urology
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urology

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Questions and Answers

What is the prognosis for survival in anuric patients without access to dialysis?

  • High chance of recovery
  • Near zero probability (correct)
  • Moderate chance of recovery
  • Dependence on antibiotic treatment

    • Which side effect is commonly associated with the use of high doses of 4-MP in cats?

  • Hypertension
  • Sedation (correct)
  • Respiratory distress
  • Severe dehydration

    • What was the antidote of choice before the development of 4-MP?

  • N-acetylcysteine
  • Activated charcoal
  • Sodium bicarbonate
  • Ethyl alcohol (correct)

    • Which class of antibiotics is most commonly associated with nephrotoxicity in dogs and cats?

    <p>Aminoglycosides</p> Signup and view all the answers

    What is the recommended dosing method for aminoglycosides to reduce renal exposure?

    <p>Total daily dose given once daily</p> Signup and view all the answers

    What complication can occur from rapid administration of intravenous antibiotics?

    <p>Acute Infusion-related Renal Failure (AIRF)</p> Signup and view all the answers

    What is a common risk incurred through aminoglycoside treatment in complicated medical conditions?

    <p>Aminoglycoside nephrotoxicity</p> Signup and view all the answers

    How long has hemodialysis been effective for recovery of renal function in certain dogs?

    <p>6 to 9 months</p> Signup and view all the answers

    What is a cause of structural urethral obstruction?

    <p>Urethral calculi</p> Signup and view all the answers

    Which of the following may facilitate a more patent urethra?

    <p>Acepromazine</p> Signup and view all the answers

    What is an appropriate action when a urinary catheter cannot pass a urethral stone?

    <p>Attempt retropulsion of the stone</p> Signup and view all the answers

    Postobstructive diuresis typically occurs after which event?

    <p>Complete urethral obstruction relief</p> Signup and view all the answers

    Which factors can lead to the early development of azotemia?

    <p>Postrenal factors</p> Signup and view all the answers

    What is likely to happen to BUN, creatinine, and phosphorus levels as uroabdomen develops?

    <p>They increase</p> Signup and view all the answers

    What should be monitored before maintaining an indwelling urinary catheter?

    <p>Urethral swelling</p> Signup and view all the answers

    Which condition can be caused by external compression in the pelvic area?

    <p>Structural urethral obstruction</p> Signup and view all the answers

    What condition may result from excess PTH at the early stages of AIRF?

    <p>Increased serum phosphorus</p> Signup and view all the answers

    What is the usual dosing range for calcitriol to effectively lower PTH without increasing serum ionized calcium?

    <p>2.5 to 3.5 ng/kg once daily</p> Signup and view all the answers

    What maximum serum phosphorus level should be controlled before starting calcitriol treatment?

    <p>6.0 mg/dL</p> Signup and view all the answers

    What is a classical renal lesion associated with acute interstitial renal failure (AIRF)?

    <p>Acute tubular necrosis (ATN)</p> Signup and view all the answers

    What is a consequence of uncontrolled hypertension in the context of kidney function?

    <p>Glomerular hypertension and hyperfiltration</p> Signup and view all the answers

    Which medication is recommended as the choice for managing hypertension in dogs?

    <p>ACE inhibitor</p> Signup and view all the answers

    Which factor is NOT a contributor to progressive azotemia in acute renal failure?

    <p>Nephron regeneration</p> Signup and view all the answers

    What cause is commonly associated with acute interstitial nephritis in dogs?

    <p>Leptospirosis</p> Signup and view all the answers

    Which factor typically correlates with a decrease in urine output?

    <p>Decreased azotemia</p> Signup and view all the answers

    What is the likely cause of urine entering the retroperitoneal space?

    <p>Tears in the bladder</p> Signup and view all the answers

    In the context of urinary tract injuries, which imaging technique is used to document urine leakage from the bladder?

    <p>Positive contrast cystography</p> Signup and view all the answers

    What does a 'ground-glass' appearance on abdominal radiographs suggest?

    <p>Uroabdomen with loss of abdominal detail</p> Signup and view all the answers

    What is indicated by higher concentrations of BUN and creatinine in abdominal fluid compared to serum?

    <p>Urine leakage into the abdominal cavity</p> Signup and view all the answers

    What is the recommended treatment for a small bladder tear?

    <p>Placement of an indwelling urinary catheter</p> Signup and view all the answers

    What might indicate the need for potassium supplementation in IV fluids?

    <p>Large urine output</p> Signup and view all the answers

    What abdominal radiographic finding is associated with a rupture of the upper urinary tract?

    <p>Loss of retroperitoneal detail</p> Signup and view all the answers

    What is the primary surgical intervention required for a ruptured urethra?

    <p>Primary surgical closure</p> Signup and view all the answers

    Which of the following signs may indicate a bladder rupture during physical examination?

    <p>Pain during abdominal palpation</p> Signup and view all the answers

    What is the most common tumor type in the urinary tract of dogs?

    <p>Transitional cell carcinoma (TCC)</p> Signup and view all the answers

    What immediate action could be necessary if urine flow cannot be established adequately?

