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Year 1/2 > Elimination & Detox 2: Sx of UT > Flashcards

Elimination & Detox 2: Sx of UT Flashcards

1
Q

why is it IMPORTANT that the KIDNEYS are RETROPERITONEAL?

A

because they’re in this THIRD SPACE, may be showing MORE SUBTLE CLINICAL SIGNS because FLUID CAN LEAK INTO THERE BEFORE IT BECOMES A BIG SYSTEMIC PROBLEM

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2
Q

___ are prone to the BLADDER MOVING POSITION depending on HOW FULL IT IS, while ___ have BLADDER STAY IN SAME POSITION in the ___ ___

A

DOGS = MOVE

CATS = SAME POSITION in CAUDAL ABDOMEN

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3
Q

LIGAMENTS of the BLADDER…

VENTRAL = ???

LATERAL..
–> what does it ATTACH?
–> WHY IS IT IMPORTANT FOR SURGEONS?

where do BLOOD & NERVE SUPPLIES ENTER the BLADDER?

A

VENTRAL ligament = connects BLADDER to LINEA ALBA & PELVIC SYMPHYSIS

LATERAL
–> attaches BLADDER to PELVIC WALLS
–> URETERS COURSE THROUGH LATERAL LIGAMENTS BEFORE ENTERING BLADDER AT TRIGONE, so IMPORTANT TO AVOID IATROGENIC INJURY

BLOOD & NERVE SUPPLY enters DORSALLY

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4
Q

BLOOD & NERVE SUPPLY to the URETHRA comes off of the ___ ___ VESSELS, and in MALES is the ___ ___, while in FEMALES is the ____ ____

A

INTERNAL PUDENDAL, PROSTATIC ARTERY, VAGINAL ARTERY

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5
Q

RENAL AGENESIS…

= what is it? what PART of the body does this TEND TO OCCUR TO?

A

= when ONE OF THE KIDNEYS DOES NOT DEVELOP, usually the RIGHT ONE

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6
Q

what is the MOST COMMON CONGENITAL ABNORMALITY of the UT?

A

ECTOPIC URETERS

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7
Q

ECTOPIC URETERS…

= what is it? & 3 locations & which is MOST COMMON

DOGS vs. CATS & FEMALES vs. MALES?

breed predisposition?

what HISTORY would we expect?

A

= when ONE or BOTH URETERS EMPTY OUTSIDE THE BLADDER, such as…
1. URETHRA (most common)
2. PROSTATE
3. VAGINA

tend to occur more in FEMALES > MALES in BOTH CATS & DOGS!

THERE IS A BREED PREDISPOSITION, SKYE TERRIERS & HUSKIES!

expect HISTORY OF INCONTINENCE since BIRTH

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8
Q

2 findings ON PE for ECTOPIC URETERS? (on female)

A
  1. WETNESS of PERIVULVAR HAIR with ODOR & IRRITATION
  2. URINE SCALDING of SURROUNDING SKIN
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9
Q

URINE SCALDING AROUND SKIN & WETNESS of PERIVULVAR HAIR with ODOR & IRRITATION

likely DZ?

A

ECTOPIC URETERS

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10
Q

ECTOPIC URETERS…

INTRAMURAL vs. EXTRAMURAL in DOGS vs. CATS?

A

INTRAMURAL are MORE COMMON IN DOGS

CATS more likely to have EXTRAMURAL & BILAERAL

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11
Q

5 SEQUELAE of ECTOPIC URETERS? which is COMMON?

A
  1. PYELONEPHRITIS & CYSTITIS
    –> MOST COMMON
  2. HYDRONEPHROSIS
    –> from URETER NOT DRAINING KIDNEY PROPERLY
  3. HYDROURETER
    –> from CHRONIC INFECTION, OBSTRUCTION & LACK OF PERISTALSIS
  4. HYPOPLASTIC BLADDER
    –> from LACK OF NORMAL FILLING in URETER
  5. URETEROCELE
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12
Q

DIAGNOSIS of ECTOPIC URETER…

on CBC/CHEM & UA?

what is the GOLD STANDARD?
–> if you DO NOT HAVE THIS, what are 3 other good options?

A

CBC/CHEM = look for AZOTEMIC if BILATERAL or INFECTION has occurred

UA = look for EVIDENCE OF INFECTION

GOLD STANDARD = CYSTOSCOPY

if CYSTOSCOPY not available…
1. EXCRETORY UROGRAPHY
2. RETROGRADE VAGINOURETHROGRAPHY
3. CT

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13
Q

what do you see?

