Urinary3- Inflammatory Dz
Card Set Information
Urinary3- Inflammatory Dz
What is the most common signalment/ animals at higher risk for perinephric pseudocysts?
cats >16 yrs
Clinical signs of perinephric pseudocysts.
lumps on abdomen/palpate very large kidneys, usually no other signs
Describe the fluid within perinephric pseudocysts.
pure or modified transudate
Describe txt of perinephric pseudocysts.
periodic drainage as cat demonstrates discomfort/decline in renal function [+/- capsulectomy for rapidly accumulating cases]
What is the prognosis of perinephric pseudocysts?
related to degree of CKD/ discomfort (CKD is not thought to be directly related...kinda unknown)
What is the most common signalment for polycystic kidney disease (PKD)?
PERSIANS, himalayans, DLH cats; avg. 7 yrs old (when they get CKD and show signs)
How is PKD inherited?
What are PKD cysts filled with?
What often accompanies PKD?
How do you diagnose PKD?
ultrasonography- honeycomb/swiss cheese appearance
How do you treat PKD?
no known treatment, non-specific therapy for renal failure
What are renal worms? (3)
Dictophyma renale, Capillaria plica, Capillaria felis-cati
How is D. renale contracted?
dog or cat drinks water from ponds/lakes containing mudworm hosts
Describe the pathogenesis of D. renale.
worm lodges in renal pelvis, leads to hydronephrosis, and obliterates the renal tubules
Clinical signs of D. renale. (3)
hematuria, uremia, palpable abdominal mass
How do you diagnose D. renale? (2)
look for ova in urine (urine sediment), may see worms in renal pelvis on US
How do you treat renal worms?
[unilateral] nephrectomy, [bilateral] nephrotomy and removal of worms
How do you prevent D. renale? (2)
don't feed raw fish/fish viscera, don't let animals drink from potentially infected water
What are the essential hosts of C. plica and C. felis-cati?
How do you diagnose Capillaria spp.?
eggs in urine
How do you treat Capillaria spp.?
may be self-limiting, Ivermectin
What is polyploid cystitis caused by?
result of chronic bacterial infections/inflammation or stones [epithelial hyperplasia secondary to bacterial invasion of bladder mucosa]
Polyploid cystitis causes ________ in the patient.
What is the treatment for polyploid cystitis? (2)
extended course antibiotic, +/- surgical removal
How can you tell the difference b/w TCC and polyploid cystitis?
polyploid cystitis occurs at apex of bladder and TCC usually occurs at trigone....BUT to definitively rule out TCC, must take surgical biopsy
Signs of proliferative urethritis. (3)
straining, hematuria, neuts/ lymphoplasmacytic inflammation
How do you differentiate proliferative urethritis from TCC?
What causes proliferative urethritis?
can be due to infectious causes or immune-mediated
How do you treat proliferative urethritis? (3)
antibiotics, NSAIDs, steroids
What is the prognosis for proliferative urethritis?
The most common form of UTI.
History commonly associated with cystitis. (5)
pollakiuria, hematuria, stranguria, malodorous urine, inappropriate urination
UA findings associated with cystitis. (3)
bacteriuria, pyuria, proteinuria
Prevalence of bacterial UTI is more common in which sex?
Natural defense mechanisms against UTI. (5)
urethral length (longer in males), sphincters, flushing via urine flow, chemical composition of urine is inhospitable to microbes (osmolality, urea conc), local innate immunity
Uncomplicated cystitis is uncommon in _________ and never occurs in _________; it is extremely common in __________.
dogs; cats; humans
Predisposing causes of cystitis. (4)
interference with normal micturition, anatomic defects, changes to urothelium, metabolic/endocrine disease
What predisposing factors interfere with normal micturition? (2)
obstruction, incomplete emptying
Anatomic defects that predispose to cystitis. (4)
urachal diverticula, ectopic ureters, juvenile vulvar conformation (hidden hoohoo), surgical relocation of the urethral meatus
What changes to the urothelium can cause complicated cystitis? (4)
traumatic catheterization, trauma, neoplasia, urolithiasis
What metabolic/immune causes can contribute to complicated cystitis? (5)
anything that causes dilute urine
, DM, corticosteroids, hyperadrencorticism, congenital immunodeficiency
Common bacterial agents in small animals. (6)
, Klebsiella, Enterobacter, Proteus
[Gram+] Coag+ staph (staph aureus, staph pseudointermedius), Enterococcus
UPEC refers to a subset of __________ that are...
E. coli; adapted to the urinary tract.
What are the key virulence factors of UPEC? (2)
P fimbrae (help organism stick to urothelium), α-hemolysin
What changes on the UA are often associated with bacterial infection? (4)
alkaline urine, struvite crystals, bacteria, WBCs
How do you usually culture urine? (2)
aerobic culture, susceptibility testing
Urease-producing bacteria, making them well-adapted to the bladder/urine. (4)
staph, proteus, enterobacter, klebsiella
Urease-producing bacteria often cause _____________.
What is the gold standard for urine collection?
Bacterial culture of urine must be ___________ to interpret.
Which drugs reach the urine (and thus can be used to treat bacterial UTI)? (7)
penicillins, cephalosporins, fluoroquinolones, trimethoprim-silfamethoxazole, tetracyclines, aminoglycosides, nitrofurantoin
Treatment based on clinical diagnosis (abnormal UA).
Treatment on the basis of significant result and antimicrobial susceptibility profile.
When is empirical therapy reasonable for treatment of bacterial cystitis?
first time with clinical signs
When should you use targeted therapy for cystitis? (2)
hospital-acquired infection, multiple infections
Define recurrent infection.
3+ episodes within 12 months
infection within 6 months with a new bacterial species
re-presentation within 6 months with the same bacterial species
persistent infection despite appropriate treatment
Common empirical choices for treatment of bacterial cystitis. (2)
beta-lactam (amoxicillin, clavamox), cephalexin
How long should you treat uncomplicated (suspected uncomplicated) cystitis?
If the antimicrobial therapy for cystitis is working, you should see improvement of clinical signs within ________.
Describe prevention of infectious cystitis. (3)
address anatomic defects, treat primary causes (metabolic), good indwelling catheter management
What is the theory behind using cranberry supplements to prevent bacterial cystitis?
prevents p fimbriae from binding to urothelia, reduces uncomplicated UTI in humans, prevents
What is asymptomatic bacteriuria?
recover bacteria from urine but no UTI; if they don't have urinary signs.... don't treat them!
Describe clinical signs associated with acute prostatitis in dogs. (6)
fever, depression, +/- urethral d/c, +/- stiff gate, defecation avoidance, pain on palpation
With prostatitis (acute and chronic), is the prostate enlarged?
only if there is concurrent BPH
Clinical signs of chronic prostatitis in dogs. (3)
often silent infection, recurrent UTI, usually non-painful palpation
How do you treat prostatitis?
surgical is abscess, antimicrobials (enrofloxacin, clindamycin if staph, chloramphenicol)
___________ will increase the cure rate of prostatitis.
Castration of intact dogs
The prostate has a very __________ pH; therefore, only ___________ drugs are useful.
acidic; lipophilic/weak base