    <p>Performing short-term peritoneal dialysis</p> Signup and view all the answers

    What symptom might suggest that a patient has sustained a ruptured bladder after administration of IV fluids?

    <p>Progressive abdominal enlargement</p> Signup and view all the answers

    How does a ureteral rupture typically get managed?

    <p>By reimplantation into the bladder</p> Signup and view all the answers

    Which condition may complicate diagnosis during an examination for urinary tract injury?

    <p>Presence of pelvic fracture</p> Signup and view all the answers

    Which of the following is a potential systemic sign related to urinary tract injury?

    <p>Dehydration</p> Signup and view all the answers

    What is the minimum diameter for stones to be visible on radiographs?

    <p>3 mm</p> Signup and view all the answers

    What condition may predispose an animal to form calcium-containing uroliths?

    <p>Hypercalcemia</p> Signup and view all the answers

    Which imaging technique is especially useful for identifying urate and cysteine uroliths?

    <p>Double-contrast radiography</p> Signup and view all the answers

    Which of the following could contribute to the supersaturation of minerals in urine?

    <p>Higher urine pH</p> Signup and view all the answers

    What is the most common site for urolith localization in the urinary tract?

    <p>Urinary bladder</p> Signup and view all the answers

    What is the main underlying cause of primary renal azotemia?

    <p>Renal parenchymal lesions</p> Signup and view all the answers

    Which of the following dietary factors is associated with potential benefits in managing chronic kidney disease (CKD)?

    <p>Phosphorus restriction</p> Signup and view all the answers

    Which breed is most commonly associated with amyloidosis in cats?

    <p>Abyssinian</p> Signup and view all the answers

    What factor does not protect the kidney from progression of chronic renal failure?

    <p>Protein restriction</p> Signup and view all the answers

    What condition is characterized by hypokalemic nephropathy in cats?

    <p>Chronic kidney disease</p> Signup and view all the answers

    Which breed is known for experiencing renal glucosuria due to tubular dysfunction?

    <p>Basenji</p> Signup and view all the answers

    Which of the following conditions can lead to chronic toxicity affecting renal function?

    <p>Environmental toxins</p> Signup and view all the answers

    What is a critical consideration regarding treatment decisions for chronic kidney disease before azotemia develops?

    <p>No substantial evidence exists to guide decisions.</p> Signup and view all the answers

    What is the most significant factor in diagnosing urinary incontinence in dogs?

    <p>Urethral pressure studies</p> Signup and view all the answers

    Which breed is noted for a high occurrence of urinary incontinence when females undergo OHE before their first heat?

    <p>Golden retriever</p> Signup and view all the answers

    What is the typical behavior of dogs with episodic urinary incontinence related to eunuchoid urinary incontinence (EU)?

    <p>Normal voiding behavior with leakage</p> Signup and view all the answers

    What is a common misleading factor in the history of cases of urinary incontinence in dogs?

    <p>Behavioral issues during housebreaking</p> Signup and view all the answers

    Which treatment has been shown to be effective in controlling urinary incontinence in dogs?

    <p>Phenylpropanolamine (PPA)</p> Signup and view all the answers

    Which statement about urinary tract imaging in dogs with incontinence is generally true?

    <p>Pelvic positioning of the bladder may sometimes be observed</p> Signup and view all the answers

    What is a potential side effect of Phenylpropanolamine (PPA) treatment in dogs?

    <p>Loss of effectiveness over time</p> Signup and view all the answers

    Which of the following best describes the urethral pressure in typical cases of permanent sphincter mechanism incontinence (PSMI)?

    <p>Both B and C are correct</p> Signup and view all the answers

    Which statement accurately describes the effect of hemodialysis on dogs with acute renal failure?

    <p>Hemodialysis of dogs for 6 to 9 months has been effective for recovery in some cases.</p> Signup and view all the answers

    What is a significant side effect associated with the use of ethyl alcohol as an antidote?

    <p>Severe depression and dehydration</p> Signup and view all the answers

    Why might aminoglycosides have reduced nephrotoxicity in recent clinical scenarios?

    <p>The use of fluoroquinolones has increased.</p> Signup and view all the answers

    What is a potential consequence of administering aminoglycosides quickly at high doses?

    <p>Acute inflammatory renal failure (AIRF)</p> Signup and view all the answers

    What dosing method can aid in reducing renal exposure to nephrotoxic aminoglycosides?

    <p>Administering the total daily dose once daily</p> Signup and view all the answers

    In the context of leptospirosis in dogs, what complication can arise?

    <p>Acute inflammatory renal failure (AIRF)</p> Signup and view all the answers

    Which statement about the requirements for cats in the treatment of ethylene glycol (EG) ingestion is accurate?

    <p>Higher doses of 4-MP are needed for cats compared to dogs.</p> Signup and view all the answers

    How long is the prognosis for survival in anuric patients without access to hemodialysis typically viewed?

    <p>Near-zero</p> Signup and view all the answers

    What clinical signs are typically observed in the case of a urethral rupture?

    <p>Hematuria, dysuria, and stranguria</p> Signup and view all the answers

    Which surgical approach is generally required for a complete rupture of the urethra?

