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Animal disease 2 > Urogenital tract > Flashcards

Urogenital tract Flashcards

1
Q

Urogenital tract

A

Upper UGT- kidneys and ureters
Lower UGT- bladder and urethra
The upper urogenital tract is always sterile and introduction of bacteria can cause significant disease
Conditions affecting the UGT are common

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2
Q

Conditions may be what for urogenital tract disease

A

Congenital
Acquired
Degenerative

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3
Q

Reproductive tract

A

Less emphasis on this in small animal medicine– most animals are spayed/neutered
Prostate and testicles in male dogs
Uterus in females

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4
Q

Acute renal failure

A

Damage to the kidneys occurs over hours to days

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5
Q

Acute renal failure can be caused by

A

Anything that decreases renal perfusion- shock, dehydration, hypotension
Anything that causes direct harm to the kidneys - trauma, infection, toxins

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6
Q

pathological changes with acute renal failure

A

Damage to nephron unit
Loss of filtration
Ultimately,
Build-up of toxins
Uremia
Acidosis
Dehydration
Eventually the kidneys shut- down causing anuria (no urine production)

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7
Q

Is ARF an emergency and why

A

ARF is an emergency
ARF is potentially fatal depending on the cause and amount of damage that has already occurred

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8
Q

History with ARF

A

Drugs: NSAIDs, aminoglycoside antibiotics
Toxins: Anti-freeze, lilies
Risk of infection, recent dehydration, hypotension (including during a GA)

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9
Q

Treatment with ARF

A

Remove toxins
Treat infection if present
FLUIDS
Flush kidneys of toxins
Restore renal blood flow
Restore hydration
Balance losses (input MUST equal output)
Twice daily weight check
Balance input and output
Watch for fluid overload (altered distribution and risk of anuria)

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10
Q

Prognosis with ARF

A

Depends on underlying cause–poor to guarded
The kidneys have a poor regenerative capacity
Healthy kidney will compensate

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11
Q

Lily toxicosis is and only affects what

A

Cats
Renal toxin
All parts of the plant are toxic
1 leaf can be fatal to a cat

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12
Q

How fast is lily toxicosis

A

2-6 hours – toxicity starts
12-18 h – kidney damage occurs
3-7 days – death from ARF

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13
Q

Treatment and response with lily toxicosis

A

Always treat as emergency
Induce vomiting (<4h since ingestion)
Start emergency detoxification
IV fluids
Detoxification with activated charcoal
Renal support

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14
Q

Ethylene glycol (antifreeze) toxicity is caused by and common in

A

Tastes sweet
Increased risk if it is the only available liquid in the Winter
Dogs, cats, (cattle)

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15
Q

When is ethylene glycol toxicity going to happen

A

Dogs: <1 tsp/kg
Cats: ¼ tsp/kg

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16
Q

Effects of ethylene glycol toxicity

A

Alcohol toxicity (immediate)
Vomiting, PUPD
Acidosis, dehydration (3h)
Calcium oxalate crystal formation causing acute kidney damage (12 h)

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17
Q

Is ethylene glycol toxicity an emergency

A

EMERGENCY: rapidly fatal from ARF

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18
Q

Treatment of ethylene glycol toxicity

A

If ingestion has occurred within the past 2 hours
Induce vomiting
Activated charcoal
IV fluids
Antidote- IV vodka

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19
Q

Chronic renal failure is common in

A

Age-related
Cats >10y; Dogs >8y

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20
Q

Progression of CRF

A

IRIS STAGING SYSTEM
Stage 1– renal insufficiency
Stage 2– start prevention
Stage 3 – clinical signs related to water loss and urea
Stage 4– end stage, requires hospitalization

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21
Q

Complications with CRF

A

Dehydration
Acidosis
Ulcerative lesions–mouth, GIT
Hypertension→retinal detachment→sudden onset of blindness
ANEMIA
Loss of EPO production
EPO is the hormone that stimulates RBC production in the bone marrow
Hypercalcemia
Proteinuria
Hyperphosphatemia and hypokalemia

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22
Q

Treatment of CRF

A

Will eventually die–this is a progressive disease
Supportive care only
Fluids
Low protein diet→decreased uremia
GI protectants, antiemetics…
Other….

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23
Q

Prognosis of CRF

A

Death in
Cats 1-5y
Dogs 6mo–2 y

24
Q

Tech notes with CRF

A

Animals with CRF are at a higher risk of adverse reactions for most drugs including general anesthesia
Many drugs are contra-indicated
GA decreases blood flow to kidneys
Kidneys already at risk
Assume most geriatrics have some degree of CKD

25
Q

Urethral sphincter mechanism incompetence (USMI) is and common in

A

(Estrogen-Dependent Urinary Incontinence)
(Hormone-Responsive Urinary Incontinence)
Incontinence– Lack of control of micturition
Older large breed females…….. that have been spayed
Problem = decreased estrogen
Diagnosis by exclusion
Lack of urethral sphincter tone

26
Q

Treatment for USMI is and for how long

A

Treatment is for life
Supplement with diethylstilbestrol (DES) or phenylpropanolamine (PPA)
DES: initially once daily for 5 days then decrease to minimal effective dose (often every 7 days)
Can suppress the bone marrow -aplastic anemia (erythropenia, possible thrombocytopenia and leukopenia)
Annual blood work is recommended
PPA: sympathomimetic- increases sympathetic tone

