Pollakiuria and Urinary Incontinence

Question 1

What are the 4 categories of “peeing in the house”?

Answer 1

Urinary incontinence
Pollakiuria
PU/PD
Inappropriate urination (behavioral)

Question 2

Small volume when relaxed in bed or lying down

Answer 2

Incontinence

Question 3

What causes sphincter incompetence?

Answer 3

Infection, partial obstruction, hormonal (estrogen, testosterone, phenylpropanolamine)

Question 4

What is the drug of choice for sphincter incompetence?

Answer 4

Estrogens!
(Estradiol)
Injectable estrogens are contraindicated in dogs

Question 5

What is the order of drug use for sphincter incompetence?

Answer 5

Estrogens (estradiol)
Alpha agonists (phenylpropanolamine)

Question 6

What is the treatment for refractory incompetence?

Answer 6

Combination estrogen/PPA

Question 7

How is sphincter hypertonicity treated?

Answer 7

Skeletal mm: diazepam, methocarbamol
Smooth mm: phenoxybenzamine (or prazosin)

Question 8

How is detrusor atony treated?

Answer 8

Bethanechol (parasympathomimetic)
Cisapride (parasympathomimetic

Question 9

How is detrusor hyperactivity treated?

Answer 9

Oxybutynin (parasympatholytic)
Propantheline (parasympatholytic)

Question 10

What causes detrusor hyperactivity?

Answer 10

Stones, infection, neoplasia, idiopathic

Question 11

Incurin (Estradiol)

Answer 11

Sphincter incompetence
Toxicity = squamous metaplasia of prostate

Question 12

Phenylpropranolamine

Answer 12

Alpha agonist
Sphincter incompetence
Toxicity = inappetence, hypertension, lethargy or hyperactivity

Question 13

Diazepam

Answer 13

Skeletal mm relaxation
Sphincter hypertonicity
Toxicity = hepatotoxicity

Question 14

Methocarbamol

Answer 14

Skeletal mm relaxation
Sphincter hypertonicity

Question 15

Phenoxybenzamine or Prazosin

Answer 15

Alpha antagonist
Smooth mm relaxation
Toxicity = hypotension

Question 16

Bethanochol

Answer 16

Parasympathomimetic
Detrusor atony
Toxicity = salivation, vomiting, diarrhea, bradycardia, miosis

Question 17

Cisapride

Answer 17

Parasympathomimetic
Detrusor atony
Toxicity = minimal

Question 18

Oxybutynin

Answer 18

Parasympatholytic
Detrusor hyperactivity
Toxicity = ileus

Question 19

Small volume, back door, frequently

Answer 19

Pollakiuria

Question 20

What tests do all pollakiuria cases need?

Answer 20

Urinalysis
Radiographs

Question 21

Small bladder: rectal palpation = mild diffusely thick urethra, licking at vulva, likeley disease?

Answer 21

Calculi
Bacterial infection
Neoplasia

Question 22

What testing should be performed for a routine UTI?

Answer 22

Aerobic culture and sensitivity

Question 23

In what breed should you avoid using sulfa drugs?

Answer 23

Dobermans

Question 24

AB duration: simple/sporadic infection

Answer 24

3-5d

Question 25

AB duration: recurrent cystitis

Answer 25

10-14d

Question 26

AB duration: pyelonephritis

Answer 26

10-14d initially May require long term

Question 27

Tx: Leptospirosis

Answer 27

Acute: doxy, IV penicillin Clearance: doxy

Question 28

Labwork: Brucellosis

Answer 28

Neutrophilic leukocytosis Monocytosis Hyperglobulinemia Polyclonal gammopathy Proteinuria

Question 29

Tx: Brucellosis

Answer 29

Quinolone po 14d Doxy po 14d *repeat until seronegative*

Question 30

Radiodense stone, bacterial UTI - most likely stone?

Answer 30

Struvite

Question 31

Struvite calculi

Answer 31

Radiodense Precipitate in alkaline pH (can be dissolved in acidifying diet)

Question 32

Calcium oxalate

Answer 32

Radiodense Schanuzers predisposed Sx tx Alkalinizing diet

Question 33

Urates

Answer 33

PSS (low BUN, alb) Dalmations Radiolucent Medical tx Alkalinizing diet

Question 34

Silicate

Answer 34

GSD and retrievers Jack shaped Radiodense Sx tx Alkalinizing diet

Question 35

Cystine

Answer 35

Doxys, bulldogs, bassets Radiolucent Medical tx, alkalinizing diet

Question 36

FLUTD

Answer 36

Sterile, bacterial, calculi, neoplasia, stress

Question 37

What should be used to treat all idiopathic FLUTD cats?

Answer 37

Canned food Stress relief

Question 38

What are the 7 most common prostatic diseases? *palpation, u/a, tx*

Answer 38

Benign prostatic hyperplasia Acute bacterial prostatitis Chronic bacterial prostatitis Prostatic abscess Prostatic neoplasia Squamous metaplasia Periprostatic cyst

Question 39

What drugs should not be used to treat prostatitis?

Answer 39

Beta lactams