    <p>Primary surgical closure</p> Signup and view all the answers

    What condition may increase the risk of bladder rupture during an examination?

    <p>Pelvic fracture</p> Signup and view all the answers

    What is a common complication associated with ureteral rupture repair?

    <p>Stricture formation</p> Signup and view all the answers

    What might indicate a developing systemic sign in a patient with urinary tract injuries?

    <p>Progressive abdominal enlargement</p> Signup and view all the answers

    How is ureteral rupture sometimes managed aside from surgical closure?

    <p>Reimplantation of the ureter into the bladder</p> Signup and view all the answers

    What is typically required if there is a significant tear in the bladder?

    <p>Surgical closure</p> Signup and view all the answers

    What is the most frequently identified urinary tract tumor in dogs?

    <p>Transitional cell carcinoma (TCC)</p> Signup and view all the answers

    Which breed is NOT commonly associated with polycystic kidney disease?

    <p>Golden retriever</p> Signup and view all the answers

    Which treatment is primarily indicated for managing high serum phosphorus levels in chronic renal failure?

    <p>Intestinal phosphate binders</p> Signup and view all the answers

    What is a significant characteristic found in the diagnosis of azotemia?

    <p>Reduction in kidney size</p> Signup and view all the answers

    In treating early chronic renal failure, which dietary change could help control PTH concentrations?

    <p>Dietary phosphate restriction</p> Signup and view all the answers

    What is a mainstay treatment for intestinal phosphate binders?

    <p>Calcium salts</p> Signup and view all the answers

    Which breed is commonly associated with multiple renal cystadenocarcinomas?

    <p>German shepherd</p> Signup and view all the answers

    Which of the following findings is NOT typically associated with renal biopsies?

    <p>Formation of nephrocalcinosis</p> Signup and view all the answers

    Which veterinary product is specifically marketed for use in cats with chronic renal failure?

    <p>Epakatin</p> Signup and view all the answers

    What factors may increase the suspicion of lily toxicity in cats?

    <p>Detection of plant pieces in vomitus or feces</p> Signup and view all the answers

    How do serovars canicola and icterohemorrhagiae typically affect liver enzymes during renal failure?

    <p>They do not typically increase liver enzymes simultaneously with renal values.</p> Signup and view all the answers

    Which of the following serovars is commonly associated with atypical infections not covered by vaccines?

    <p>Grippotyphosa</p> Signup and view all the answers

    What renal physiology change precedes increases in BUN and serum creatinine due to infections from contaminated sources?

    <p>Reduction in urine specific gravity (USG)</p> Signup and view all the answers

    What clinical syndrome is created by lily intoxication specifically in cats?

    <p>Acute interstitial renal failure (AIRF)</p> Signup and view all the answers

    What is a common outcome for cats suffering from severe azotemia due to lily ingestion?

    <p>Prolonged medical treatment before potential recovery</p> Signup and view all the answers

    Infections with what type of serovars are caused by encroachment of wildlife into suburban living spaces?

    <p>Atypical serovars</p> Signup and view all the answers

    What is a significant complication of renal failure often observed with atypical serovars such as pomona and grippotyphosa?

    <p>Severe azotemia and oligoanuria</p> Signup and view all the answers

    What is the most common cause of urine leakage into the peritoneal cavity?

    <p>Bladder tears from blunt trauma</p> Signup and view all the answers

    Which imaging finding is indicative of a rupture in the upper urinary tract?

    <p>Streaking of the retroperitoneal space</p> Signup and view all the answers

    What laboratory finding in abdominal fluid suggests the presence of urine?

    <p>Higher BUN and creatinine levels than in serum</p> Signup and view all the answers

    What is the first recommended intervention for a small bladder tear?

    <p>Placement of an indwelling urinary catheter</p> Signup and view all the answers

    Which method can be used to document urine leakage from the bladder?

    <p>Positive contrast cystography</p> Signup and view all the answers

    What condition can arise due to prolonged urethral obstruction?

    <p>Urethral stricture formation</p> Signup and view all the answers

    What would indicate a need for potassium supplementation in IV fluids during urinary tract management?

    <p>Large urine output</p> Signup and view all the answers

    What is the expected change in urine output as azotemia decreases?

    <p>Increase in urine output</p> Signup and view all the answers

    What is the role of calcitriol in managing PTH levels without increasing serum ionized calcium?

    <p>To lower PTH levels primarily without affecting phosphorus</p> Signup and view all the answers

    Which of the following is a significant cause of progressive azotemia in acute renal failure?

    <p>Obstruction due to intratubular pressure</p> Signup and view all the answers

    What is a critical maximum serum phosphorus level that should be controlled before initiating treatment with calcitriol?

    <p>6.0 mg/dL</p> Signup and view all the answers

    Which renal lesion is classically associated with acute interstitial renal failure (AIRF)?

    <p>Acute tubular necrosis (ATN)</p> Signup and view all the answers

    How does increased systemic hypertension impact kidney function?

    <p>Contributes to glomerular hypertension and further nephron damage</p> Signup and view all the answers

    What could be a potential consequence of starting calcitriol treatment without controlling serum phosphorus levels?

