Clinical Technique Exam 1

water makes up how of total body weight

60%

how is water added to the body

1. ingestion

2. synthesized in the body as a result of the oxidation of carbohydrates

where is the total body water distributed

1. intracellular

2. extracellular

3. transcellular (±)

all the fluids in the cells

Intracellular compartment

all the fluids outside the cells

extracellular compartment

specialized type of extracellular fluid

transcellular compartment

~40% of body weight is which type of fluid compartment

intracellular compartment

~20% of body weight is which type of fluid compartment

extracellular compartment

less than 1% of body weight

transcellular compartment

Gibbs-Donnan Effect

the extra osmotic pressure of protein solutions caused by impermeable protein molecules, resulting in uneven distribution of small, permeant cations and anions in blood plasma

extracellular compartment is broken down into

interstitial fluid ~ ¾
blood plasma ~ ¼

Transcellular compartment includes

• synovial

• peritoneal

• pericardial

• intraocular

• cerebrospinal

Extracellular fluid composition of body fluids

LARGE AMOUNTS

• sodium

  • chloride

• bicarbonate

SMALL AMOUNTS

• potassium

• calcium

• magnesium

• phosphate

• organic acid ions

• sulfate

Intracellular fluid composition of body fluids

LARGE AMOUNTS

• potassium

• phosphate

• organic acid ions

MODERATE AMOUNTS

• magnesium

• sulfate

SMALL AMOUNTS

• sodium

• chloride

• bicarbonate

• almost no calcium

osmosis

net diffusion of water from a region of high water concentration to one of lower water concentration

movement between compartments

plasma osmolality

~ 280-302 mOsm/L

Osmotic Pressure

precise amount of pressure required to prevent osmosis

• point where there is no net diffusion, everything is at equilibrium

Signs of Urinary Tract Disorders

• Pollakuria

• Incontinence/ inappropriate urination

• Dysuria

• Straguria

• Hematuria

• Polyuria

• Polydipsia

Pollakiuria

increased frequency of urination

Dysuria

painful urination

Straguria

slow painful discharge of urine

Hematuria

bloody urine

Polyuria

increased urination

Polydipsia

increased water consumption

Lower urinary tract signs

• Urolithiasis

FISH

• Increased frequency (pollakiuria)

• Incontinent or inappropriate urination

• Straguria

• Hematuria

Lower Urinary Tract Infection

microbial colonization of the urinary bladder and/or the proximal portion of the urethra

Lower Urinary Tract Infection is common in which sex

female dogs

less common in male dogs

uncommon in cats

Lower Urinary Tract Infection is common in which age

all ages are affected, but more common in older animals

what is the limit of urine culture for k9 cystocentesis

>1,000 cfu/ml

what is the limit of urine culture for k9 catheterization

>10,000 cfu/ml

what is the limit of urine culture for k9 voided

>100,000 cfu/ml

what is the limit of urine culture for fel cystocentesis

> 1,000 cfu/ml

what is the limit of urine culture for fel catheterization

> 1,000 cfu/ml

what is the limit of urine culture for fel voided

> 10,000 cfu/ml

most common causes of UTI

aerobic bacteria

most common causes of UTI

Escherichia, Staphylococcus, and Proteus

most common canine urolithiasis

1. struvite stones

2. ca ox

3. purines

most common feline urolithiasis

1. struvites (50%)

2. Ca Ox (50%)

3. urates (purines)

what are the main causes of urolithissis

1. supersaturation of urine with minerals that lead to cyrstalluria

2. delayed passage of crystals through the urinary tract

3. reduction of normally present inhibitors of crystal growth and aggregation

what chemicals prevent the formation of crystals

citrate

pyrophosphates

how do crystals stay in the urinary tract

adherence of crystals to damaged mucosa

or

stationary foreign body

what factors contribute to supersaturation of urine with minerals leading to crystalluria

• diet

• pH changes causing reduced solubility of crystals

• concentrated urine enhancing crustal concentration

• congenital abnormalities

magnesium ammonium phosphate / triple phosphate / MgNH4PO4 is

struvite crystals

what dog breed is predisposed to all types of urinary crystals

Miniature Schnauzer

what breed is considered a Stone dog

Miniature Schnauzer

what dog breeds are most commonly diagnosed with struvite urolithaisis

Miniature Schnauzer, scottish terrier, beagle, perkingese, welsh corgi, poodle

what sex is most likely going to be diagnosed with struvite urolithaisis

females!

