Littérature Flashcards
(939 cards)
Outcomes following balloon dilation in dogs with urethelial carcinoma: 12 cases (JAVMA, 2019)
Outcome
Recurrence
Complications
- Improvement of instruction in 75% (most of the dogs that did not improve had prostatic carcinoma)
- recurrence in 55% within 48-296 days
- hematuria, urinary incontinence, dysuria
Endoscopic nephrolithotomy for removal of complicated nepthroliths in dogs and cats (JAVMA 2019)
Indication for removal
Caracteristics of neproliths
Outcome
Complications
Indication: calculi displacing the parenchyma (44%), recurent UTI (31%), ureteral outflow obstruction (25%)
Caracteristics: 2.5 cm, 44% mixed, 31% calcium, 12.5% xanthine, 12.5% cystine
Outcome: 100% resolution of complicated stones + improvement of creatinine, 94% nephroliths free
Complications: hemorrhage requiring transfusion, renal capsule tear, ureteral puncture (6% each)
Factors associated with postobstructive diuresis following decrompressing surgery with SUB or stent in cats: 37 cases (JAVMA 2019)
Note: post-obstive diuresis = > 2ml/kg/h
- Factors associated with diuresis
- Survivial to discharge
- Azotemia resolved in how many cats
- When was maximal urine output
Associations:
- CKD - less severe POD
- anuria prior to surgery: longer POD
- Lower BSC, signs of V+/A-: POD more severe
- USG negative correlation with POD and positive correlation with severity
92% survived
50% had resolution of azotemia
Maximal POD: at 12 hours
Can ligation caudal to a vesicovaginal fistula resolve signs of urinary incontinence (JAVMA 2019)?
Yes
Complications and clinical utility of AUS guided pyelocentesis and antegrage pyelography in cats and dogs (48 cases) JAVMA 2019
Diagnostic rate
Complication (minor / major)
Advantage of sampling pelvis over bladder
94%
minor 24% and major 2%
No advantage
Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and duration of urinary catheter retention and hospitalization for male cats (JAVMA 2019)
Conclusion
No significant effect of bladder lavage
- Recurrence 13% vs 19% in non-flush
- Duration of U-cath 37 hours vs 36
- Hospitalization: both 3 days
Is ultrasound sensitive for detection of cause and location of ureteral obstruction ? (JAVMA 2019)
Sensitive for detection of ureteroliths
Evaluation of association between U-cath placement and risk of recurrent urethral obstruction in cats (JAVMA 2018)
Recurrence rate between 2 groups
Risks factors for recurrence
Conclusion
11% for inpatient and 31% for outpatient (95% of them was within 1 week)
Risk factor: abnormal urine color at the time of catheter removal
Outpatient care is reasonable alternative
Characterizaton of subclinical bacteriuria, bacterial cystitis and pyelonephritis in dogs with CKD (JAVMA 2018)
Positive urine culture
Most common infectious organism
Was CKD associated with presence of bacteriuria
18.1% of dogs had positive urine culture
(45% subclinical, 40% pyelonephritis, 15% cystitis)
Ecoli (then klebsiella and staph pseudointermedius)
The presence or stage of CKA that not associated with the presence of bacteriuria, which was actually lower than in dogs with other systemic diseases (DM, Cushign’s)
Survival analysis of associations between peridontal disesa and risk of development of CKD in cats (JAVMA 2018)
How many cats developed CKD and was peridontal disease a risk?
Which cats were at greater risks? Lower risks?
1.8% of cats with CKD and increased risk with cats with peridontal disease
Higher risks: purebred, female, undergo anesthesia, having cystitis, older and lower BSC. Lower risk: history of hepatic lipidosis and DM
Effect of refrigeration on urine sample (JAVMA 2018)
significant lower CFU count in samples refrigerated in TSB
Treatment of congenital distal ureteral orifice stenosis by endoscopic laser ablation in dogs: 16 cases (JAVMA 2018)
Presentation
Was treatment succesful
Labrador, with history of incontinence, infection, vomiting and diarrhea. Left side most affected
Treatment successful in all without complication
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 (JAVMA 2018)
Dogs with elevated creatinine had better or worse specimen?