    <p>Worsening of hyperphosphatemia</p> Signup and view all the answers

    What is the typical dosing recommendation of ACE inhibitors for managing hypertension in dogs?

    <p>0.5 to 1.0 mg/kg twice daily</p> Signup and view all the answers

    Which condition can result in acute interstitial nephritis in dogs, particularly linked to infectious causes?

    <p>Leptospirosis</p> Signup and view all the answers

    What is the average time required for the dissolution of canine uroliths when using a diet designed for struvite dissolution?

    <p>12 weeks</p> Signup and view all the answers

    What dietary changes are recommended if a portosystemic shunt is not correctable?

    <p>Feed low protein and alkalinizing diet</p> Signup and view all the answers

    Which of the following statements about sterile uroliths is true?

    <p>Treatment is similar to infection-induced struvite uroliths without the need for antimicrobials.</p> Signup and view all the answers

    What is the primary risk associated with the use of allopurinol in urolith treatment?

    <p>Increased risk of developing xanthine uroliths</p> Signup and view all the answers

    Which condition is NOT mentioned as a factor to prevent recurrence of infection-induced uroliths?

    <p>Renal failure</p> Signup and view all the answers

    What type of uroliths occurs infrequently in dogs and cats?

    <p>Calcium phosphate uroliths</p> Signup and view all the answers

    What is recommended to maintain urine pH when treating for causes of urolith formation?

    <p>Maintain urine pH at 7.0 to 7.5</p> Signup and view all the answers

    What is an appropriate treatment for infection-induced uroliths?

    <p>Antimicrobial therapy based on culture and sensitivity</p> Signup and view all the answers

    What is the primary method used to confirm cholecalciferol toxicity?

    <p>Very high concentrations of 25-hydroxyvitamin D</p> Signup and view all the answers

    Which condition is commonly associated with bilateral renal cystadenoma in German shepherds?

    <p>Generalized nodular dermatofibrosis</p> Signup and view all the answers

    What is a common clinical sign of pyelonephritis?

    <p>Leukocyturia</p> Signup and view all the answers

    Which of the following tumors may be considered a less common primary renal tumor?

    <p>Adenoma</p> Signup and view all the answers

    What is a typical presentation of renal adenocarcinoma?

    <p>Polar mass lesion</p> Signup and view all the answers

    What is a common consequence of cholecalciferol toxicity?

    <p>Hypercalcemia</p> Signup and view all the answers

    Which urinary tract condition is characterized as more commonly chronic rather than acute?

    <p>Pyelonephritis</p> Signup and view all the answers

    What usually contributes to poor prognosis in bilateral renal cystadenoma?

    <p>Renal failure</p> Signup and view all the answers

    What must be retained within the urinary tract for urolith formation to occur?

    <p>The nidus</p> Signup and view all the answers

    What technique can be used to retrieve a urolith smaller than the diameter of the urethra?

    <p>Voiding urohydropropulsion</p> Signup and view all the answers

    How long should medical dissolution therapy continue after radiographic resolution of uroliths?

    <p>1 month</p> Signup and view all the answers

    What is advisable to do for preventing the recurrence of uroliths?

    <p>Increase water intake</p> Signup and view all the answers

    Which of the following is NOT a recommended prevention strategy for uroliths?

    <p>Feeding only dry food</p> Signup and view all the answers

    What surgical consideration should be taken if no improvement is observed after 4 to 6 weeks of medical therapy for uroliths?

    <p>Consider surgery</p> Signup and view all the answers

    Which type of uroliths are likely to recur most frequently?

    <p>Calcium oxalate</p> Signup and view all the answers

    What is a common characteristic of the nidus in urolith formation?

    <p>It must be retained within the urinary tract</p> Signup and view all the answers

    What is a common cause of obstructive nephropathy related to the kidneys?

    <p>Obstruction of ureter from a lesion in the bladder trigone</p> Signup and view all the answers

    Which bacteria is most commonly associated with urinary tract infections in dogs and cats?

    <p>E. coli</p> Signup and view all the answers

    What is the most reliable sample method for diagnosing urinary tract infections in male dogs?

    <p>Catheterized samples</p> Signup and view all the answers

    Which of the following is NOT commonly associated with bacterial urinary tract infections?

    <p>Mycoplasma spp.</p> Signup and view all the answers

    What treatment is typically indicated for unilateral renal neoplasia?

    <p>Nephrectomy</p> Signup and view all the answers

    Which factor may affect the interpretation of urinary tract infection in females when using catheterized samples?

    <p>High contamination from urethral and genital flora</p> Signup and view all the answers

    What is the primary cause of Primary Sphincter Mechanism Incompetence (PSMI) in dogs?

    <p>Hormonal changes after spaying</p> Signup and view all the answers

    What can be concluded about bacterial counts in cystocentesis samples?

    <p>Growth in samples with more than 1000 CFU suggests infection</p> Signup and view all the answers

    What is the characteristic feature of E. coli in relation to UTIs?

    <p>It accounts for the majority of canine UTIs</p> Signup and view all the answers

    Which surgical option is more invasive and has largely been replaced by urethral bulking procedures?

