Clin Med V: Urologic Emergncies

Azotemic

Increased nitrogenous waste in the blood.

Cystotomy:

Incision into the urinary bladder.

Dysuria:

Painful urination.

Urethrostomy:

A surgical procedure to create a permanent opening into the urethra usually to remove obstruction.

Micturition:

The desire or frequency of urination

Polyuria:

Excessive urination

Stranguria:

Frequent, difficult, and painful passage of urine.

Pollakiuria:

Passing small amounts of urine frequently

Uroliths

Stones in any section of the urinary tract

Oliguria

Decreased ability for urine production and excretion.

Anuria:

Failure of the kidneys to produce urine.

Uremia:

A raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys

What are common causes of urinary obstruction?

• Urethral plugs

• Uroliths

• Nephroliths

• Tumors

• Blood clots

What are the mineral types of uroliths?

• Phosphate

• Urate

• Cystine

• Oxalate

What type of crystals are urethral plugs composed of? Do they affect dogs or cats more?

• Struvites

• Cats

Where is the most common spot for cats to block?

Tip of the penis.

Where is the most common spot for dogs to block?

Bladder of the neck or urethra.

Why don’t female cats usually block?

Females have a shorter and wider urethra.

What are signs of urinary obstruction in cats?

• Stranguria

• Pollakuria

• Longer time in litter box

• Hematuria

• Restless

• Vocal

• Uncomfortable

What is the order of treatment for a blocked cat?

• Analgesics

• IV cath

• Urinary cath

• Blood collection

• ECG

Why should you check an ECG on a blocked patient?

For signs of hyperkalemia

How do you perform a cystocentesis?

• Use a 22g, 1.5” needle with a 6 or 12 ml syringe

• With one hand, palpate and immobilize the bladder

• needle is inserted ventral to midline between pelvis and dome of the bladder

• Tip of the needle is aimed caudally at 45 degree angle

• Sample is aspirated

• If unsuccessful, both needle and syringe should be changed out prior to another attempt

What does hyperkalemia cause?

• Bradycardia

• Diminished P waves

• Widened QRS complex

• Increased T wave

How is hyperkalemia treated?

• Dextrose

• Insulin

• NaHCO3

• LRS/plasmalyte

What are the risks of urinary catheterization?

• Cause injury

• Induce UTI’s

• Cause urethra strictures

• Rupture bladder

What kinds of u caths can be used in male cats?

• Tomcat

• Slippery Sam

• Red Rubber

• MILA

How often should urinary output be checked?

Every 2-4 hours

What is the normal urine output?

1-2ml/kg/hr

Whens hould the urinay catheter be pulled?

12-48 hours after placement

What drug helps reduce internal urethral sphincter tone?

Phenoxybenzamine

What drug helps decrease spasm of the urethra?

Prazosin

What drug increases detrusor muscle tone?

Bethanecol

Common urinary diets for cats:

• Feed canned food

• Feed acidifying diets to decrease struvite crystals

What are signs of urinary obstruction in dogs?

• Whining to go out

• Trying to pee without result

• Urinating blood

• Vomiting or lack of appetitie

• Lethargy

Why are radiographs and ultrasounds performed in a dog?

To identify location of stone or blockage

What kind if urinary catheters are placed in dogs?

• MILA

• Foley

• Red Rubber

A nonsurgical method of removing uroliths from the urinary bladder:

Urohydropulsion

Common urinary diets in dogs:

• Struvites→ acidifying diet

• Ammonium urate→ non-acidifying diet

What is AKI and what does it stand for

• Sudden decrease in kidney function over days to weeks

• Acute Kidney Injury

Causes of AKI?

• Ischemia

• Shock

• Hypovolemia

• Hemorrhage

• Decreased cardiac output

• Heart failure

• Renal thrombosis

• Nephrotoxins

• Antimicrobials

• Anesthetics

• Heavy metals

• Analgesics

• Snake venom

How does one present with AKI?

• Anorexia

• V/D

• Halitosis

• Scleral infection

• Oliguria

• Ataxia

• Listlessness

• Polyuria

• Anuria

What is CKF and what does it stand for

• Injury to the kidney that is cumulative over months to years, there is little to no potential for repair.

• Chronic Kidney Failure

What causes CKF

• Congenital disease'

• From kidney disease acquired through life

Peritoneal dialysis:

utilizes the patients own peritoneum as a semipermeable membrane across which watse products, glucose, and albumin are removed from the blood.

Hemodialysis

Incoroporates an artificial kidney or dialysis filter to reduce the azotemia and correct life-threatening fluid, electrolyte and acid-base imbalances.

why are renal transplants performed

to treat cats wirh AKI or CKF if regeneration and recovery of the exisiting kidneys is unlikely.

At what pH do calcium oxalate crystals form? What kind of diet should they eat

• <6

• Alkaline

where is the left kidney in relation to the right

lower (caudal)

Common drug for AKI

Furosemide

different causes of urianry incontience

• neurogenic

• non-neurogenic

• IVDD

• paradoxial

• partial obstruction

• ectopic ureters

C/s of urinary incontinence

• Urine leakage

• older spayed female, intact M

• Perineal area wet

How is urinary incontinence diagnosed

UA

Rads

bloodwork

how is urinary incontience treated

• proin

• testosterone

what does benign prostatic hyperplasia occur the most in

intact dogs

what happen with BPH

Prostatic enlargement that outs pressure on the bladder and colon

What else urethral plugs contain

• RBC

• WBC

• bacteria

• epithelial cells

• sperm

what can happen secondary to canine uroliths

bacterial infections

calcium oxalate crystals in dogs:

M 5-12 years

urate crystals in dogs:

M 3-6 years

what does SUB stand for? Who is commonky used for

• Subcutaneous uteral bypass

• those who commonll block

bladder cancer in dogs

• TCC

• scotties and westies

what should you never do with TCC

cystocentesis

treatment for hyperkalemia

• dextrose

• insulin

• calcium

• lrs

how is hematocrit affected with CKF

anemic/low