ID IMAGING TECHNIQUE

what is this BEING USED TO DIAGNOSE?

A

see URETERS with OBLONG SHAPE that DO NOT FILL PROPERLY

IMAGING TECHNIQUE = RETROGRADE VAGINOURETHROGRAPHY

used to DIAGNOSE ECTOPIC URETERS

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14
Q

SURGICAL TREATMENT for ECTOPIC URETERS…

should be performed WHEN? & why?

A

perform EARLY to PREVENT SECONDARY ABNORMALITIES resulting from INFECTION or OBSTRUCTION

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15
Q

NEOURETEROSTOMY…

treatment for WHAT?

steps? (5)

A

treatment for INTRAMURAL ECTOPIC URETERS

steps?
1. start with VENTRAL MIDLINE CYSTOTOMY (must OPEN BLADDER to get to URETERS)

  1. inspect TRIGONE for URETERAL OPENINGS/SWELLINGS
  2. use SCALPEL to make 3-5 MM INCISION through BLADDER MUCOSA into URETERAL LUMEN
  3. SIMPLE INTERRUPTED SUTURES
  4. PLACE CATHETER DISTALLY to ID URETER & LIGATE or RESECT
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16
Q

INTRAVESICULAR TECHNIQUE…

used to treat WHAT?

4 steps?

A

used to treat EXTRAMURAL ECTOPIC URETERS

4 steps?
1. CUT URETER
2. use HEMOSTAT & POKE HOLE in APEX OF BLADDER
3. PULL END OF URETER INTO BLADDER
4. SUTURE URETER INTO BLADDER

17
Q

PROGNOSIS for ECTOPIC URETERS when…

SURGERY ALONE?

SURGERY + MEDICAL MANAGEMENT?

we should MONITOR for ___ POST-OPERATIVELY

A

SURGERY ALONE = RESOLUTION of INCONTINENCE occurred in about 20-60% of DOGS

SURGERY + MEDICAL MANAGEMENT? = ADDITIONAL 7-30% of dogs RESOLVED INCONTINENCE!

we should MONITOR for UTIs POST-OPERATIVELY

18
Q

what is the MOST COMMON COMPLICATION of ECTOPIC URETERS?

what CLINICAL SIGN does it cause?

A

URETHRAL SPHINCTER MECHANISM INCONTINENCE

causes PERSISTENT INCONTINENCE

19
Q

HYDRAULIC OCCLUDER…

used to treat WHAT?

two steps?

in MALE DOGS, be sure to…

if we STILL SEE the issue, what can we do?

A

used to treat URINARY INCONTINENCE

steps?
1. placed AROUND URETHRA & stabilize with a SUTURE
2. then, FILL WITH SALINE via PORT

in MALE DOGS, go CAUDAL TO THE PROSTATE to AVOID DAMAGING/OBSTRUCTING URETERS

if we STILL SEE URINARY INCONTINENCE, can INJECT SALINE into PORT to TIGHTEN OCCLUDER

20
Q

URETEROCELE…

= what is it?

pathophysiology? (2)

treatment? (1)

A

= CYSTIC DILATION of PORTION OF URETER that ENTERS TRIGONE

pathophysiology?
1. DILATION of URETER in TRIGONE can COMPRESS NECK OF THE BLADDER
2. causes LOWER URINARY TRACT SIGNS like STRAINING & IRRITATION

treatment? = usually need to RESECT THE DILATED PORTION OF URETER

21
Q

PERSISTENT URACHUS…

= what is it?

treatment? (2)

A

= when URACHAL REMNANTS PERSIST instead of FORMING THE VENTRAL LIGAMENT OF THE BLADDER, leading to URINE LEAKAGE from UMBILICUS

treatment?
1. SURGICAL EXCISION
2. ANTIBIOTIC THERAPY

22
Q

RENAL NEOPLASIA…

commonality in DOGS/CATS?

often __ behavior

MOST COMMON renal neoplasia in..
DOGS?
CATS?

A

UNCOMMON in DOGS/CATS

often MALIGNANT behavior

MOST COMMON renal neoplasia in..
DOGS? = CARCINOMA unless VERY YOUNG, THEN NEPHROBLASTOMA
CATS? = LYMPHOMA

23
Q

DIAGNOSIS of RENAL TUMORS..

usually occurs in WHAT AGE/SEX animals?

breed predilection?