    <p>Colposuspension</p> Signup and view all the answers

    Which breed of dog has the highest reported incidence of developing PSMI after spaying?

    <p>Boxers</p> Signup and view all the answers

    What is the defined success rate for collagen implantation for treating urinary incontinence?

    <p>68%</p> Signup and view all the answers

    Which gender is significantly more likely to show signs of incontinence due to ectopic ureters?

    <p>Females</p> Signup and view all the answers

    In which timeframe after spaying does a decline in urethral closure function typically begin?

    <p>Within the first 12 to 18 months</p> Signup and view all the answers

    What percentage of dogs weighing more than 20 kg may develop PSMI after being spayed?

    <p>31%</p> Signup and view all the answers

    What complications might arise from decreased maximum urethral closure pressure after spaying?

    <p>Urinary incontinence</p> Signup and view all the answers

    What condition can result from the ingestion of NSAIDs due to their effect on renal vasodilatory prostaglandins?

    <p>Acute renal failure</p> Signup and view all the answers

    What is the likely outcome of severe and rapid hypercalcemia on kidney function?

    <p>Acute interstitial renal failure</p> Signup and view all the answers

    Which type of neoplasm is most commonly found in the kidneys of dogs?

    <p>Adenocarcinoma of the renal tubule</p> Signup and view all the answers

    What symptom is typically associated with renal lymphoma in cats?

    <p>Bilateral presentation</p> Signup and view all the answers

    What is the recommended method to prevent acute interstitial renal failure after NSAID ingestion?

    <p>Administer IV fluids for 2 to 3 days</p> Signup and view all the answers

    Which of the following cancers can cause obstruction or renal bleeding originating from the renal pelvis?

    <p>Transitional cell carcinoma</p> Signup and view all the answers

    What is a significant risk factor associated with NSAID use that can compound its effects on the kidneys?

    <p>Impaired synthesis of vasodilators</p> Signup and view all the answers

    How long can acute renal failure due to NSAID toxicity potentially last without intervention?

    <p>3-5 days</p> Signup and view all the answers

    What condition is primarily associated with tubular dysfunction caused by a genetic factor in certain dog breeds?

    <p>Tubular dysfunction (Fanconi syndrome)</p> Signup and view all the answers

    Which dietary intervention has shown potential benefits for managing chronic kidney disease (CKD) in dogs and cats?

    <p>Phosphorus restriction</p> Signup and view all the answers

    What is a known complication associated with chronic kidney disease that might be exacerbated by certain environmental agents?

    <p>Neoplasia</p> Signup and view all the answers

    What condition involves renal structural lesions primarily due to parenchymal issues?

    <p>Primary renal azotemia</p> Signup and view all the answers

    Which renal condition is characterized by dysfunction specific to glucose reabsorption in certain dog breeds?

    <p>Renal glucosuria</p> Signup and view all the answers

    What is the expected outcome of protein restriction as a standalone therapy for chronic renal failure (CRF)?

    <p>No protective effect against kidney progression</p> Signup and view all the answers

    Which breed is specifically noted for being predisposed to develop amyloidosis?

    <p>Siamese cat</p> Signup and view all the answers

    What factor is considered critical in the diagnosis and treatment decisions for chronic kidney disease (CKD) before azotemia develops?

    <p>Imaging techniques</p> Signup and view all the answers

    Which condition is not a recognized cause of acute tubular necrosis (ATN)?

    <p>Excessive fluid therapy</p> Signup and view all the answers

    Which statement accurately reflects the relationship between nephrotoxins and acute renal injury?

    <p>Nephrotoxicants may cause renal damage without requiring systemic hypotension.</p> Signup and view all the answers

    What is the primary treatment approach in managing acute interstitial renal failure (AIRF)?

    <p>Optimal IV fluid therapy</p> Signup and view all the answers

    Which of the following is a true nephrotoxin?

    <p>NSAIDs</p> Signup and view all the answers

    Which factor is least likely to contribute to the development of tubular lesions?

    <p>Anemia</p> Signup and view all the answers

    In treating hypokalemia, what is a key consideration for potassium salt administration?

    <p>Assess potassium status periodically</p> Signup and view all the answers

    Water intoxication in patients with acute renal failure is most likely due to which factor?

    <p>Increased fluid intake without restriction</p> Signup and view all the answers

    Which of the following factors is a complication when using NSAIDs in patients with renal injuries?

    <p>Potential for further ischemic damage</p> Signup and view all the answers

    What is the primary outcome of progressive chronic kidney disease (CKD) if left untreated?

    <p>Chronic renal failure (CRF)</p> Signup and view all the answers

    Which of the following accurately describes the changes observed in kidney size and function as CKD progresses?

    <p>Progressive decrease in kidney size and function</p> Signup and view all the answers

    What mechanism contributes to the progressive destruction of the chronically damaged kidney?

    <p>Glomerular hypertension</p> Signup and view all the answers

    Which treatment method is identified as beneficial in the management of protein-losing nephropathy associated with CKD?

    <p>Angiotensin-converting enzyme (ACE) inhibitors</p> Signup and view all the answers

    Which of the following is considered a primary mechanism leading to gastric issues in patients with chronic renal failure?

