Urology

Question 1

urinary system function

Answer 1

maintain body homeostasis through eliminating waste products, blood filtration/reabsorption/secretion, fluid balance regulation, hormone production

Question 2

creatinine

Answer 2

by-product of muscle metabolism, produced at a constant rate and filtered out by the glomeruli
small amounts produced daily but elevated levels seen with lack of functional glomeruli
influenced by fluid and hydration levels, pre-renal factors like shock, post-renal factors like bladder and urethral obstructions

Question 3

urea nitrogen

Answer 3

by-product of protein metabolism
filtered out by glomeruli
increased levels = decreased function
up to 40% reabsorbed by tubules
absorption rate inversely related to urine output

Question 4

FLUTD

Answer 4

feline lower urinary tract disease
common in cats 2-6 years
can be obstructive or non-obstructive

Question 5

FLUTD CS

Answer 5

stranguria, dysuria, hematuria, pollikuria, inappropriate urination

Question 6

FLUTD dx

Answer 6

rule out UTI- do culture and sensitivity, imaging and ultrasound- thick bladder wall from inflammation, +/- chem: BUN and creatinine

Question 7

FLUTD tx

Answer 7

opioids, supplements (#1 glucosamine, #2 pheromones- Feliway), Amitriptyline, control stress
can take up to 4-6 weeks to reach therapeutic levels

Question 8

client education for FLUTD

Answer 8

stress plays a role, can reoccur unpredictably, clean litter box, enrichment

Question 9

litterbox rule of thumb

Answer 9

1 per cat + 1 more

Question 10

urinary obstructions (UO)

Answer 10

restricted urine flow from urethra out urinary tract- emergency!!
by-products can’t get out and can get toxic (elevated potassium levels = heart issues)

Question 11

UO causes

Answer 11

neoplasia, prostatic disorders, strictures, functional obstruction
uroliths (dogs), urethral plugs (cats)

Question 12

urolith

Answer 12

stone formed from mineral salts found in the urinary tract
if passed save for analysis

Question 13

urethral plug

Answer 13

mineral crystals, WBCs, RBCs, protein (mucus), and epithelial cells
if passed save for analysis

Question 14

UO CS

Answer 14

pollikuria, stranguria, anuria, uremia, hematuria, vocalize while urinating
can lead to dehydration –> hypovolemia, hypothermia, hyperkalemia

Question 15

UO dx

Answer 15

biochems: elevated potassium, phosphorus (metabolic acidosis), BUN, creatinine
imaging: rads +/- ultrasound

Question 16

UO tx

Answer 16

1 relieve obstruction with urinary catheter

then…
sodium bicarb (for metabolic acidosis) and IVF to stabilize
diet: s/d food- for struvite crystals, only use short term (no longer than 6 months), c/d food- makes urine pH more acidic to dissolve crystals, provides calcium/struvite protection, can use long term
*only canned foods

Question 17

cystitis

Answer 17

UTI
rare to see in healthy cat
common in female dogs

Question 18

cystitis causes

Answer 18

bacteria gets into urinary tract from feces
#1. E. coli

Question 19

cystitis CS

Answer 19

pollikuria, lick genitals, dysuria, hematuria, stranguria

Question 20

cystitis dx

Answer 20

urinalysis with culture and sensitivity

Question 21

cystitis tx

Answer 21

antibiotics

Question 22

nonrenal causes for elevated levels of urea nitrogen

Answer 22

amount of protein ingested and absorbed, fever, corticosteroids

Question 23

which biochem values evaluates renal failure?

Answer 23

SDMA, BUN, creatinine

Question 24

SDMA

Answer 24

symmetric dimethylarginine
elevated when as little as 25% renal function is lost which helps identify renal failure before CS show up

Question 25

what percentage of renal failure is occurring when we start seeing CS?

Answer 25

75%

Question 26

which scale is used to determine the stage of renal failure?

Answer 26

IRIS scale (1-4)

Question 27

how can we prevent progression of renal failure?

Answer 27

fluid therapy, diet- low protein, phosphorus, sodium; high potassium, vitamin B, omega 3 and 6 fatty acids

Question 28

chronic renal failure CS

Answer 28

hypertension!! -can lead to acute blindness if goes untreated

Question 29

causes of acute renal failure

Answer 29

heat stroke, poorly managed anesthesia, toxin ingestion

Question 30

chronic renal failure tx

Answer 30

can only manage it
diuresis used for acute renal failure- be careful of fluid overload

Question 31

fluid overload signs

Answer 31

serous nasal discharge, lung crackles, chemosis (swelling of conjunctiva), restlessness

Question 32

what should you monitor in a patient with UO?

Answer 32

monitor dehydration, mentation, HR, ECG

Question 33

urinary incontinence causes

Answer 33

anatomical, neurologic

Question 34

urinary incontinence

Answer 34

common in female older dogs, medium or large breed

Question 35

urinary incontinence dx

Answer 35

rule out other causes, urinalysis (UTI rule out), imaging (anatomical causes), neuro exam (neurologic causes)

Question 36

urinary incontinence tx

Answer 36

surgery if anatomical and can be corrected
or drugs: phenylpropanolamine, estrogen

Question 37

acute renal disease

Answer 37

sudden onset
causes: hemodynamic/hypoperfusion, nephrotoxic, intrinsic and systemic disease

Question 38

acute renal disease dx

Answer 38

biochems, SG, toxin screening, imaging

Question 39

acute renal disease tx

Answer 39

depends on underlying cause
IVF

Question 40

acute renal disease CS

Answer 40

anorexia, depression, diarrhea, vomiting, halitosis (bad breath), listlessness