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Renal > Urethral Obstruction > Flashcards

Urethral Obstruction Flashcards

1
Q

What sex of dogs and cats are most commonly affected by urethral obstruction?

A

Males

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2
Q

Why are males more prone to urethral obstruction than females?

A

Complicated path and narrow lumen of male urethra

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3
Q

What are physical obstructions that can occur in the urethra?

A

Urolith, neoplasia, stricture, mucosal plug

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4
Q

What kind of mechanical obstruction occurs in the urethra?

A

Severe urethral spasma

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5
Q

What is the most important life-threatening e-lyte imbalance assoc. w/urethral obstruction?

A

Hyperkalemia

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6
Q

Why does urethral obstruction cause hyperkalemia?

A

Decreased renal potassium excretion and extracellular shift d/t acidosis

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7
Q

How does hyperkalemia affect cardiac myocytes?

A

Affects resting membrane potential and eventually disables depolarization of cells

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8
Q

What ECG changes are assoc. w/hyperkalemia?

A

Bradycardia, tall/narrow T waves, wide QRS, decreased/absent P waves

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9
Q

How does 0.9% NaCl IVFT help treat hyperkalemia?

A

Dilutes serum potassium

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10
Q

How does IV Ca gluconate help treat hyperkalemia?

A

Restores membrane potential and re-establishes normal depolarization

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11
Q

Does IV Ca gluconate lower K+ levels?

A

NO

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12
Q

How does IV dextrose and regular insulin help treat hyperkalemia?

A

Moves potassium back into cells

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13
Q

Why should you never give insulin alone to a hyperkalemic patient?

A

Can result in hypoglycemia and seizures

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14
Q

How does sodium bicarb help treat hyperkalemia?

A

Shifts potassium back into cells as pH increases

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15
Q

How does metabolic acidosis result from urethral obstruction?

A

Kidneys unable to excrete H+ ions

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16
Q

How does the body compensate for metabolic acidosis caused by urethral obstruction?

A

Resp compensation w/incr. RR/tidal volume

17
Q

What does metabolic acidosis predispose the patient to?

A

Cardiac arrhythmias, CNS depression, decr. catecholamine responsiveness

18
Q

How do you treat metabolic acidosis?

A

Relieve obstruction, IVFT, Na bicarb if severe

19
Q

How does azotemia/hyperphosphatemia result from urethral obstruction?

A

Occurs d/t decr renal excretion of urea/other waste products

20
Q

How do you treat azotemia/hyperphosphatemia?

A

Relieve obstruction, IV fluid diuresis

21
Q

When will you see hypoCa with urethral obstruction?

A

2* to hyperphosphatemia

22
Q

How does hypoCa further compromise a urethral obstruction?

A

Compromises neuromuscular excitation and cardiac contractility (can cause seizures)

23
Q

How do you treat hypoCa?

A

IV Ca gluconate

24
Q

How do you diagnose a urethral obstruction?

A

Straining, decompression, and a distended/turgid bladder

25
Q

What fluids are needed to rehydrate a urethral obstruction?

A

Potassium free fluids (best choice is NaCl)

26
Q

How can you relive a urethral obstruction?

A

Urinary catheter retropulsion

27
Q

How do you prevent re-obstruction?

A

Place indwelling catheter

28
Q

How long is an indwelling catheter left in place for a urethral obstruction?

A

Until azotemia, e-lyte imbalances resolve (12-24h after)

29
Q

Are male or female cats more likely to become obstructed?

A

Male

30
Q

How will the bladder palpate on a blocked cat?

A

Firm

31
Q

What causes hyperkalemia assoc. w/urethral obstruction?

A

Impaired urinary excretion of potassium

32
Q

Why is hyperkalemia an emergency?

A

Can lead to life-threatening arrhythmias

33
Q

When doing a perineal urethrostomy, which nerves must you try to preserve in order to avoid urinary incontinence?

A

Pudendal nerves

34
Q

How do you treat hypertonicity of the urethral muscle?

A

Phenoxybenzamine

35
Q

Why do you not want to treat bladder inflammation with corticosteroids?

A

Predisposes them to UTIs

Renal (10 decks)

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