    <p>Increased circulating gastrin</p> Signup and view all the answers

    What timing is recommended for administering phosphate binders to maximize their effectiveness?

    <p>With food or within 1 to 2 hours after food</p> Signup and view all the answers

    What is a documented effect of renal secondary hyperparathyroidism on kidney function?

    <p>Renal mineralization and damage</p> Signup and view all the answers

    Which class of medication is typically considered first-line treatment for gastric hyperacidity in patients with chronic renal failure?

    <p>H2 receptor antagonists</p> Signup and view all the answers

    What is typically observed during the latent phase of acute interstitial renal failure (AIRF)?

    <p>Asymptomatic state in animals</p> Signup and view all the answers

    What is the prognosis for leptospirosis in comparison to other causes of azotemia?

    <p>It generally has the best prognosis for survival</p> Signup and view all the answers

    In the maintenance phase of renal injury, which of the following conditions accurately describes azotemia?

    <p>It does not respond to removal of the inciting cause</p> Signup and view all the answers

    What is a common characteristic of the maintenance phase in AIRF?

    <p>It is a fixed phase of excretory renal failure</p> Signup and view all the answers

    What indicates severe kidney injury during the maintenance phase of AIRF?

    <p>Normal Glomerular Filtration Rate (GFR)</p> Signup and view all the answers

    In the context of ethylene glycol (EG) intoxication, what is a key distinction between dogs and cats?

    <p>The lethal ingestion amount is higher for cats</p> Signup and view all the answers

    Which laboratory finding is typically associated with EG intoxication during clinical examination?

    <p>Severe metabolic acidosis</p> Signup and view all the answers

    What can be inferred about the prognosis of cases with oliguric renal failure in acute interstitial renal failure?

    <p>The prognosis is typically poor</p> Signup and view all the answers

    Which metabolic condition is NOT typically associated with an increased risk for urinary tract infections (UTIs)?

    <p>Hypoadrenocorticism</p> Signup and view all the answers

    Which of the following treatments is generally not recommended for uncomplicated urinary tract infections in dogs?

    <p>Extended tetracyclines</p> Signup and view all the answers

    Which anatomical defect is most likely to require exclusion in diagnosing urinary tract issues?

    <p>Ectopic ureters</p> Signup and view all the answers

    What is the primary goal of urinary antimicrobial treatment in cases of UTIs?

    <p>To achieve sterile quantitative culture results</p> Signup and view all the answers

    Which urinary antibacterial treatment is preferable for organisms exhibiting resistance?

    <p>Fluoroquinolones</p> Signup and view all the answers

    In what situation is urinary culture most important?

    <p>When multiple bacteriuria is detected</p> Signup and view all the answers

    How long is urinary antimicrobial treatment typically prescribed for uncomplicated UTIs?

    <p>2 to 3 weeks</p> Signup and view all the answers

    Which of the following statements about urinary retention after voiding is accurate?

    <p>It can complicate urine sterilization</p> Signup and view all the answers

    What do uroliths form from in susceptible individuals?

    <p>Oversaturation of minerals in urine</p> Signup and view all the answers

    Which imaging technique is particularly useful for demonstrating radiolucent uroliths?

    <p>Double-contrast radiography</p> Signup and view all the answers

    Which of the following is NOT a risk factor for urolith formation?

    <p>High moisture diet</p> Signup and view all the answers

    What is a common differential diagnosis when evaluating for uroliths?

    <p>Cystitis</p> Signup and view all the answers

    What should be done with any retrieved uroliths following surgical removal?

    <p>Analyze for chemical composition</p> Signup and view all the answers

    What defines prerenal azotemia?

    <p>Decreased renal blood flow leading to nitrogenous waste accumulation</p> Signup and view all the answers

    Which condition is most likely to lead to postrenal azotemia?

    <p>Obstruction of urine outflow from both kidneys</p> Signup and view all the answers

    Which of the following is a common cause of chronic renal failure (CRF) in dogs?

    <p>Chronic tubulointerstitial nephritis of unknown cause</p> Signup and view all the answers

    What is typically observed in a patient with prerenal azotemia?

    <p>Normal kidney size and concentrated urine</p> Signup and view all the answers

    Which condition can lead to familial nephropathy in cats?

    <p>Renal amyloidosis in Abyssinians</p> Signup and view all the answers

    What signifies the presence of leakage of urine in postrenal azotemia?

    <p>Variable urine specific gravity and possible urine sediment abnormalities</p> Signup and view all the answers

    Which of the following best describes chronic obstructive uropathy?

    <p>Persistent obstruction leading to hydronephrosis</p> Signup and view all the answers

    What is a frequent diagnostic challenge when differentiating types of nephropathy?

    <p>Chronic pyelonephritis and chronic tubulointerstitial nephritis</p> Signup and view all the answers

    Which of the following is a characteristic of chronic renal failure (CRF)?

    <p>Presence of nephron dropout and interstitial nephritis</p> Signup and view all the answers

    What factor is considered the most important in evaluating the cause of azotemia?

    <p>Urine specific gravity (USG)</p> Signup and view all the answers

    Which of the following statements about lower urinary tract disorders is true?

