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Veterinary Medicine > Urogenital Surgery > Flashcards

Urogenital Surgery Flashcards

1
Q

How large should a kidney be on xray?

A

Cat 2-2.5x L2

Dog 2.5-3.5x L2

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2
Q

How is a renal lymphoma treated?

A

chemotherapy

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3
Q

How is unilateral renal neoplasia treated?

A

Ureteronephrectomy

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4
Q

What are the 2 most common embryological abnormalities of the bladder?

A

Patent urachus

Vesicourachal diverticulum

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5
Q

What suture material should be used to close the bladder?

A

Monofilament absorbable i.e. PDS

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6
Q

what are the 3 indications for a tube cystotomy?

A

Decompression of atonic bladder
Urethral transection
Bladder neck/urethral tumour

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7
Q

How should a bladder rupture be treated?

A

May heal on own.

If not - debride and suture. Can omentalise.

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8
Q

What proportion of the bladder may be removed surgically?

A

75%

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9
Q

Where are the 3 places that males are predisposed to urethral Dz?

A

Neck of bladder - prostate
Pelvic - #s can injure
Penile - limited distension capacity

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10
Q

What are the 4 predisposing factors for urethritis?

A

Trauma
Catheter
Urolith
Neoplasia

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11
Q

How is a urethral prolapse treated in the male?

A

Purse string suture.
Can resect tissue.
CASTRATE, sedate, buster collar.

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12
Q

What are the signs of urethral blockage?

A 
Dysuria
Anuria
Haematuria
Dripping urine
Abdominal pain
Uraemia
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13
Q

Why is IVFT used in urethral obstruction?

A

Correct acid/base imbalance and electrolyte disturbances

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14
Q

How should a bladder be emptied in a blocked urethra?

A

Cystocentesis

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15
Q

What surgical procedure is performed if retro-hydropulsion is unsuccessful at removing a urethral calculi?

A

Urethrotomy

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16
Q

Where is the preferred site of urethrostomy on male neutered animals?

A

Scrotal

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17
Q

When is a pre-pubic urethrostomy performed?

A

insufficient urethral length for pelvic urethrostomy

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18
Q

What is the treatment for urethral neoplasia?

A

Sx unlikely - can resect parts.
Permanent tube cystotomy/stent.
Palliate - poor px.

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19
Q

When can kittens be neutered from? (BSAVA)

A

4m+

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20
Q

What manouvre can be used on the RHS to locate the ovary?

A

Duodenal

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21
Q

What manouvre can be used on the LHS to locate the ovary?

A

Colonic

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22
Q

Which 2 ligatures should be used in the cervix during an OVH?

A

Transfixing + encircling

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23
Q

Which pattern should be used in the abdo wall following a bitch spay?

A

Simple continuous

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24
Q

What are your 3 options for skin suture pattern following an OVH?

A

Intradermal

Interrupted/cruciate mattress

Staples

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25
Q

What are your 2 landmarks for a feline flank spay?

A

External angle of ilium

Hip

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26
Q

Which analgesia should pets be given after neutering?

A

Local!
Methadone (premed)
NSAID post
(+paracetamol in dogs)

3-5days!!

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27
Q

What is the strength holding layer of the abdomen?

A

Fascia of rectus abdominus

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28
Q

Which drug helps 90% of dogs with post-neutering USMI?

A

Phenylpropanolamine - increases muscle tone

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29
Q

What is the second line treatment for post-neutering USMI?

A

Ephedrine

3rd: estriol

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30
Q

If medical treatments don’t solve post-op USMI - what are the surgical options? (3)

A

Colposuspension
Hydraulic urethral occluder
Urethral submucosal collagen injections

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31
Q

Which 2 nerves are responsible for bladder filling and storage?

A

Pudendal (somatic) and Hypogastric (SYMP)

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32
Q

Which nerve is responsible for bladder emptying?