4 clinical signs? which one is MOST COMMON IN CATS?

2 common PE findings? one is +/-

A

usually occurs in OLDER MALE DOGS & CATS

NO BREED PREDILECTION

4 signs?
1. ANOREXIA
2. DEPRESSION
3. WEIGHT LOSS
4. HEMATURIA –> especially in CATS

2 PE?
1. ABDOMINAL ENLARGEMENT w/ PALPABLE MASS
2. +/- LAMENESS

24
Q

DIAGNOSIS of RENAL TUMORS…

IMAGING? which is MOST SENSITIVE/CONFIRMATORY?

A

IMAGING via…
1. RADS (abdominal & thoracic)
2. US
3. CT –> SENSITIVE & CAN CONFIRM TUMORS

25
Q

PERINEPHRIC PSEUDOCYSTS

etiology?

= what is it?

what should we do PRIOR to DRAINING?

A

etiology is UNKNOWN

= SUBCAPSULAR FLUID ACCUMULATION in a CYST in the KIDNEY

we should MAKE SURE IT’S NOT URINE PRIOR to DRAINING

26
Q

ID LESION

A

PERINEPHRIC PSEUDOCYSTS

27
Q

ID DZ

A
28
Q

LAB FINDINGS for RENAL TUMORS…

do we expect to find CONCURRENT UTIs? if so, WHAT 3 CLINICAL SIGNS ARE MOST COMMON?

___ FAILURE may be present if DISEASE is ____

A

DO NOT expect to find CONCURRENT UTIs w/ tumors, but CAN see…
1. HEMATURIA
2. PYURIA
3. PROTEINURIA

RENAL FAILURE may be present if DISEASE is BILATERAL

29
Q

RENAL TUMORS can be associated with ___ SYNDROMES, resulting in… (three)

A

PARAENOPLASTIC SYNDROMES

  1. POLYCYTHEMIA
  2. HYPERCALCEMIA/HYPOGLYCEMIA
  3. HYPERTROPHIC OSTEOPATHY
30
Q

TREATMENT of RENAL NEOPLASIA…

when can we perform NEPHRECTOMIES? (2)

tx for CATS W/ LYMPHOMA?

PROGNOSIS is WORSE FOR ___ > ___

____ is OFTEN PRESENT AT TIME OF DIAGNOSIS

A

NEPHRECTOMIES if it’s…
1. ONLY UNILATERAL
2. NO EVIDENCE of METASTASIS

CATS W/ LYMPHOMA likely to RESPOND TO CHEMO

PROGNOSIS is WORSE for SARCOMA > CARCINOMA

METASTASIS is OFTEN PRESENT AT TIME OF DIAGNOSIS

31
Q

URETERAL NEOPLASIA…

PRIMARY in DOGS & CATS?

SECONDARY = which is MOST COMMON?

A

PRIMARY is RARE IN DOGS & NOT REPORTED IN CATS

SECONDARY = TRANSITIONAL CELL CARCINOMA

32
Q

what is the MOST COMMON BLADDER TUMOR?

___ is COMMON & SPECIFICALLY we can see ____ ____ to… (3)

A

TRANSITIONAL CELL CARCINOMA!

METASTASIS is COMMON & SPECIFICALLY we can see LOCAL EXTENSION to…
1. URETERS
2. URETHRA
3. PROSTATE

33
Q

BLADDER TUMORS are MORE OFTEN ____

A

MALIGNANT

34
Q

what is the GOLD STANDARD for BLADDER NEOPLASIA DIAGNOSIS?

what should we AVOID when PERFORMING THIS DIAGNOSTIC & why?

what is ANOTHER GOOD OPTION for DIAGNOSIS?

A

CYSTOSCOPY & BIOPSY so that WE CAN SEE INVOLVEMENT OF PROSTATE, URETHRA, BLADDER etc.

AVOID PERCUTANEOUS NEEDLE because it can SEED TUMOR

CT is ALSO ANOTHER GOOD OPTION

35
Q

if we need to SURGICALLY TREAT BLADDER TUMORS, we should EXCISE with ____ MARGINS & we can ____ up to ____-____% of the BLADDER

we can also add what 2 medical treatments?

A

1 CM MARGINS & REMOVE up to 70-80% OF THE BLADDER

2 medical treatments?
1. NSAIDs
2. CHEMOTHERAPY

Year 1/2 (139 decks)

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