    <p>Urinary incontinence and neoplasia can occur in the bladder.</p> Signup and view all the answers

    At what point does increased serum phosphorus typically become evident in chronic renal failure?

    <p>After 85% of nephron mass is nonfunctional</p> Signup and view all the answers

    Which of the following conditions is most likely to cause illness in animals compared to lower urinary tract disorders?

    <p>Renal pelvic obstruction</p> Signup and view all the answers

    What is a commonly presumed cause of chronic renal failure?

    <p>Glomerular injury from unknown etiology</p> Signup and view all the answers

    Which imaging method is generally indicated for assessing upper urinary tract disorders?

    <p>Ultrasonography (USG)</p> Signup and view all the answers

    Which statement about urine concentration in dogs and cats is correct?

    <p>Cats cannot produce highly concentrated urine.</p> Signup and view all the answers

    Which condition does NOT typically predispose dogs to urinary tract infections (UTIs)?

    <p>High dietary fiber</p> Signup and view all the answers

    What is the recommended duration for urinary antimicrobial treatment of uncomplicated UTIs?

    <p>2 to 3 weeks</p> Signup and view all the answers

    Which of the following is NOT a first-line choice for urinary antimicrobials?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which of the following conditions can lead to urinary concentrating defects?

    <p>Diabetes mellitus</p> Signup and view all the answers

    Which urinary antimicrobial treatment is deemed appropriate for highly resistant organisms?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which condition is unlikely to be a result of urinary retention after voiding?

    <p>Permanent sterilization of urine</p> Signup and view all the answers

    Which of the following factors could contribute to the likelihood of a urinary tract infection in dogs?

    <p>Hyperadrenocorticism</p> Signup and view all the answers

    What is a key criterion for determining treatment success in urinary tract infections?

    <p>Negative urine culture results</p> Signup and view all the answers

    Which statement accurately describes struvite uroliths in dogs and cats?

    <p>Struvite is the most common type of urolith in dogs.</p> Signup and view all the answers

    Which breeds of dogs are considered at increased risk for developing struvite uroliths?

    <p>Miniature schnauzer and shih tzu</p> Signup and view all the answers

    What urinary condition is strongly associated with the formation of infection-induced struvite uroliths?

    <p>The presence of urease-producing organisms</p> Signup and view all the answers

    Which management strategy is NOT recommended for preventing recurrence of struvite uroliths?

    <p>Maintaining a urine pH below 6.5</p> Signup and view all the answers

    What dietary changes should be made to reduce the risk of developing struvite uroliths?

    <p>Avoid diets that acidify urine</p> Signup and view all the answers

    In cats, which breeds are considered to have a decreased risk of developing struvite uroliths?

    <p>Abyssinian and Birman</p> Signup and view all the answers

    What is a common characteristic of ammonium urate uroliths?

    <p>They are often associated with increased dietary intake of purines.</p> Signup and view all the answers

    Which method is recommended for the surgical removal of struvite uroliths?

    <p>Urohydropropulsion</p> Signup and view all the answers

    Which condition reflects a potential outcome after treatment for ethylene glycol toxicity?

    <p>Full recovery of renal function</p> Signup and view all the answers

    What is an early indicator of ethylene glycol toxicity that can develop shortly after ingestion?

    <p>Oliguria followed by anuria</p> Signup and view all the answers

    Which method is used for definitive diagnosis of ethylene glycol intoxication?

    <p>Colorimetric reaction on test kit</p> Signup and view all the answers

    What is the primary treatment option administered before ethylene glycol is fully metabolized?

    <p>4-methylpyrazole (4-MP)</p> Signup and view all the answers

    Which factor is associated with the possible development of prerenal azotemia in the context of ethylene glycol toxicity?

    <p>Increased blood urea nitrogen levels</p> Signup and view all the answers

    What is a possible outcome of administering IV fluids for the management of ethylene glycol toxicity?

    <p>Supportive therapy leading to renal recovery</p> Signup and view all the answers

    What is the primary diagnostic method for confirming cholecalciferol toxicity?

    <p>High concentrations of 25-hydroxyvitamin D</p> Signup and view all the answers

    Which complication might arise from the slow development of azotemia related to renal lesions?

    <p>Prolonged recovery from kidney injury</p> Signup and view all the answers

    What potential symptom can indicate the need for dialysis in patients with severe ethylene glycol intoxication?

    <p>Persistent oligoanuria with high azotemia</p> Signup and view all the answers

    Which of the following statements about pyelonephritis is accurate?

    <p>Escherichia coli is commonly associated with upper UTIs.</p> Signup and view all the answers

    What is a common diagnostic challenge in identifying calcipotriene toxicity?

    <p>Absence of identifiable metabolites in the blood</p> Signup and view all the answers

    What characterizes bilateral renal cystadenoma in specific dog breeds?

    <p>Association with generalized nodular dermato-fibrosis</p> Signup and view all the answers

    Which clinical sign is most consistent with renal adenocarcinoma?

    <p>Polar mass lesion detected during examination</p> Signup and view all the answers

    Which condition most commonly results from nephrotoxic exposures leading to chronic damage?

