SA Sx Urinary I
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Which ovary empties into a renal vein?
left ovarian vein to renal vein
What is an example of emergency urinary system surgery?
- urinary tract obstructed or injured
- (#1 trauma to bladder)
What is a "cullen sign"?
eccymosis in sublumbar region of ventral abdomen
What is the difference between controlling a bleed v. a hemorrhage?
hemorrhage = life threatening
What classification of peritonitis is a uroperitoneum?
what are 2 possible approaches for nephrectomy?
Is creatinine or BUN more reliable when evaluating uroperitoneum?
Creatinine (bigger molecule)
How many main arteries does kidney have?
1-3 (patient dependent so make sure to check for multiples)
Should renal artery and vein be ligated together or separately?
Should the renal artery or vein be transected first in nephrectomy? What is exception to this rule?
- artery first
- (vein first if kidney is abscessed)
Should ureter be transected close to kidney?
NO! locate near neck of bladder to avoid urine back flow
How long can a rummel tourniquet be safely left in place?
What is term for stones in kidney? What does BUN level look like?
- BUN elevated if bilateral condition
After removing nephrolith, what should be done before closing the abdomen?
flush ureters w/warm saline
Nephrotomy is indicated when how much renal function remains?
What is an alternative way to close kidney incision other than using suture?
hold kidney together, allowing clot to form the closure
When suturing kidney capsule, what pattern?
- simple continuous
- (old method is mattress in parenchyma)
Are dogs or cats more often effected by hydronephrosis? what are some causes?
- lithiasis, stenosis (via OVH), compression, parasite)
What are some diagnostics for determining if d. renale is source of hydronephrosis?
- intravenous pyelogram
- urinalysis to ID eggs
Are ectopic ureters more common in males or females? Dog: bilateral or unilateral usually? Cat?
- females (25:1)
- dog: unilateral (poodle, husky, labrador)
- cat: bilateral (rare in cat)
Where does the normal ureter open into?
trigone of bladder
What is the difference between intramural and extramural ectopic ureters?
- intramural: runs submucosally
- extramural: bypasses bladder completely, opens into urethra
What diagnostic help determine type of ectopic ureter?
double contrast study (excretory pyogram + pneumocystography)
What is main clinical sign with ectopic ureters? what is likelihood this will resolve after sx?
- 60% correct post op
what sx is indicated to correct the intramural ureter? What suture is used? Suture from inside out or outside-in?
- monofilament 4-0 to 6-0
- always suture from mucosa to skin to avoid blocking new stoma (inside out)
What sx is indicated to correct extramural ureter?
- ureteroneocystostomy (ureter relocation)
- (fish mouth to make ureter wider)
where is incision made on ventral abdomen approach to cytotomy?
ventral midline from umbilicus to pubis
Once stay sutures or babcock forceps expose the bladder, what needs to be done before incising the bladder? Where will bladder be incised?
- pack off area w/moist lap sponges
- empty bladder by compression or aspirate
- incise on ventral surface to avoid trigone area
What is sympathetic innervation to bladder and urethra? What is parasympathetic? Somatic?
- symp: hypogastric n. (relax bladder/constrict urethra)
- parasymp: pelvic n.(contracts bladder to empty)
- somatic: pudendal n
how do you close cystotomy?
- 1 or 2 layers
- do NOT go through mucosa
- absorbably sutures
- simple continuous or interrupted; Cushing/Lembert
Since the bladder has great regeneration capability, how long before it recovers almost 100% original strength?
- (total re-epithelialization in one month)
How much of the bladder can be removed?
up to 75-80%
What are 4 salvage procedure options to re-establish urinary outflow?
- trigonal-colonic anastomosis
- ureteral-colonic anastomosis
- urethral-colonic implantation
What is a patent urachus?
congenital anomalies where urachus opens externally at umbilicus (urine dripping from umbilicus)
In the cat with vesicourachal diverticulum are there usually radiographic signs and signs of UTi?
can be seen on rads even without signs of UTI
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