UTIs & Stones (Marin) Flashcards

1
Q

who are the only ones who are “allowed” to get UTIs

A

female dogs

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2
Q

what is the most common agent in UTIs?

A

E coli or staph

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3
Q

clinical signs of a UTI include

A

hematuria, stranguira, pollakiuria, dysuria, urge incontinence, stinky urine, cloudy urine

if pyelonephritis, will have systemic signs like fever

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4
Q

if you have an active sediment +/- bacteria AND you have clinical signs of a UTI, then…

A

you likely have a UTI

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5
Q

if you have a recurrent/complicated UTI, the two categories of why this happens are…

A

relapse/persistent/refractory: the same organism is causing the infection and something is causing that bacteria to stick around (hooded vulva, wrong antibiotic, compliance issue, etc)

reinfection: a new organism is causing signs likely due to a suppressed immune system (cushings, CKD, diabetes, prednisone use, obesity, neoplasia, etc)

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6
Q

Princess Barkarella the 5yo FS dog comes to you with hematuria, stranguria, and seemingly needing to pee way more often per the owner. You do a urinalysis and find active sediment. the dog has never had a UTI before. what antibiotic do you want to prescribe? which ones should you avoid?

A

amoxicillin or TMS for 2-5 days

DO NOT USE: fluoroquinolones, 3rd gen cephalosprins, cefovecin

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7
Q

when is generally the most appropriate time to culture the urine?

A

you dont need to culture if it seems to be a sporadic cystitis in a female dog, but for recurrent bacterial cystitis, then you need a culture FO SHO

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8
Q

Princess Barkarella the 5yo FS dog was sent home with amoxicillin for 5 days, but she comes back with what seems like recurrent cystitis. besides a urine culture, what should you screen her for?

A

endocrinopathies, CKD, pyelonephritis, uroliths, abnormal vulvar conformation, neoplasia

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9
Q

a recessed or hooded vulva can be responsible for

A

recurrent cystitis/UTIs

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10
Q

what is the proper way to treat recurrent/complicated UTIs, either from chronic disease like cushings or from pyelonpehritis, etc?

A

4-6 weeks of the proper antibiotic based on culture, and a recheck culture 1 week after to make sure negative, then 3-5 days at the end of treatment

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11
Q

why do we need to repeat urine cultures when treating recurrent/complicated cystitis?

A

because we don’t want the animal on an antibiotic that doesn’t work! this would just be wasteful and could cause resistance

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12
Q

Wiggles McSlobberpants seems to have recurrent cystitis and you decide to do a urine culture. The report comes back as E coli and enterococcus. whats the deal with enterococcus?

A

it’s usually a contaminant and not a true pathogen, especially when it’s one of two bacteria that was cultured.

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13
Q

you have a female dog named Captain Snifflebutt with clinical signs of a UTI and no stones but the culture is coming back negative. do you believe it?

A

heck no, cultures are not 100% sensitive! treat her anyway you dinkus

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14
Q

Wiggles McSlobberpants has recurrent cystitis so you send her home with an antibiotic based on culture results. how should you monitor her after treatment is completed?

A

once the treatment is completed, do a recheck urinalysis every 3 months (this is approximate and can change depending on the case)

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15
Q

the two types of urinary stones most common in dogs and cats are

A

struvite and calcium oxalate

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16
Q

how do crystalluria and urolith differ?

A

crystalluria simply means crystals in the urine and it can sometimes be harmless and not clinically relevant

urolith=one or more crystallized minerals + organic matrix. Nidus is the nucelus, and then they have a shell.

17
Q

male dogs like to get which stones?
female dogs like to get which stones?
who likes to get urate stones?

A

male dogs: oxalate>struvite
female dogs: struvite>oxalate, can be associated with UTIs

dalmations and bulldogs: urates

18
Q

male cats like to get which stones?
female cats like to get which stones?

which cats like to get urates?

A

male cats: more calcium oxalates
female cats: 50/50, but struvite stones usually sterile

siamese: urates

19
Q

Meowington von Purrface comes in with hematuria, stranguria, and some urinary incontinence. On PE she has a thickened bladder wall. Her CBC is normal and her chem panel is also normal. her UA shoes an INACTIVE sediment. what do you suspect? what diagnostics would you like to perform?

