Diagnostics Flashcards
(31 cards)
What are some normal findings on bladder ultrasonography?
Pelvis hyperechoic to the medulla
Cortex hypoechoic to the spleen
Urethra not normally imaged
What should you examine on the bladder using ultrasound?
Wall thickness
Masses - use Doppler to assess blood flow
Calculi - distal acoustic shadowing
Defects
Where should you place the ultrasound probe to examine the prostate?
Near the pubis
How might an abnormal prostate appear on ultrasound?
Mixed echogenicity
Distal acoustic shadowing - mineralisation
Cavities filled with fluid - abscessation
What can pneumocystograms provide extra information for?
Bladder position Small radiopaque calculi Radiolucent calculi Luminal soft tissue abnormalities Mucosal detail - fibrosis and thickness Integrity of the bladder - air leaks into abdomen
He should you perform a pneumocystogram?
Put air into the bladder using a urinary catheter (sterile technique)
10 ml/kg CO2 or NO - negative contrast agent
(Risk of fatal air embolism with air)
Stop instillation if there is
- pain response
- resistance to injection / back pressure
- reflux occurs around the catheter
How can you perform a positive pneumocystogram?
Catheterise bladder in a sterile manner Organic iodine positive contrast agent Dilute with sterile saline Instill 10 ml/kg into the bladder Reduce volume as for pneumocystogram
What is the best technique for assessing the bladder wall and intra-luminal filling defects?
Double contrast study
Tells us about: Neoplasia - positive contrast adheres to neoplasia Small calculi in the bladder Bladder wall structure and integrity Intra-luminal filling defects
How can you perform a positive contrast study?
Injects a small volume of positive contrast into the bladder
Instill air after
How can you best image the ureters?
Intravenous urogram
Good for imaging hydroureter and ectopic ureter
Outline the procedure of an intravenous urogram.
Enema
Plain abdominal radiographs
Air in bladder
IV contrast agent via cephalic catheter
0 mins - blood pool
5 mins - kidney, renal pelvis, proximal ureter
10 mins - entering bladder (ectopic ureters at bladder neck)
15 mins - contrast agent in caudal bladder
How can you perform a retrograde urethrogram and what does it tell you?
Contrast material insected distally through the urethra, up to bladder
Shows obstruction, rupture and urethritis
What is a retrograde vaginourethrogram?
Positive contrast injected into vagina as it is difficult to catheterise the urethra of the bitch
What methods can you use to biopsy the urinary tract?
FNA
Catheter suction - bladder, urethra and prostate samples
Surgical biopsy - cystotomy - incisional or excisional
What type of contrast agent must you use?
Water soluble, iodine based contrast
How to perform an intravenous urogram
Check renal function first - azotaemia, proteinuria and hydration
- stabilise if necessary
Starve for 12h, enema IVFT and GA Take a VD and lateral first Inject contrast agent (2ml/kg) as a bolus X-ray 0 - blood pool 2 - nephrogram 5 - pyelogram
Pmeumocystogram
Left lateral and catheterise
X-ray before
10-40 ml air cat, 50-300 ml dog
Double contrast cystogram
Inject 5-20ml constrast first
Roll and massage
Then fill with air
Retrograde urethrogram
Catheterise - into the vulva and clamp - distal penis and clamp Moderately distend bladder with air Inject 2ml/kg iodine Expose at the end
What are differentials for a marked, uniform increase in renal size?
Hydronephrosis
Neoplasia
Peri-nephric pseudocyst
Subcapsular abscess / haematoma
What can cause in irregular, unilateral increase in renal size?
Neoplasia
Renal cysts
Abscess / granuloma / haematoma
What can cause an irregular decrease in renal size? (Microrenale)
CKD
Atrophy
Dysplasia
What can cause a mild, bilateral, smooth increase in renal size?
AKI
Pyelonephritis
PSS
Amyloidosis
What can cause a marked increase in renal size, bilateral and smooth?
Hydro nephrosis
Lymphoma
FIP
