Lecture 9: Small Animal Urogenital

Question 1

What is your landmark for the right gutter

Answer 1

Descending duodenum

Question 2

what structures are in the right gutter?

Answer 2

right adrenal gland, right kidney, right ovary, right limb of pancreas

Question 3

what structures are in the left gutter?

Answer 3

left ovary, left kidney, left adrenal gland

Question 4

To expose the right kidney, right adrenal, right ovary and right limb of the pancreas what must you move

Answer 4

Descending duodenum

Question 5

Does the right kidney sit more cranial or caudal, compared to the left

Answer 5

Cranial

Question 6

What structure can the right adrenal gland be hiding under

Answer 6

Caudate lobe of liver

Question 7

which gutter is it easiest to see the caudal vena cava and portail vein?

Answer 7

right gutter

Question 8

What is the landmark for the left gutter

Answer 8

Descending colon

Question 9

To expose left kidney, left adrenal and left ovary what must you retract

Answer 9

Descending colon

Question 10

The renal vessels and ureter are located on the ___ aspect of the kidney

Answer 10

Medial

Question 11

what arteries are these?

Answer 11

Question 12

The ureters course ___to the bladder

Answer 12

cranial/dorsal

Question 13

The adrenal glands sit ___- relative to kidneys

Answer 13

Cranial medially

Question 13

which sex’s bladder is more dorsal?

Answer 13

male

Question 14

what is indicated by the black circles

Answer 14

Adrenal glands

Question 15

Where do the ureters attach

Answer 15

Dorsal aspect of the bladder on the trigone/ ureterovesicular junction

Question 16

The uterus sits ___ to the bladder

Answer 16

Dorsal

Question 17

The urinary bladder apex is cranial or caudal

Answer 17

Cranial

Question 18

What structures are contained within the spermatic cord

Answer 18

Testicular artery, vein and nerve, ductus deferens (vas deferens) surrounded by vaginal tunic

Question 19

Identify 1-3

Answer 19

1. Pampiniform plexus (venous network)
2. Ductus deferens
3. Vaginal tunic

Question 20

The contents of the spermatic cord pass through what structure to course down towards the testicle

Answer 20

Inguinal canal

Question 21

Where does the vasculature that supplies the male and female urogenital system come from

Answer 21

Dorsal aspect off the aorta

Question 22

Do you want to do a cystotomy on the dorsal or ventral aspect and why

Answer 22

Ventral, less vasculature

Question 23

What connects the ovaries to the body wall

Answer 23

Suspensory ligament

Question 24

What ligament do you want to break off during spay to allow for better visualization

Answer 24

Suspensory ligament

Question 25

What vein and artery do you need to ligate during spay

Answer 25

Uterine

Question 26

What structure is a swelling of the caudal uterine body

Answer 26

Cervix

Question 27

What ligament attaches ovary to the uterine horn

Answer 27

Proper ligament

Question 28

If you are unsure whether you grabbed the ureter or the uterine horn how can you differentiate between the two

Answer 28

Tract back Caudally and see if you see the bifurcation of the uterine Horn, if not you have the ureter

Question 29

What is being held by the hemostat

Answer 29

proper ligament

Question 30

identify 1-3

Answer 30

1. Suspensory ligament 2. Vascular pedicle 3. Uterine horn

Question 31

what ligament is this

Answer 31

Broad ligament

Question 32

What is the red arrow pointing to

Answer 32

Round ligament

Question 33

What ligament provides a tight band of tension that can be broken down to increase exposure during spays

Answer 33

Round ligament

Question 34

What is the black arrow pointing to

Answer 34

uterine artery

Question 35

What is indicated by the asterisks

Answer 35

Mineralized opacity in the urinary bladder, potential stone

Question 36

what is indicated by the white arrows

Answer 36

Urethral stones

Question 37

Where should you make your incision for cystotomy and why

Answer 37

Ventral aspect of bladder to avoid vessels and ureters

Question 38

What do you want to do after you scope out bladder stones

Answer 38

Flush normograde and retrograde

Question 39

What is indicated by the arrow and how should it be approached during cystotomy

Answer 39

Arrow: caudal superficial epigastric vessel During cystotomy best to make incision on either side but if not possible can cut through it and ligate

Question 40

What is the holding layer for cystotomy closure

Answer 40

Submucosa

Question 41

What is indicated by the yellow arrows

Answer 41

Struvite bladder stones (magnesium stones) that appear smooth on rads

Question 42

What is the most common stone type

Answer 42

Struvite

Question 43

___induced stones are more common in dogs

Answer 43

UTI

Question 44

Sterile Struvite stones are more common in what species

Answer 44

Cats

Question 45

What pH do Struvite stones tend to form in

Answer 45

Alkaline urine with pH >6.5-7.1

Question 46

What pH do calcium stones tend to form in

Answer 46

Acidic urine

Question 47

What stones can you use dietary dissolution

Answer 47

Magnesium (not calcium)