A

uroliths

either abdominal rads (the best choice) or ultrasound

20
Q

list some characteristics of calcium oxalate, struvite, and urate stones to help you differentiate which is which (by the way you are an absolute queen and I love you so much)

A

calicum oxalate: rough, rosette/star shaped, and opaque on rads

struvite: smooth, round, a little bit opaque on rads

urate: smooth, round, more radiolucent on rads

21
Q

what is the connection between struvite cyrstals and urase producing bacteria in DOGS?

A

for most stones when you do a urine culture, it comes back negative, but for struvite it comes back positive for urase producing bacteria, such as: staph, proteus, enterococcus. (this is for dogs). For these bacteria to grow there has to be an increase in pH.

22
Q

for struvite crystals in cats, what is special about them?

A

they are not infection related and are usually associated with sterile urine. it can be due to diets high in certain minerals and protein. they can also be normal in the urine IF the urine is concentrated and there’s few of them.

23
Q

risk factors for struvite crystals in female dogs is

A

UTIs

24
Q

struvite uroliths should me medically dissolved in dogs and cats UNLESS:

A
  • medications or dissolution foods can’t be administered or are contraindicated
  • the urolith cannot be adequately bathed in modified urine from the diet OR
  • there is an ucontrollable infection
25
Q

Miss Poops-a-Lot is a dog that has been diagnosed with struvite uroliths. Her infection seems to be controlled for now. How will you treat her?

A
  • urinary management diet for dissolution
  • antibitoics the ENTIRE TIME (because as stone dissolves it releases bacteria into the matrix)

stone will take 2-6 weeks to resolve

recheck rads and culture every 2 ish weeks until you see the stones have dissolved

continute the diet and antibiotics for 2 weeks after rads show that the stone is fully dissolved

26
Q

a female cat named Lady Toot has been diagnosed with struvite crystals. How will you treat her?

A

dissolution urinary diets, and have the cat stay on this long term because they are good at prevention

NO ANTIBIOTICS are needed because in cats these are sterile

increase water consumption–>dont forget about FLUTD!

27
Q

why might your treatment of a UTI or stone fail?

A

you had the incorrect diagnosis, the UTI was not treated, lack of diet intake, and predisposing causes

28
Q

who is predisposed to getting calcium oxalate stones?

A

small breed male dogs, older dogs

29
Q

true or false: calcum oxalate stones rarely reoccur

A

FAKE NEWS B*TCH THEY REOCCUR ALL THE TIME

30
Q

a 8yo MN shitzu named GayBoi comes to you with stranguria. Based on his signlament, you suspect _____ and want to do ______ for diagnostics and you want to offer _______ for treatment.

A

calcium oxalate stones

UA: urine might be acidic and you might be able to see some of the crystals
Culture: sometimes a secondary UTI is present

rads: very opaque so will see them

treatment: cystotomy, or other minimally invasive techniques if there’s few stones

31
Q

GayBoi’s owner wants to know how they could have prevented his calcium oxalate stones. you say

A

urinary management diet FOR LIFE, and frequent rechecks/imaging every 3-6 months FOR LIFE

they WILL come back and prevention is very important

32
Q

Gayboi’s owner says they have another dog at home that is Gayboi’s brother and he is only 2 years old. He is also a shitzu.The owner asks, should I start him on a urinary diet too?? You say…. (remember Gayboi has calcium oxalate crystals)

A

I would put the 2yo brother on a urinary diet and start screening him at age 5 with urinalysis and imaging. I would also suggest the owners get pet insurance…cuz…yikes

33
Q

calcium oxalate cystoliths associated with or without clinical should should be removed by

A

minimally invasive procedures where possible (avoid urethrea surgery)

34
Q

should you send stones for analysis

A

yes beech what did you think the right answer was…geez

35
Q

what exactly is a “minimally invasive procedure” for calcium oxalate stones?

A

finger up the bung hole with a U cath thing

voiding hydropulsion: fill the bladder up, swish it around, and then squeeze the bladder so it all comes out, hopefully the stones come with it

36
Q

true or false: urate crystalluria is never normal

A

so tru bestie

37
Q

which stone type can be associated with signs of hepatic encephalopathy/portosystemic shunt?

A

urate

38
Q

in dalmations or bulldogs that do not have PSS and have urate stones, what is the treatment?

A

surgery/hydropulsion/laster blast

urinary diet

allopurinol: a xanthine oxidase inhibitor