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HLW
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What are 5 types of incontinence?
- urge (inflammation/infection)
- congenital (ectopic ureter, patent urachus)
- paradoxical (partial obstruction)
- neurogenic
- urethral sphincter mechanism incompetence
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For incontinence due to urethral sphincter incompetence, what are some medical options to try before sx?
estrogen, testosterone, sympathomimetic drugs
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What are sx options for urethral sphincter incompetence?
- colposuspension
- cystourethopexy
- injecting teflon or collagen around sphincter
- hydraulic occluders
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what is usual age for bladder lithiasis? What % are lower urinary tract v. kidney stones?
- 3-7 years
- 90% LUT/10% renal
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What is another possible differential is bladder appears to have radiolucent stones?
blood clot
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what are problems associated with thin walled bladder?
- hematuria
- can't shrink back down so retain urine/difficult to express
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Which stones are usually large and multiples?
struvite
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What breed is more prone to get struvites?
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what breed is prone to ammonium urate?
- dalmation (genetic, lacks enzyme)
- bull dog
- PSS (collie, yorkshire, schnauzer)
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What breed is prone to cystine cystoliths? what about oxalates?
- dachshund
- basset
- yorkshire
- chihuahua
- oxalates=schnauzer
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What breed is most susceptible to recurrece of cytoliths?
- dachshund (47%)
- dalmation (33%)
- schnauzer (18%)
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What should be attempted if calculi is in urethra?
try to flush into bladder for removal
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For combined scrotal urethrostomy and cystotomy, which opening can be left open for recurrent situations? Where is incision made?
- prescrotal incision
- leave urethra open if recurrent
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what are some common neoplasias seen in bladder? which effects the trigone?
- leiomyoma (fibroma)
- transitional cell carcoma (common at trigone)
- adenocarcinoma
- leiomyosarcoma
- rhabdomyosarcoma
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What is treatment option for TCC?
piroxicam (immune modulator to slow growth)
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what are cauliflower like lesions in the bladder and how are they treated?
- polyps
- cystectomy to remove tumor w/margins (pediculated better prognosis)
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what are clinical signs for bladder trauma?
- dysuria, anuria
- hematuria
- fluid in abdomen
- swelling and discoloration of skin
- abdomen distention and pain
- uremia
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Uroabdomen is medical emergency. What are some clinical signs?
- hyperkalemia
- uremia
- dehydration
- abdominocentesis/radiology
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what is normal urine production rate?
1-2 ml/kg/hr
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Is diagnostic peritoneal lavage or abdominocentesis preferrable?
DPL (wear gloves and scrub first)
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when performing the water test in the bladder, how is urethra occluded?
ringer in rectum to hold it down
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what are indications for urinary diversion?
- neoplasia
- trauma
- neurogenic incontinence
- temporary following sx, exp. repaired rupture bladder
- (last resort technique!)
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Following urinary diversion, what are some post op concerns?
- antibiotics needed intermittently for life
- culture for abs limited value bc mix w/feces
- ascending infection
- urine scald w/cystostomy
- incontinence w/cystostomy
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what are causes of feline urinary incontinence?
- neurogenic causes (common)
- iatrogenic from sx
- juvenile vaginal aplasia w/abnormal bladder, short urethra
- FLUTD (thick wall so decr. compliance)
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do males or females have problems with urethra. blockage more often?
- males (cone shaped end in cat)
- fem: shorter/wider
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how do you know appropriate length for urinary catheter? where can catheter get stuck when trying to place?
- premeasure or mark w/sharpie once urine starts to flow upon placement
- at ischial arch
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What is hypospadia?
incomplete closure on midline of penis/urethra --> can resemble a vulva and result in incontinence
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where in male do uroliths commonly lodge?
behind os penis (form gran. tissue and embed) --> dilate and back flow
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What is common age for urolith? Breed disposition?
- 3-7yr
- schnauzer, dalmation, bull dog, dachshund, basset, terrier, beagle, GS, poodle
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