UTIs

Question 1

sporadic bacterial cystitis

Answer 1

bacterial cystitis WITH clinical signs

< 3 UTIs in 12 months
no known urinary tract or systemic comobidities

Question 2

recurrent bacterial cystitis

Answer 2

bacterial cystitis WITH clinical signs

> 3 UTIs in 12 months
2 UTIs in 6 months

often associated with systemic comobidities

Question 3

subclinical bacteriuria

Answer 3

positive urine culture WITHOUT clinical signs

Question 4

what are the lower urinary tract signs

Answer 4

pollakiuria
hematuria
stranguria
dysuria
periuria

Question 5

what is the ideal sampling and evaluation method of urine cultures

Answer 5

cystocentesis

plate immediately after collection (can refrigerate up to 24 hours)

Question 6

urine sediment indication of UTI

Answer 6

bacteriuria
pyuria

may not need to culture if owner is financially limited

Question 7

when should a CBC/chem be performed in a patient with LUTS

Answer 7

signs of systemic illness
recurrent UTIs

Question 8

automated dilution susceptibility testing

Answer 8

measures the least amount of the antibiotic needed to inhibit 90% of bacterial growth

Question 9

multidrug resistance

Answer 9

resistance to >3 antibiotic classes

Question 10

common comorbidities that result in reinfection

Answer 10

immunosuppression
renal disease
metabolic diseases (hyper/hypothyroidism)

Question 11

niduses that can cause relapse of UTI

Answer 11

foreign bodies
bladder polyps
proliferative urethritis
neoplasia
sequestered UTIs
deep seated tissue infections
uroliths
stents

Question 12

how do uroliths cause relapse of UTI

Answer 12

bacteria can be incorporated into the mineral layers –> shed into urine

Question 13

what bacteria is good at forming biofilms in the urine

Answer 13

E. coli

Question 14

do dogs with normal ultrasounds need to be sent for cystoscopy

Answer 14

not unless they have clinical signs beyond the LUTS

Question 15

indications for bladder biopsy

Answer 15

must have ALL three:

1. LUTS
2. no antibiotic treatment in the past 3-5 days
3. negative urine culture

goal is to check for deep seated infection despite sterile urine sample

Question 16

when is cystoscopy indicated

Answer 16

• abnormalities ID’d on ultrasound
• normal US but animal is clinically unwell

Question 17

MOA of cranberry

Answer 17

PAC compounds; inhibits the adhesion of pathogen to the uroepithelium

Question 18

is prostatic disease more common in dogs or cats

Answer 18

dogs

NOT seen in cats

Question 19

do all intact dogs get BPH

Answer 19

YES - all intact dogs have benign prostatic hyperplasia but NOT all are clinical for it

Question 20

5 a-reductase

Answer 20

converts testosterone into 5a DHT

Question 21

5a DHT

Answer 21

principal androgen; higher affinity and slower dissociation than testosterone

Question 22

what are the protective mechanisms that a normal prostate has against bacterial colonization

Answer 22

1. high urine flow
2. high pressure
3. bactericidal fluid
4. local IgA production

Question 23

clinical signs of prostatic disease

Answer 23

1. urethral discharge - bloody
2. tenesmus
3. hematuria
4. dysuria
5. fever, vomiting, anorexia, weight loss

Question 24

ddx for symmetric and nonpainful prostate on rectal exam

Answer 24

BPH

Question 25

ddx for asymmetric or painful prostate on rectal

Answer 25

neoplasia vs prostatitis

Question 26

benign prostatic hyperplasia (BPH)

Answer 26

hypertrophy and hyperplasia or the prostatic cells seen in older intact dogs

Question 27

what causes BPH

Answer 27

low 5aDHT and testosterone high estradiol estradiol causes cells to get bigger and more numerous

Question 28

BPH treatment

Answer 28

castration > medical therapy castration is the most rapid treatment option for involution

Question 29

medical BPH treatment

Answer 29

5a reductase inhibitors causes atrophy of the glandular and stromal parts takes longer to involute and will return to previous size once medication is stopped

Question 30

prostatitis/prostatic abscess

Answer 30

infection of the prostate from ascending infection from the urethra occurs most often secondary to BPH, squamous metaplasia, or neoplasia

Question 31

pathogens that cause prostatitis

Answer 31

E. coli mycoplasma staph strep klebsiella proteus pseudomonas brucella

Question 32

clinical signs of prostatitis

Answer 32

prostatic pain fever lethargy hematuria

Question 33

diagnosis of prostatitis

Answer 33

enlarged prostate on rectal and ultrasound urine culture prostate aspirate - most diagnostic

Question 34

treatment for prostatitis

Answer 34

enrofloxacin 4-6 weeks