what cat breeds are most commonly diagnosed with struvite urolithaisis

none, theyre all equally likely to form struvites

how do you treat struvite urolithaisis

urohydropropulsion

shockwave lithotripsy

cystotomy

medical dissolution via diet

how do you prevent the formation of struvites

promote ACIDIC urine via drugs or diet

what drugs promote acidic urine

• methionine

• ammonium chloride

what dog breeds are most commonly diagnosed with Calcium oxalate urolithaisis

Miniature schnauzer, lhasa apso, yorkshire terrier

what cat breeds are most commonly diagnosed with Calcium oxalate urolithaisis

himalyan, persian

what age for dogs are more likely to develop Ca Ox urolithaisis

5-12 years

what age for cats are more likely to develop Ca Ox urolithaisis

4-9 years

what sex is most likely to form calcium oxalate urolithaisis

males!

how do you treat calcium oxalate crystals

urohydropropulsion

shockwave lithotripsy

cystotomy

how do you prevent the formation of ca ox urolithaisis

promote an ALKALINE urine via drugs or diet

what drugs promote ALKALINE urine

NaHCO3

citrate salts (polycirta-K)

how does urate urolithasis form

from the impaired conversion of uric acid to allontonin

what dogs are more likely to form urate uroliths

dalmatians, english bulldogs or animals with portosystemic shunts

how do defects in the portosystemic shunt cause urate crystals

due to impaired metabolism of uric acid to ammonia

what cats are more likely to form urate uroliths

none- equal opportunity

what ages are more likely to form urate uroliths without portosystemic shunts

3.5 years

what ages are more likely to form urate uroliths with portosystemic shunts

< 1 year

what sex are more likely to form urate uroliths

common in male dogs without shunts

how do you treat urate urolithasis

urohydropropulsion

shockwave lithotripsy

cystotomy

medical dissolution via drugs

what drugs is used to dissolve urate crystals

Allopurinol

what is allopurinol

a xanthine oxidase inhibitor that blocks conversion of xanthine to uric acid

how do you prevent urate urolithaisis

low purine alkalizing diet { PROMOTE ALKALINE URINE]

backcross project to genetically correct dalmatians

restricted urine flow from the kidneys through the urinary tract to the external urethral orifice

urinary tract obstruction

why are urinary tract obstructions more common in males

they have a longer urethra that bends and (for dogs) they have an os penis which causes the urethra to narrow where stones can get lodges

what are the clinical signs of uremia

lethargy

dull attitude

vomiting

dehydration

weakness

hypothermia

tachypnea

bradycardia/tachycardia

stupor

coma

seizures

what is uremia

build up of non-protein nitrogenous waste products

what are the causes of urinary tract obstruction

• intraluminal

• intramural

• miscellaneous

what is a intraluminal obstruction

blocking the passage/ lumen

• uroliths

• urethral plugs

• blood clots

what is the most common cause of intraluminal obstruction in male dogs

urolithiasis

what is the most common cause of intraluminal obstruction in tomcats

urethral plugs

what is the most common site of intraluminal obstructions

urethra

what is a intramural obstruction

outside the passageway but constricting the walls of the passageway

neoplasia, fibrosis, scarring, prostate disorders, edema, ruptures

what is a miscellaneous obstruction

displacement of bladder through perineal hernia,

neurogenic (the nerves in the bladder are malfunctioning)

What are the goals of treating urinary tract obstruction

1. combating metabolic derangements that occur with post renal uremia

2. restoring and maintaining a patent pathway for urine outflow

3. implementing specific treatment for underlying cause of urine retention

FLUTD

feline lower urinary tract disease

what are the clinical signs of FLUTD

straining, hematuria, pollakiuria, and inappropriate urinatiion (FISH signs)

what is idiopathic cystitis

noninfectious, inflammatory, lower urinary tract disease

what does idiopathic cystitis cause

inflammation of the bladder and urethra (lower urinary tract)

what is the treatment for idiopathic cystitis

spontaneous recovery regardless of treatment

how many cats are affected by idiopathic cystitis

55-65%

how many cats are affected by FLUTD

1.5% of cats

what is the cornerstone of treatment for urinary issues

WATER

why is water important for treatment of urinary issues

helps dilution of crystals and flush things out to prevent irritation

what is the aim of transfusion medicine

-          to save lives of patients through the safe use of blood products

what are the most common blood products available

o   Whole blood

o   Packed red blood cells

o   Fresh frozen plasma

o   Frozen plasma

o   Platelet rich plasma

o   Platelet concentrate

o   Cryoprecipitate

what is the unit volume of fresh whole blood

450 ml = 1 unit

what is the unit volume of packed red blood cells

250 ml = 1 unit

what is packed RBC

-          Whole blood that is prepared by centrifugal separation of the red cells from the plasma

what is the purpose of using whole blood

to provide RBCs to carry O2 to tissues (mainly for anemic patients)

which blood products provides RBC, plasma platelets, and ALL stable clotting factors

whole blood

what is the shelf life of whole blood

35 days

what are packed RBC used for

used to

o   Increase circulating RBC mass

o   Increase the O2 carrying capacity to recipients blood

o   Tx conditions such as congoing hemorrhage, and chronic anemia