Small Animal Urinary Surgery 1 and 2

Question 1

List four pre-operative considerations you should make before renal or ureteric surgery.

Answer 1

Hypoproteinemia
Electrolytes and fluid statues
Haematology
Clotting abnormalities

Question 2

What drugs should you avoid for renal and ureteic surgery?

Answer 2

Avoid CP (due to hypotension) and NSAIDs

Question 3

List three sampling methods of the kidneys

Answer 3

FNA
Tru-cut
Incisional

Question 4

What is the prognosis for dogs with renal carcinomas, sarcomas and nephroblastomas?

Answer 4

Carcinoma > 16 months
Sarcoma > 9 months
Nephroblastoma > 6 months

Question 5

What is the prognosis for cats with renal lymphoma?

Answer 5

> 3-6 months

Question 6

What are cystoliths?

Answer 6

Urinary bladder calculi

Question 7

What are choleliths?

Answer 7

Gallbladder calculi.

Question 8

Which breed of dogs and which breed of cats are over-represented with renal calculi?

Answer 8

Siamese
Bichon frise

Question 9

What are the three situations in which you would consider surgery for renal calculi?

Answer 9

Obstructive
Refractory UTI
Refractory haematuria

Question 10

Describe the medical management that can be used for ureteric calculi

Answer 10

Diuresis - 405 days may encourage the ureterolith to move into the bladder
Lithotripsy - not in cats
Ureteral relaxants - glucagon/amitiptyline

Question 11

What are the three main complications of a ureterotomy?

Answer 11

Breakdown
Leakage/uroabdomen
Stricture formation

Question 12

What are the two methods of ureteral stenting?

Answer 12

Open or minimally invasive procedure requiring fluoroscopy

Question 13

What is a subcutaenous ureteral bypass?

Answer 13

Artifical catheters from renal pelvis to bladder outside the ureter.

Question 14

List three ways that hydronephrosis can present.

Answer 14

Urine accumulation
Dilation of the renal pelvis
Progressive destruction of the renal medulla

Question 15

List three causes of hydronephrosis

Answer 15

Pyelonephritis
Obstruction
Congenital stenosis.

Question 16

What breeds are presdisposed to ectopic ureters?

Answer 16

Golden retriever and labrador

Question 17

What is the imaging modaility of choic for ectopic ureters?

Answer 17

CT with contrast

Question 18

What are the two types of ectopic ureters and which is more easy to treat?

Answer 18

Intramural and extramural.
Intramural much more common.

Question 19

Why may males present with ectopic ureters later in life?

Answer 19

Compensate for abnormal opening fo may present later in life.

Question 20

Which type of ectopic ureters can be treated by laser ablation and in which animals?

Answer 20

Intramural, females.

Question 21

Which animals should you use open surgery to correct intramural ectopic ureters?

Answer 21

Males or very small females.

Question 22

What procedure if performed to extramural ectopic ureters?

Answer 22

Ureteroneocystostomy

Question 23

What is the success rate for ectopic ureters?

Answer 23

50-70%

Question 24

What type of surgery is bladder and uretheral surgery considered to be?

Answer 24

Clean/contaminated

Question 25

List four pre-operative considerations for bladder and urethral surgery

Answer 25

Renal function Electrolytes and fluid status Haematology Clotting abnormalities

Question 26

Where are polypoid cystitis usually found?

Answer 26

At the bladder apex

Question 27

What is the only bladder calculi that can be dissolved?

Answer 27

Struvite

Question 28

Which breeds are predisposed to a urethral prolapse?

Answer 28

Brachycephalic breeds

Question 29

What is the point of retrohydropropulsion?

Answer 29

To avoid urethral surgery.

Question 30

What urethrostomies should you use in a dog or cat for recurrent urethral obstruction?

Answer 30

Cat - perineal urethrostomy Dog - scrotal urethrostomy

Question 31

List three ways to treat an atonic bladder.

Answer 31

Keep bladder decompressed for 4-6 weeks Detrusor stimulants - bethanecol Urethral relaxant - phenoxybenzamine

Question 32

What percentage of bladder tumours in dogs and cats are malignant?

Answer 32

97%

Question 33

Where do transitional cell carcinomas tend to grow?

Answer 33

Around the bladder trigone

Question 34

List three palliative measures for bladder neoplasia?

Answer 34

Cystostomy for urine diversion when tumour is obstructing the urethra. Urethral stening to relieve the obstruction. Laser debulking.

Question 35

List three indications for a tube cystostomy

Answer 35

Obstructed bladder due to stone, atony and urethral rupture.

Question 36

What are three types of catheters that can be used in a tube cystostomy?

Answer 36

Foley catheter Locking-loop pigtail catheter Low profile tube

Question 37

What should you use to diagnose a urinary tract rupture?

Answer 37

IVU (intravenous urethrogram)

Question 38

What does USMIA stand for?

Answer 38

Urethral sphincter mechanism incompetence

Question 39

What are the types of medical management you can use with USMI?

Answer 39

Oestrogen Alpha-adrenergics - phenylpropanolamine Testosterone supplementation in males