37. Diseases of the urinary bladder and prostate in dogs and cats Flashcards

1
Q

Lower urinary tract disease?

A
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2
Q

Cystitis?

A

Cystitis

Infectious: Bacteria (dogs) (Mycoplasma spp./ Capillaria plica);

Polypoid cystitis (chronic bacterial inflammation; DDx: Tumour)

Sterile: Interstitial; Idiopathic[Fe.]

Primary/Secondary: Tumour; Stone

DDx: Stone; Tumour; Prostatic disease; Anatomical abnormalities;

Bleeding disorders; Haemoglobinuria; Myoglobinuria

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3
Q

Bacterial Cystitis?

A

BACTERIAL CYSTITIS

Predisposed: Older animals; Dogs > Cats; Females > Males

Causes

E. coli; Staphylococcus spp.; Streptococcus spp.; Proteus spp.

Multi-drug resistance: Corynebacterium ureolyticum + contributing

factors (those affecting bacterial virulence; Abnormal host defence

mechanism – See previous topic)

Clinical signs

§ Pollakiuria § Dysuria

§ Urge incontinence § Haematuria

§ Distended bladder § Painful bladder

§ Thick bladder wall § Bladder mass

§ Stranguria § Small bladder

§ Periuria § Urolithiasis

Diagnosis - Lab. D

Macroscopic changes: Haematuria or pyuria

Sediment: Bacteria; RBCs; WBCs; Epithelial cells; ± Struvite

Alkaline or normal pH; Culture & sensitivity by cystocentesis

Treatment

Abx Treatment

§ Simple infection: 7-10 days

§ Complicated cases 3-6 weeks

§ Good penetration into urine:

§ Amoxiclav

§ Cephalosporin

§ Fluroquinolones

§ Trimethoprim sulphonamides

Pain management: NSAIDS & Opioids

Spasmolytics; Cranberry products (act as an analgesia)

SUBCLINICAL BACTERIURIA

When there is a positive bacterial culture but with Ø CSx of cystitis.

Ø Tx; Only a follow-up is needed if asymptomatic; If +++ bacteria

→ Abx treatment

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4
Q

FLUTD(feline lower urinary tract disease)?

A

FLUTD(FELINE URINARY TRACT DISEASE)

Group of diseases with the same symptoms but different aetiology

Aetiology

FIC (Feline idiopathic cystitis) → 60-70% of cases

Stones → 20% of cases

Bacterial cystitis → 1-3%

Tumour; Anatomical disorder; Trauma; Stricture

Clinical signs

§ Dysuria

§ Haematuria

§ Periuria

§ Urethral obstruction

Physical exam: Good general condition; Bladder → Small & painful

Diagnosis

Urinalysis

Sediment: RBCs (typically seen in FIC); WBCs (typically seen in bacterial cystitis); Crystals ≠ Urolithiasis!

Culture: Used to rule out/confirm bacterial cystitis

Imaging: Reveals urolithiasis, tumours & anatomical disorders

Dx of FIC is by Dx of exclusion

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5
Q

Urethral Obstruction(“the blocked cat” ?

A

URETHRAL OBSTRUCTION (“THE BLOCKED CAT”)

Male cats are predisposed: Uroliths; Crystals; Thrombus; Urethral plug (mineral & organic complex); Urethral spasm alone

Physical exam: Extremely filled, tense & painful bladder (Ø

Expressible)

Clinical signs: Lethargy; Dehydration

Life-threatening condition – Bladder rupture; Postrenal azotaemia

Treatment:

§ Emergency catheterisation (this can be combined with

decompressive cystocentesis

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6
Q

Feline Idiopathic cystitis?

A

FIC (FELINE IDIOPATHIC CYSTITIS)

Maladaptive response to environmental stressors (including

boredom) → Sterile cystitis

General exam: CSx of cystitis; Good general condition; May be associated with macroscopic sediment (sand)

Presentation: Acute, self-limiting episodes (3-5 days) → 80-95%

Predisposition

§ Stray cats § Orphans

§ Indoor cats § Boring environment

§ Dry food § Low water intake

§ New baby/pet § Travel of owner

§ Cats from shelters § Multi-cat households

§ Obesity § Changes of routine

Treatment

§ ↑ water intake

§ Medication: Opioids; NSAIDS; Spasmolytics; Gabapentin

(Remember that giving pills acts as a stressor)

§ Stress medication: Tryptophane; Pheromone diffuser

§ Bladder mucosa protectants

§ Diet: Urinary prescription diet (Hills c/d urinary stress)

§ Environmental enrichment acts as a great preventor

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7
Q

Pathogenesis of fic adrenal and hormonal pathway diagram?

A
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8
Q

Lower Urinary tract tumour?

A

Lower Urinary Tract Tumour

Transitional cell carcinoma (TCC) → Trigonum area (dogs);

Rhabdomyosarcoma

Diagnosis

§ Imaging

§ Urine sediment

§ Biopsy

DDx: Polypoid cystitis (pedunculated masses); Blood clot; Cystitis;

Urolithiasis

Treatment: Piroxicam

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9
Q

Urinary bladder rupture?

A

Urinary bladder Rupture

Leads to Postrenal azotaemia

Causes: Trauma; Cystitis; Tumour; Urolithiasis

Diagnosis: Imaging; Abdominal:Serum creatinine (>2:1)

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10
Q

Prostatic diseases clinical signs diagnosis and prostatic hypertrophy?

A

Prostatic diseases

Predisposed: Older dogs

CLINICAL SIGNS

Urethral bleeding; Tenesmus; UTI; Haematuria

DIAGNOSIS

§ Rectal digital palpation: Size; Shape; Symmetry;

Consistency; Pain

§ Imaging: X-ray; US

§ Urinalysis; Cytology; Biopsy

§ Examination of prostatic fluid & semen

PROSTATIC HYPERTROPHY

Symmetrical enlargement with/without cavitary lesions (seen on US)

Treatment: Symptomatic; Castration; Antiandrogens (+

progesterone)

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11
Q

Prostatitis?

A

PROSTATITIS

Acute/chronic bacterial infection with/without abscessation

Prostatic hypertrophy predisposes to prostatitis

Clinical signs

May be severe

§ UTI signs

§ General signs

§ Shock

Treatment

§ Treat for shock

§ Abx

§ Drainage (surgical/US-guided)

§ Castration

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12
Q

Paraprostatic cyst and prostate tumour?

A

PARAPROSTATIC CYST

Müllerian duct remnant or retention cyst; Large in size

Treatment: Castration; Surgical removal

PROSTATE TUMOUR

Adenocarcinoma (more common in old & neutered dogs)

Metastatic & urethral compression may be seen

Treatment:

§ Castration

§ TCC Tx: Surgery & NSAID (Piroxicam)

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