Urinary System Disease

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Urinary System Disease
2013-04-17 22:01:33
Animal Diseases Six

Animal Diseases
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  1. What is the anatomy of the urinary system?
    • kidneys
    • ureters
    • bladder
    • urethra
  2. What are the functions of the urinary system?
    • waste removalĀ 
    • eryhtropoietin production
    • water and electrolyte balance
  3. What are the different urinary system diseases?
    • feline cystitis
    • canine cystitis
    • transitional cell carcinoma
    • leptospirosis
    • renal failure - acute and chronic
    • spay incontinence
  4. What are the different types of feline cystitis?
    • FLUTD - feline lower urinary tract disease
    • FLUTI - feline lower urinary tract inflammation
    • FUS - feline urologic syndrome
    • feline interstitial cystitis
  5. What are the clinical signs of feline cystitis?
    • hematuria
    • pollakiuria
    • dysuria
    • stranguria
    • vocalizing during urination
    • licking genitalia
    • inappropriate urination
    • obstruction
  6. What are the clinical signs of a cat that is obstructed?
    • inability to urinate
    • straining in the litter box - owner's may report constipation
    • hiding
    • painful abdomen
    • depression
    • weakness
    • anorexia
    • dehydration
    • hypothermia
    • acidosis
    • electrolye
    • disturbances
    • bradycardia
  7. How do we diagnose feline cystitis?
    • clinical signs
    • urinalysis - assess for crystals
    • urine culture - negative
    • radiographs
  8. How do we treat an unobstructed feline cystitis?
    • most will be asymptomatic in 5 - 7 days without treatment
    • 70% of cats with idiopathic FLUTD respond to placebo therapy
    • antibiotics only if bacteria are present - culture and sensitivity
    • diet change - canned food, add water to dry food to achieve more dilute urine
    • alkaline urine with struvite crystals - struvite prevention diet
    • alkaline urine with no crystals - tranquilizers, antispasmodics, amitriptyline
    • reduce stress
  9. How do we treat obstructed feline cystitis?
    • relieve the obstruction
    • pass urethral catheter - avoid leaving in - can cause ascending bacterial infection
    • fluid and electrolyte therapy
    • perineal urethrostomy (PU) if needed
    • nutrition - acidifying diet
    • may obstruct again
  10. What causes canine cystitis?
    • usually bacterial
    • Escherichia coli, Staphylococcus intermedius, Streptococcus spp, Proteus, Klebsiella, Pseudomonas
  11. What are the natural defense mechanisms for canine cystitis?
    • frequent voiding of urine
    • urethral/ureteral peristalsis
    • glycosaminoglycans in mucosa
    • pH
  12. What are the causes of canine cystitis?
    • ascending infection most common
    • may descend from kidney, or come from prostate
    • microorganisms must adhere to and colonize the mucosal lining
  13. What are the clinical signs of canine cystitis?
    • frequent voiding of small amounts of urine
    • dysuria
    • hematuria
    • cloudy urine, abnormal color
    • frequent licking at urethral area
    • abnormal urine
  14. How do we diagnose canine cystitis?
    • urinalysis - sediment and dipstick (bacterial, increased WBCs)
    • urine culture and sensitivity
    • radiographs
    • ultrasound
  15. How do we treat canine cystitis?
    • antibiotics - clavamox, baytril, trimethoprim sulfa, cephalexin
    • give 10 - 14 days for first time treatment
    • chronic infection - 4 - 6 weeks
    • diagnose and treat underlying disease - neoplasia of the bladder, diabetes mellitus, pyometra
  16. What is TCC?
    transitional cell carcinoma
  17. What is transitional cell carcinoma?
    bladder neoplasia
  18. What is the most common malignant bladder tumor of dogs?
    transitional cell carcinoma
  19. Is TCC more common in males or females?
  20. Is TCC more common in dogs or cats?
    • dogs
    • rare in cats
  21. What are the clinical signs of transitional cell carcinoma?
    • hematuria, pollakiuria, dysuria
    • signs of urethral obstruction
    • chronic UTI - urinary tract infection
    • signs of metastasis
  22. How do we diagnose transitional cell carcinoma?
    • rectal palpation may reveal changes
    • urine sediment
    • radiographs
    • ultrasound
    • biopsy
  23. How do we treat transitional cell carcinoma?
    • surgical excision is the best treatment but is often not possible
    • chemotherapy or radiation therapy - short remission - weeks to months
    • antibiotics
  24. What is the prognosis for transitional cell carcinoma?
    • prognosis is good if surgically removed, benign
    • prognosis is poor if tumor has invaded surrounding tissues
  25. What causes leptospirosis?
    • Leptospira interrogans bacteria
    • Leptospira canicola
    • Leptospira icterohemorrhagica
    • Leptospira pomona
    • Leptospira grippotyphosa
  26. How is Leptospirosis usually transmitted?
    through infected urine
  27. Where does leptospirosis usually enter the body?
    • through mucous membranes, multiple in renal tubules
    • inflammation int he kidney is due to multiplication of the organisms and toxic by products
