN schnazuer, pom, yorkie
A prospective randomized study of efficacy of 2 treatment protocols in preventing recurrence of clinical signs in 51 male cats with obstructive idiopathic cystitis.
Ran Nivy, jvim 2019
low dose meloxicam (0.025 mg/kg/day) vs phenoxybenazmine + alprazolam x 2 w
24% had rFIC signs, 16% of them had rUO in 6mo
No diff. in rUO b/w 2 groups
Therapeutic use of tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of subcutaneous ureteral bypass device mineralization in cats.
Colin Chik jvim 2019
tEDTA well tolerated and resolved mineralization seen in SUBs
Symmetric dimethylarginine concentrations in dogs with International Renal Interest Society stage 4 chronic kidney disease undergoing intermittent hemodialysis.
André Nanny Vieira Le Sueur jvim 2019
SDMA is dialyzable and can be removed by IHD
SDMA still correlated better w/ renal function than sCr in CKD dogs undergoing IVF and IHD
Urine neutrophil gelatinase‐associated lipocalin to diagnose and characterize acute kidney injury in dogs
Erika Monari jvim 2020
uNGAL sig. higher in AKI dogs but couldn’t ddx VR- vs I-AKI
(presence of tubular damage in transient AKI.)
Urinary NGAL was significantly higher in dogs with inflammatory AKI, whereas no difference with respect to sepsis or outcome was identified.
Acute on chronic kidney disease in cats: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome
Hilla Chen jvim 2020
Anorexia, lethargy, wt loss, V+
Cause: ureteral obstruction, renal ischemia, pyelo, others, unknown
58% survived to discharge
-MS 66 days
Nonsurvivors had shorter LOH, higher age + sCr+ BUN + Phos, and lower venous pH
sCr @ presentation and @ discharge were associated w. long-term survival
sPhos associated w/ short-term outcome
The ultrasonographic medullary “rim sign” versus medullary “band sign” in cats and their association with renal disease
Alessia Cordella jvim 2020
band sign (thick hyperechoic ill-defined band) more frequently associated w/ KD whereas rim signs can be seen in normal cats
Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study
Laura Pearl Cole jvim 2020
75% dogs had SH
-16% had retinopathy
Dogs w/ FO @ presentation more likely to be hypertensive compared to dogs w/o FO
Dogs who didn’t survive more likely to be FO
no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria
Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival
Asia Dunaevich jvim 2020
Anorexia, leth, V+, D+
Inflammatory, pyelo, ischemic, unknown
35% mortality
IRIS stage, RR, CK, and sCr @ presentation associated w/ survival
LOH longer in survivors
The association of bacteriuria with survival and disease progression in cats with azotemic chronic kidney disease
Camilla Hindar jvim 2020
No significant difference in survival time
no significant difference was found in the frequency of CKD progression
no significant difference was found in the frequency of CKD progression between cats with true UTI, subclinical bacteriuria or no-PUC
PUC in cats with CKD do not affect disease progression or survival time
