Urogenital articles Flashcards

1
Q

Evaluation of nafamostat mesilate as an alternative anticoagulant during intermittent hemodialysis in healthy Beagle dogs

Joon-hyuk Choi et al jvecc 2018

A

Nafamostat mesilate (NM) = serine protease inhibitor

0.25 mg/kg/hr maybe an alternative to UFH for IHD

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2
Q

Treatment of acute kidney injury associated with cyclosporine overdose in a dog using hemodialysis and charcoal hemoperfusion

Gilad Segev et al jvecc 2018

A

Combined hemodialysis and charcoal hemoperfusion treatment can significantly reduce blood cyclosporine concentrations following acute intoxication or overdosage

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3
Q

Evaluation of a prognostic scoring system for dogs managed with hemodialysis

Francesca Perondi et al jvecc 2018

A

Presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis.

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4
Q

Hemodialysis catheter-associated fibrin sheath in a dog

Langston jvecc 2018

A

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

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5
Q

Ultrasound-guided placement of pigtail cystostomy tubes in dogs with urethral obstruction.

Christine A Culler jvecc 2019

A

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

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6
Q

Effect of intra-abdominal hypertension on plasma exogenous creatinine clearance in conscious and anesthetized dogs.

Min Jang et al jvecc 2019

A

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

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7
Q

Incidence of bacteriuria at presentation and resulting from urinary catheterization in feline urethral obstruction.

Edward S Cooper,et al jvecc 2019

A

No +ve culture @ presentation
13% had +ve culture at removal
-Streptococcus and Pasteurella

Don’t rec ABX

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8
Q

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

A

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

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9
Q

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

A
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
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10
Q

Postmortem urinary tract changes in cats with urethral obstruction

Mauro JVECC 2020

A

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

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11
Q

Retrospective evaluation of urinary indwelling catheter type in cats with urethral obstruction (January 2014 to December 2014): 91 cases

Davidow jvecc 2020

A

No diff in outcome between 3.5 Fr argyle vs red rubber u-cath
rUO 11% at 30 days

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12
Q

Comparison of right lateral versus left lateral versus sternal recumbence intra-abdominal pressure measurements in normal dogs

Lapa jvecc 2020

A

No sig. diff in IAP b/w RLAT, LLat, or sternal

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13
Q

Successful medical management of perinephric abscess and urosepsis following urethral obstruction in a cat

Norkus JVECC 2020

A

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

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14
Q

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

A

cerenia 1 mg/kg IV 10 mins prior to 50 mg/kg TXA prevented vomiting

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15
Q

Outcomes in dogs with uroabdomen: 43 cases (2006–2015)

Janet A. Grimes javma 2018

A

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

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16
Q

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

A

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

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17
Q

Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats

Megan Cray VMD javma 2018

A

Use of SUB to relieve ureteral obstruction 2ry to obstructive pyonephrosis

Pyonephrosis = infective hydronephrosis, is typically associated with renal pelvis abscess formation

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18
Q

Outcome of ureteral stent placement for treatment of benign ureteral obstruction in dogs: 44 cases (2010–2013)

Pavia javma 2018

A

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

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19
Q

Evaluation for association between indwelling urethral catheter placement and risk of recurrent urethral obstruction in cats

Marc A. Seitz DVM; javma 2018

A

rUO: 11% inpatient and 31% outpatient

rUO high in outpatient group

Increasing abnormal urine color @ time of catheter removal was sig. associated w/ rUO

20
Q

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

A

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

21
Q

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

A

In-hospital rUO rate was 17%

Bladder flushing at time of catheterization did not affect rUOv

22
Q

Complications and clinical utility of ultrasonographically guided pyelocentesis and antegrade pyelography in cats and dogs: 49 cases (2007–2015)

Etedali JAVMA 2019

A

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

23
Q

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

A

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

24
Q

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

A

Dorsal vs sternal had no effect on short- or long-term complications of a PU

25
Q

Accuracy of urine dipstick tests and urine glucose-to-creatinine ratios for assessment of glucosuria in dogs and cats

Caroline F. Aldridge javma 2020

A
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

26
Q

Regional Citrate Anticoagulation for Intermittent Hemodialysis in Dogs

T. Francey, A. Schweighauser jvim 2018

A

Anticoagulation efficacious

Satisfactory results in >90% of the heparin-free treatments, allowing HD treatment in dogs at risk of or with active bleeding.

27
Q

Pyelonephritis in Dogs: Retrospective Study of 47 Histologically Diagnosed Cases (2005–2015)

J. Bouillon, jvim 2018

A

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

28
Q

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

A

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)

29
Q

Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications

Roberta Troìa jvim 2018

A

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

30
Q

Factors associated with survival in dogs with chronic kidney disease

Adam J. Rudinsky jvim 2018

A

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

31
Q

Associations between increased body condition score, bodyweight, age and breed with urethral obstruction in male castrated cats

A Jukes VET J 2019

A

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.

32
Q

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

A

Lepto dogs had higher FE K, glucosuria, and +ve dipstick glucose

uNGAL similar in lepto vs other AKI causes

33
Q

NEJM 2020

STARRT-AKI: Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury

A

Accelerated RRT strategy (ASAP, w/in 12h) did not lower risk of death at 90 days

34
Q

Risk factors for positive urine cultures in cats with subcutaneous ureteral bypass and ureteral stents (2010-2016).

Lucy Kopecny jvim 2019

A
  1. Enterococcus spp most common
  2. Cats received ABX post-op less likely to have +ve urine culture.
  3. had LURT, pyelo signs, or both
35
Q

Risk factors for Candida urinary tract infections in dogs and cats.

Krystle L Reagan JVIM 2019

A

Admin of ABX 30 days prior to dx (dogs + cats), immunosuppressant (dogs), LURT dz (cats).

Diabetes or hospitalization not factors

36
Q

Urinary neutrophil gelatinase-associated lipocalin (NGAL) in dogs with stable or progressive kidney disease.

Yoojin M Kim, jvim 2019

A

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

37
Q

Epidemiologic evaluation of calcium oxalate urolithiasis in dogs in the United States: 2010-2015.

Vachira Hunprasit jvim 2019

A

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

38
Q

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

A

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

39
Q

Therapeutic use of tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of subcutaneous ureteral bypass device mineralization in cats.

Colin Chik jvim 2019

A

tEDTA well tolerated and resolved mineralization seen in SUBs

40
Q

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

A

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

41
Q

Urine neutrophil gelatinase‐associated lipocalin to diagnose and characterize acute kidney injury in dogs

Erika Monari jvim 2020

A

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.

42
Q

Acute on chronic kidney disease in cats: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome

Hilla Chen jvim 2020

A

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

43
Q

The ultrasonographic medullary “rim sign” versus medullary “band sign” in cats and their association with renal disease

Alessia Cordella jvim 2020

A

band sign (thick hyperechoic ill-defined band) more frequently associated w/ KD whereas rim signs can be seen in normal cats

44
Q

Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study

Laura Pearl Cole jvim 2020

A

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

45
Q

Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival

Asia Dunaevich jvim 2020

A

Anorexia, leth, V+, D+
Inflammatory, pyelo, ischemic, unknown

35% mortality

IRIS stage, RR, CK, and sCr @ presentation associated w/ survival

LOH longer in survivors

46
Q

The association of bacteriuria with survival and disease progression in cats with azotemic chronic kidney disease

Camilla Hindar jvim 2020

A

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