  28. What are the clinical signs of Leptospirosis?
    • acute renal failure, with or without hepatic involvement
    • dehydration, vomiting, fever, thirst
    • reluctance to move (myositis)
    • jaundice
    • petechial hemorrhages
    • peracute shock and death
  29. How do we diagnose Leptospirosis?
    • serum titers
    • polymerase chain reactions (PCR) - can identify the serovar
  30. How do we treat Leptospirosis?
    • supportive therapy
    • antibiotics
  31. How do we educate clients about Leptospirosis?
    • immunization
    • adequate sanitation of the kennel
    • decrease exposure to wild or domestic carriers
    • zoonotic
  32. How long do animals shed the leptospirosis virus in their urine?
    for up to 6 months
  33. How do humans usually get leptospirosis?
    from contact with cattle or wild rodents
  34. Is renal failure acute or chronic?
    can be either
  35. What is the job of the kidneys?
    filtration and waste management
  36. Approximately _____ of the total cardiac output passes through the kidney at any one time.
  37. What can a reduction in blood flow to the nephrons cause?
    renal failure
  38. What causes renal failure?
    • nephrons are damaged
    • filtration declines
    • build-up of toxins in the body - azotemia
    • azotemia produces the clinical signs of renal failure
  39. When does renal failure occur?
    when 75% of the nephrons cease to function
  40. What is acute renal failure?
    abrupt decrease in filtration
  41. What does acute renal failure result in?
  42. What are the causes of acute renal failure?
    • hypoperfusion - dehydration, hemorrhage
    • toxins - AMGs - gentamicin, Metofane, ethylene glycol
  43. What are the clinical signs of acute renal failure?
    • lethargy
    • depression
    • vomiting
    • diarrhea
    • anorexia
    • dehydration
    • maybe fever
    • polyuric or oliguric
    • kidneys painful on palpation
  44. How do we diagnose acute renal failure?
    • physical exam, history - potential exposure to a nephrotoxin
    • urinalysis, blood chemistries
    • increased BUN and creatinine
    • renal biopsy - definitive but usually not done
  45. What is the treatment for acute renal failure?
    • IV fluids - induce diuresis - to increase blood flow and infiltration in the kidneys
    • discontinue nephrotoxic drugs
    • supportive care for GI sings
    • provide adequate and high quality nutrition
    • if acute renal failure is reversible, nephron repair and compensation occur within 10 - 21 days
  46. What is CRF?
    chronic renal failure
  47. What is considered chronic renal failure?
    persistent azotemia for more than 2 weeks
  48. What is chronic renal failure a loss of?
    nephrons and filtration
  49. Chronic renal failure causes a decreased production of what?
    the hormone erythropoietin - anemia
  50. What are the clinical signs of renal failure?
    • history of weight loss
    • PU/PD
    • weakenss
    • dullness
    • lethargy
    • anorexia
    • vomiting
    • diarrhea
    • oral ulceration
    • non-regenerative anemia
    • small irregularly shaped kidneys
  51. How do we diagnose chronic renal failure?
    • clinical signs
    • increased BUN, creatinine
    • USPG under 1.020, proteinuria
    • non-regenerative anemia
    • hyperphosphatemia
    • hypokalemia, abnormal blood Ca
    • metabolic acidosis
  52. How do we treat chronic renal failure?
    • severity of clinical signs can be reduced with proper treatment
    • fluid therapy - owners can be taught to give SQ fluids at home
    • phosphate binder - Amphojel
    • postassium supplemtn - Tumil - K
    • sodium bicarbonate
    • erythropoientin injections for anemia
    • GI medications for nausea, vomiting and diarrhea - ranitidine - Zantac - H2 blocker
    • nutritional support with high quality, low quantity protein diet
  53. How do we educate clients about chronic renal failure?
    • chronic renal failure is progressive and irreversible
    • fluids may be required at home
    • eventually the pet will experience a decrease in quality of life
    • may have to consider euthanasia
  54. What causes spay incontinence?
    • estrogen deficiency
    • urethral incontinence - loss of smooth muscle tone of the urethra
    • allows leakage of urine from the bladder
    • responsive to reproductve hormones
  55. What are the clinical signs of spay incontinence?
    • medium to large breed dogs
    • urine leakage when sleeping
    • perineal area stays moist
    • older spayed female dog
  56. How do we diagnose spay incontinence?
    • history and physical exam
    • urinalysis and urine sediment
    • work up for underlying disease such as the ones that cause PU/PD
  57. How do we treat spay incontinence?
    • identify and treat urinary tract infection if present
    • drugs - PPA, DES
  58. What is PPA?
    • phenylpropanolamine
    • stimulates smooth muscle contractions of the urethral muscle
    • used as a decongestant in humans
    • removed from human market due to potential to cause stroke
  59. What is DES?
    • diethylstilbestrol
    • estrogen drug
  60. What are the side effects of PPA?
    • anxiety
    • hyperactivity
    • tachycardia
    • GI upset
  61. What are the side effects of DES?
    causes bone marrow suppression