Which type of needle is best?
What was the diagnosis in the samples obtain?
What was the complications?
Dogs with creatinine > 5 were more likely to have insufficient specimens sample
16 needle yielded slightly more specimen than 14 and more than 18. Also 16 were less likely to contain medulla
Note: samples obtain via laparotomy/laparoscopy were more likely to contain medulla also
Immune-mediated glomerulonephritis (40.6%), focal segmental to global glomerulosclerosis (18.4%), amyloidosis (12.3%), tubulo-interstitial disease (8.2%), non-immune mediated nephropathy (7.3%)
Present in 3.4% - hematuria was the main
More serious with 14 gauge needle
Clinicopathologic and microbiologic findings associated with emphysematous cystitis in 27 dogs (JAAHA 2018)
Location of gas
Comorbidities
Infectious agent
Wall and lumen (51.9%)
Wall (33%)
Lumen (14.8%)
Diabetes (33%), neurologic disease (26%), adrenal disease (19%)
Does silver coated urinary catheters provide clinical benefits over standard catheters?
No - it is associated with earlier bacteriuria but not UTI
Evaluation of diagnostic utility of cytology of renal FNA from dogs and use of AUS features to inform cytologic diagnosis (JAVMA 2018)
How many specimen adequate for interpretation?
Renal FNA are more useful for which purpose?
72% were adequate
sensitivity/specificity for neoplasia: 78% and 50%
sensitivity/specificity for non-neoplasia: 50% and 77%
Lymphoma had 100% sensitivity
Presence of neoplasia, especially if presence of mass on AUS
Outcome of ureteral stent placement for treatment of benign ureteral obstruction in dogs: 44 cases (JAVMA 2018)
Underlying reason for stenting
Outcome
Complications
- obstructive nephrolithiasis (84%), stricture (9%), both (7%)
- Sucessful in 45/55 via endoscopy and 100% via surgery
Note: median hospitalization 1 day and improvement of creatinine (from 2 to 1.3)
UTI: 59% prior to stenting and 26% after
Treatment of pyonephrosis with a SUB device in four cats (JAVMA 2018)
Outcome?
Cystotomy tube became occluded with purulent materia; 1/4 cats
One cat had persistent bacteriuria without clincia signs
US evaluation of the bladder following cystotomy (JAVMA 2018)
Outcome
Recurrence
Medial wall thickeness of the ventral aspect peaked at 1 day post-op, but was still present after 3 months in 50% of cases
Recurrence of hyperechoic foci occured in 11/18 dogs , with a median of 17 days post-op
Use of SUB for treatment of benign ureteral obstruction in 134 cats (174 devices) (JAVMA 2018)
Underlying cause for SUB
Pre/post op findings of creatinine and pelvic dilation
Complication
Outcome (survival rate)
Ureterolithiasis (65.5%), stricture (16.1%), both 16.7%, pyenephrosis (0.6%)
Note: 39% of cats had bilateral involvement
Pre-op: azotemia in 95% of cats with a creatinine of 6.6 and 3 months post-op 2.6. Pelvic diameter 9.2 pre op and 1.5 post op
Complications: occlusion with blood clots in 8.1%, device leakage in 3.5%, kinking in 4.6%. Most common long term was catheter mineralization in 24.2% 463 days after placement (especially if high iCa post-op)
Survival rate 94%
Long term complication:
Is cystoscopic-guided laser ablation of an orthotopic ureterocele secondary to ureterovesicular stenosis a safe and effective treatment ? (JAVMA 2018)
Yes
Clinical performance of commercial point-of-care urine culture system for detection of bacteriuria? (JAVMA 2018)
Usefulness
Limitations
All results for stroed cultures were identical to those from reference lab (sensitivity 93%, specificity 100%)
77-58% of bacteria were correctly identified and 39% antimicrobial susceptibility were accurate - inaccuracy of some antimicrobial
Which group of cats with SUB or sent had lower risk of complications and longer survival time? (JAVMA 2018)
SUB
Should urinary tract obstruction be considered as a differential for cats with pleural effusion? (JAVMA 2018)
Yes - removal of hydronephrotic kidney was curative