27
Q

Treatment of USMI

A

Stilbestrol (diethylstilbestrol)- is often the treatment of choice for spayed, mature, female, dogs
Initially once a day for 5 days and then usually only once a week so good compliance
Estrogen can potentially suppress the bone marrow causing estrogen induced aplastic anaemia (manifested with low platelet counts, petechiation and ecchymotic lesions, bruising, very low RBC count, and even low WBC count)
Annual blood work is required
Phenylpropanolamine- another commonly used treatment option
Available in liquid or tablet form
Needs to be administered every 12 hours in most cases
Can be used in males or immature dogs
Can be used as a combination therapy with DES in poorly responsive cases
Monitoring of blood work recommended
$$

28
Q

Inappropriate elimination for cats

A

Bad news for cats
Over 100 000 cats enter shelter every year
50% of cats in shelter are euthanized
Most common reason for relinquishing a cat to a shelter is inappropriate elimination

29
Q

Reasons for inappropriate elimination

A

Aversion to
Litterbox
Type of litter
Location of the litterbox
Substrate preference
Separation anxiety
Medical management, litter box makeover and environmental enrichment are all importanti in improving the issue
Most commonly more then one is the cause

30
Q

UTI is

A

Bacteria most common
Ascending from exterior
Skin or feces; distal urethra
More common in females than males
Males usually have an underlying pathology

31
Q

Risk factors for UTI

A

Sphincter incontinence
UGT abnormalities
Indweling u-catheter
Crystalluria/ urolithiasis
Decreased frequency of urination
Diabetes mellitus
Prostate /uterine infection
Estrus

32
Q

Presenting signs with UTI

A

Inappropriate urination
Stranguria, pollakiuria
Hematuria, cloudy urine, licking ant prepuce or vulva
Sometimes will have no observable signs until systemic disease is present

33
Q

Diagnosis of UTI

A

Gold standard for diagnosis is urinalysis on urine collected by aseptic technique (cystocentesis)
Ask owners to not let the animal urinate for a couple hours prior to the appointment
In-clinic microscopy
Culture and sensitivity- if recurrent infections or the animal is not responding to therapy

34
Q

Treatment results for UTI

A

Resolution
Recurrent
Resistant
If untreated, can lead to pyelonephritis

35
Q

Pyometra is

A

INTACT female dogs and cats
Bacterial infection of the uterus

36
Q

What causes pyometra

A

Estrus
Decreased immune responsiveness
Relaxation of the cervix
Mucosal hypertrophy
E.coli > other

37
Q

open pyometra is

A

Draining
Less risk of rupture
Easier to diagnose
Better prognosis

38
Q

Closed pyometra is

A

May not see outward signs
Risk of necrosis/rupture causing bacteremia
Poor prognosis if not caught early

39
Q

Surgical treatment of pyometra

A

Ovariohysterectomy
Treatment of choice for open and closed pyometra
A higher risk surgery than healthy dog spay
Significant risk of uterine rupture with closed pyometra

40
Q

Medical management of pyometra

A

Open pyometra ONLY
>50% recurrence rate with subsequent heat cycle if the animal is not bred
Prostaglandins and antibiotics

41
Q

Crystalluria means

A

crystals in urine

42
Q

Urolithiasis means

A

stones in urine

43
Q

Pahtology of crystalluria and uroliathiasis

A

Rub on bladder mucosa → inflammation
Embeds in bladder mucosa → inflammation
Obstruction of ureters or urethra
Damage to kidney if renolith or ureterolith is present can male it difficult to resolve UTIs

44
Q

Diagnosis and treatment of crystalluria and urolithiasis

A

Imaging
Not all types of stones will show up on radiographs
Ultrasonography
Surgery - cystotomy
Dissolution diet
Analysing the stones/crystals is part of the diagnosis
Types of stones determines course of treatment and long term prevention plan

45
Q

Prevention of crystalluria and urolathiasis

A

Must do for life
>70% recurrence rate
Prescription diet
Increased water intake
Increase frequency and volume of urination
Urine pH

46
Q

Types of crystals/stones

A

Struvite- triple phosphate; Mg-ammonium phosphate
Ca-oxalate
Ammonium urate

47
Q

Struvite is caused by and how to treat

A

Primary UTI
Treat infection
Dissolvable

48
Q

Ca-oxalate is caused by and can they dissolve

A

Genetics (lack of nephrocalcin); diet high in Ca/VitD
Diet and breeding
Can’t dissolve

49
Q

Ammonium urate is caused by and can they dissolve

A

Genetics (Dalmations); liver shunt
Diet and breeding
Can’t dissolve

50
Q

Presentation of FLUTD

A

Indoor, male cats
Recognize these clinical signs
Straining in litter box
Vocalizing while urinating
Lack of urine production
Licking at prepuce/penis
Inappropriate urination (dribbling, leaking) in a male cat

51
Q

When is FLUTD an emergency

A

If blocked over 24 hours
Uremia
Acidosis
Dehydration
Hyperkalemia- which leads to bradycardia
Can also cause urethral stricture
Will lead to an increased risk of recurrent obstructions or permanent blockage

52
Q

Obstructive FLUTD can be caused by

A

Stones
Crystals (struvite or calcium oxalate)
Mucus plugs
Physical blockage of the urethra; can be unblocked
Catheterization

53
Q

Idiopathic cystitis is and caused by

A

Triggered by stress
Males, indoor, overweight
Inflammation of the bladder- without an obvious cause
Swelling blocks urethra

54
Q

Clinical signs of idiopathic cystitis

A

Pollakiuria
Stranguria
Hematuria
Vocalizing in the litterbox

55
Q

Idiopathic cystitis treatment

A

Anti-inflammatories?
Omega 3 fatty acids?
Anti Anxiety medications?
Adequan?
Environmental enrichment
Minimize stress

Animal disease 2 (8 decks)

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