A

Pelvic (PARA)

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33
Q

What are the signs of a filling defect in the bladder?

A

Urinary normally
Dribble urine
Reduced bladder capacity

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34
Q

What may cause bladder filling abnormalities?

A

Ectopic ureters
Reduced pressure at bladder neck
Involuntary contractions (infection, calculi, neoplasia)

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35
Q

What are the signs of bladder emptying abnormalities?

A

Distended bladder
No normal urination
Constant urine dribbling

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36
Q

What may cause a bladder emptying abnormality?

A

Urethral obstruction
Chronic distension
Dyssynergia

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37
Q

What is the most common cause of incontinence in the bitch?

A

USMI

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38
Q

What are the signs of USMI?

A

Incontinence when relaxed

Otherwise urinate normally

39
Q

What is the cause of USMI?

A

Low urethral tone
Obesity
Hormonal influence possible (speyed befroe 1st season)

40
Q

How is congenital USMI treated?

A

1st season resolves it in 50% of cases

If not: Inc muscle tone and reduce contributing factors

41
Q

Apart from phenylpropanolamine, which drugs can be given to male dogs with USMI?

A

Oestrogen based drugs

42
Q

Which breeds of dog are predisposed to ectopic ureters?

A

Golden Retriever
Lab
Skye terrier
Husky

43
Q

Where do ectopic ureters commonly empty?

A

Urethra, vagina or rectum

44
Q

What is a common 2e condition for ectopic ureters?

A

UTIs

45
Q

In a patient with an ectopic ureter you perform an ExLap and find Unilateral ectopia, severe hydronephrosis. Best surgical option?

A

Ureteronephrectomy

46
Q

In a patient with an ectopic ureter you perform an ExLap and find extramural ectopia. Best surgical option?

A

Ureteral transection and re-implantation

47
Q

In a patient with an ectopic ureter you perform an ExLap and find intramural ectopia. Best surgical option?

A

Intravesical repair

48
Q

What is the most common cause of incontinence in the Cat?

A

Tail pull injury or sacral # (neurogenic)

Can also have juvenile or iatrogenic

49
Q

How long can a ureteral obstruction exist before the damage it causes is irreversible?

A

7d

50
Q

What can be done for a traumatic avulsion of the ureter at the bladder?

A

re-implantation

51
Q

What are the 2 CIs for OVH prior to 1st season? (bitch)

A

Juvenile Vaginitis

Juvenile USMI

52
Q

What are the 2 major advantages to OVH prior to 1st season?

A

BVs smaller

Reduced mammary neoplasia

53
Q

When should an elective OVH take place?

A

> 12w after oestrus or >6-8w PP (>3w post-weaning)

54
Q

Which hormone drives cystic endometrial hyperplasia?

A

Progesterone - growth of glands, reduced action of myometrium, allows bacteria to thrive

55
Q

What are the signs of pyometra?

A 
V+
PUPD
Inappetance
Dehydration
Palpably enlarged uterus
56
Q

What are the 3 mainstays of OVH treatment?

A

IVFT
ABs
OVH

57
Q

How can you confirm ovarian remnant syndrome?

A

Stimulation tests

58
Q

How can vaginal hyperplasia be treated?

A

WILL regress after follicular phase

In meantime: collar, lubrication and if prolapsed - purse string

59
Q

Where is a canine episiostomy cut?

A

12 o clock

60
Q

What is the major indication for an episioplasty?

A

Excess skin folds cause peri-vulval dermatitis

61
Q

What are the 3 possible clinical signs with ovarian neoplasia?

A

Malignant effusion
Abdo mass symptoms
Hormonal Dysfunction

62
Q

What investigations can be done for an ovarian tumour/

A 
Palpate!
H/BC
Rx
US
Abdominocentesis
ExLap
63
Q

90% of canine uterine tumour are which type of neoplasia?

A

Leiomyoma

64
Q

What is the Px for Leiomyomas?