Question 48

How long can dietary dissolution of stones take and what should you be doing in meantime

Answer 48

Can take 8 weeks, repeat rads every 4 weeks, monitor for urethral obstruction

Question 49

Up to __% of urine samples in normal dogs have Struvite crystals

Answer 49

50%

Question 50

T or F: crystalluria is always an indicator of stone formation

Answer 50

False! 50% of normal dogs have crystals in their urine so important to ask about urinary behavior and perform rads

Question 51

How does voiding urohydropropulsion work

Answer 51

Fill bladder with saline and express stones out Only works for stones < 5mm and in dogs >8kg

Question 52

Case example: 9yr, FI KCCS with 1 week lethargy, decrease appetite, PU/PD, febrile, increase HR and RR. Mildly tense on abdominal palpation, abdomen feels distended and doughy. CBC shows marked neutrophilia with left shift, chem shows hyperglobulinemia and hypoalbuminemia. UA=1.010, pH=7, bacteriuria and pyuria. The following x-ray was taken. What is the problem

Answer 52

pyometra

Question 53

When can pregnancy be detected by palpating vesicles

Answer 53

25-35 days

Question 54

In pregnant small animal, uterine swelling can be seen on radiographs when

Answer 54

21-45 days

Question 55

When can calcification of skeletal structures be seen during pregnancy

Answer 55

Day 45

Question 56

When can gestational sacs be seen on ultrasound

Answer 56

As early as 20-22 but easier to see by day 25 with heartbeat

Question 57

What are you looking for in ultrasound of suspected pyometra

Answer 57

Placing prob on ventral aspect, visualize bladder and then look dorsal to bladder to find uterus and note an anechoic fluid filled structures

Question 58

What is the following ultrasound indicative of

Answer 58

Pyometra

Question 59

When does pyometra typically present after estrus

Answer 59

2-4 months

Question 60

At what age is pyometra typically diagnosed

Answer 60

>7

Question 61

What bacteria is commonly cultured in pyometra

Answer 61

E. Coli

Question 62

What type of pyometra has purulent vaginal discharge

Answer 62

Open cervix pyometra

Question 63

What type of pyometra may have no vaginal discharge and are more systemically ill

Answer 63

Closed cervix pyometra

Question 64

What is the survival rate of pyometra with surgery

Answer 64

95%

Question 65

What is the survival rate of pyometra with surgery if there is a uterine rupture

Answer 65

50%

Question 66

What is the survival rate of pyometra with medical management

Answer 66

85% with 30% recurrence

Question 67

When is breeding recommended if pursuing medical management of pyometra

Answer 67

Next cycle

Question 68

What is the treatment for pyometra

Answer 68

Ovariohysterectomy

Question 69

What percent of dogs and cats are cryptochorid

Answer 69

15% dogs and 1% cats

Question 70

When are testicles palpable in scrotum

Answer 70

6-8 weeks

Question 71

What side/testicle descends first

Answer 71

Left

Question 72

What side is cryptorchidism more common on

Answer 72

Right for inguinal and abdominal

Question 73

For large breed dogs is inguinal or abdominal cryptorchidism more common

Answer 73

Abdominal

Question 74

What are cryptorchidism patients at greater risk for

Answer 74

Intrabdominal testicular torsion and neoplasia

Question 75

Neuter before ___yrs old is recommended

Answer 75

5 yrs

Question 76

T or F: cryptorchidism is heritable and therefore breeding is not recommended

Answer 76

True

Question 77

What is a good method to use to find undescended testicle

Answer 77

Find the prostate and then the ductus deferens and trace it

Question 78

When performing a rectal exam, what structures would you mainly feel in an Intact male at the tip of your finger

Answer 78

Prostate, Trigone of bladder (potential stones)

Question 79

During a rectal exam when you flip finger ventrally to palpate dorsally what structures are you examining

Answer 79

LN, aortic pulse, and LS pain

Question 80

When doing a rectal exam and examining ventral aspect what you are examining

Answer 80

Urethra, check for any masses or stones

Question 81

If you are unable to distinguish between an anal gland abscesses and a fistula what can you do

Answer 81

Prescribe antibiotics in both scenarios because that will treat the abscess and temporarily the fistula, but the fistula will come back if just treated with antibiotics because it is immune mediated and therefore needs immunosuppressive drugs

Question 82

What is indicated by the asterisks

Answer 82

sublumbar lymphadenopathy that is compressing colon

Question 83

What is indicated by the arrow

Answer 83

enlarged prostate that is compressing colon **some mineralization present in the prostate that can be indicative of metastatic neoplasia

Question 84

What is the site of a simple abdominocentesis

Answer 84

On linea alba, 1-2cm caudal to umbilicus

Question 85

If unable to obtain fluid from simple abdominocentesis what can you do

Answer 85

4 quadrant abdominocentesis around umbilicus