A

Good if no mets - remove surgically

65
Q

The majority of feline uterine tumour are which type of neoplasia?

A

Adenocarcinomas (Px guarded)

66
Q

What is the most common tumour in the bitch?

A

Mammary Carcinoma

67
Q

Which mammary glands are most commonly affected by neoplasia in the bitch?

A

Caudal mammary glands

68
Q

Which neoplastic Dz is hard to differentiate from mastitis due to its poor demarcation, ulceration and reddening?

A

Inflammatory carcinoma - poor Px

69
Q

What is the difference in malignancy between feline and canine mammary tumours?

A

Dog: 30-50%
Cat: 90%

70
Q

Which mammary glands are most commonly affected by neoplasia in the queen?

A

cranial mammary glands

71
Q

What are the clinical signs of prostatic Dz?

A

Urinary (dysuria, blood dripping)
Defaecatory (tenesmus, flat faeces, constipation)
HL pain/stiffness

72
Q

How is prostatic Dz diagnosed?

A 
Palpation
Urinalysis
Rx
Prostatic massage/biopsy
Abdo US
73
Q

What are the 5 major Ddz of prostatic Dz?

A 
BPH
Prostatitis
Prostatic Abscessation
Prostatic cysts
Prostatic Neoplasia
74
Q

How is BPH treated?

A

Castration +/- anti-androgens

75
Q

How does BPH present?

A

Symmetrically enlarged and non-painful

76
Q

How does prostatitis/Prostatic abscess present?

A

Asymmetrical, painful enlargement
Dog febrile
Stiff HL
Abdo pain

77
Q

How are prostatic abscesses treated?

A

ExpCoel + drainage of abscess

4-6w course AB to follow

78
Q

How are prostatic cytsts treated?

A

Excision (if paraprostatic)

Drainage and omentalisation

US drainage

Castration

79
Q

What is the most common prostatic neoplasia in dogs?

A

Adenocarcinoma

80
Q

What % of prostatic neoplasia has metastasised at time of diagnosis?

A

80%

81
Q

How do prostatic adenocarinomas metastasise?

A

VIa LN to lungs, skeleton (lumbar)

May directly extend into colon/bladder

82
Q

How is prostatic adenocarcinoma diganosed?

A

Rx: wispy lumbar vertebrae, mineralised prostare
US
Biopsy (catheter/FNA)

83
Q

How is prostatic neoplasia tretaeD?

A

Palliate - analgesia and stool softeners, urethral stent

84
Q

When is scrotal ablation indicated?

A

Scrotal Dz

85
Q

What is the reccomended Tx for cryptorchidism?

A

Bilateral castration

86
Q

What are the 3 types of testicular tumour in the dog?

A

Sertoli Cell tumour
Seminoma
Interstitial Cell tumour

87
Q

What are the 2 reasons that treatment of sertoli cell tumours is important?

A

Produce oestrogen and metastasise readily

88
Q

What are the clinical signs of a sertoli cell tumour?

A 
Abdo distention
Feminisation
Haem abnormalities (myelotoxicity)
Prostatic enlargement
89
Q

Which testicular tumours do NOT metastasise?

A

Interstitial cell tumour

90
Q

How are testicular tumours treated?

A 
Castrate
Blood Transfusion (severe anaemia and TCP)
91
Q

What is phimosis usually 2e to?

A

Trauma
Neoplasia
Infection

92
Q

How is phimosis treated?

A

ABs if infected
Urinary diversion (catheter)
Preputial lavage

Resolve stricture if present

93
Q

How is paraphimosis treated?

A

Identify cause
Relieve constriction
Reduce oedema: massage, diuretic, CS
Flush prepuce with saline and lube

94
Q

How are fractures of the os penis treated?

A

Urethral catheter as stent
Stabilise with plate
Can manage conservatively!

Veterinary Medicine (68 decks)

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