    <p>Chronic renal failure</p> Signup and view all the answers

    How does pyelonephritis typically present in chronic cases?

    <p>Asymptomatic until late stages</p> Signup and view all the answers

    What is the most significant risk associated with bilateral renal cystadenoma?

    <p>Increased risk of renal failure</p> Signup and view all the answers

    What is the most common bacterial cause of urinary tract infections in dogs and cats?

    <p>E. coli</p> Signup and view all the answers

    Which of the following microorganisms is least commonly associated with urinary tract infections in dogs?

    <p>Escherichia coli</p> Signup and view all the answers

    What methodological limitation is found in samples taken from catheterized female dogs suspected of having a urinary tract infection?

    <p>High contamination rates from urethral and genital flora.</p> Signup and view all the answers

    In the case of obstructive nephropathy, what is a common anatomical cause for obstruction?

    <p>Lesion in the bladder trigone.</p> Signup and view all the answers

    What treatment is considered the primary intervention for unilateral renal neoplasia?

    <p>Nephrectomy</p> Signup and view all the answers

    Which of the following statements about bacterial urinary tract infections is true?

    <p>Dogs younger than 10 rarely develop UTIs unless there are underlying conditions.</p> Signup and view all the answers

    What factor might complicate the interpretation of cystocentesis urinary samples?

    <p>Growth of more than 1000 CFU.</p> Signup and view all the answers

    Which species of bacteria is associated with urinary tract infections but is considered less common in dogs?

    <p>Bacteroides spp.</p> Signup and view all the answers

    What bacterial colony count is traditionally required to diagnose a UTI?

    <p>1000 CFU/mL</p> Signup and view all the answers

    What is the most common condition in cats associated with irritative voiding signs?

    <p>Feline idiopathic cystitis</p> Signup and view all the answers

    Which clinical signs are typically associated with feline lower urinary tract disease (LUTD)?

    <p>Hematuria and dysuria</p> Signup and view all the answers

    What happens to WBC counts in the urinary sediment of cats with idiopathic cystitis?

    <p>WBC counts are occasionally mildly increased</p> Signup and view all the answers

    What potential cause of LUTD in young cats is considered exceedingly uncommon?

    <p>Bacterial UTI</p> Signup and view all the answers

    Which statement about the diagnosis of feline idiopathic cystitis is true?

    <p>Urinary tract imaging may be used to rule out other conditions.</p> Signup and view all the answers

    What is the typical duration for treatment of bacterial UTIs to be curative?

    <p>6 to 8 weeks</p> Signup and view all the answers

    What urinary sediment characteristic is frequently noted in cats with idiopathic cystitis?

    <p>Presence of RBCs with minimal WBC response</p> Signup and view all the answers

    What is the primary reason for environmental modification in cats with FIC?

    <p>To enhance exploration and excitement</p> Signup and view all the answers

    Which method is NOT typically used for diagnosing uroliths?

    <p>Blood culture</p> Signup and view all the answers

    What condition may be indicated if hematuria and bacteriuria are found in a urinalysis?

    <p>Urolithiasis</p> Signup and view all the answers

    Which urolith type is primarily associated with hypercalcemia in dogs and cats?

    <p>Calcium oxalate</p> Signup and view all the answers

    Which of the following is a possible reason that crystalluria is not helpful in diagnosing uroliths?

    <p>Crystalluria can occur without the presence of stones</p> Signup and view all the answers

    What is a recommended practice for litter box management in multi-cat households?

    <p>Provide one litter box for each cat plus one extra</p> Signup and view all the answers

    What becomes evident during a physical examination in cases of urolithiasis?

    <p>Palpable stones in the bladder or urethra</p> Signup and view all the answers

    Which of the following is an atypical laboratory finding in dogs with calcium oxalate uroliths?

    <p>Elevated urine pH</p> Signup and view all the answers

    What condition is typically classified as prerenal azotemia?

    <p>Dehydration</p> Signup and view all the answers

    Which urinary specific gravity (USG) is expected in a case of dehydration in dogs?

    <p>1.030</p> Signup and view all the answers

    What is a likely cause of postrenal azotemia?

    <p>Urinary obstruction</p> Signup and view all the answers

    Which of the following conditions can lead to chronic renal failure (CRF) in cats?

    <p>Chronic pyelonephritis</p> Signup and view all the answers

    What condition is commonly associated with familial nephropathy in dogs?

    <p>Amyloidosis</p> Signup and view all the answers

    Which hallmark finding aligns with prerenal azotemia diagnosis?

    <p>Normal kidney size on imaging</p> Signup and view all the answers

    In what type of azotemia would one expect urine to be highly concentrated?

    <p>Prerenal azotemia</p> Signup and view all the answers

    What is commonly identified in cases of chronic tubulointerstitial nephritis (TIN)?

    <p>Unknown cause</p> Signup and view all the answers

    Which nephrotoxic agent is commonly associated with acute tubular necrosis in cats?

    <p>Grape ingestion</p> Signup and view all the answers

    What is the expected urine output for patients on intravenous fluids?

    <p>2.0 to 5.0 mL/kg/h</p> Signup and view all the answers

    Which of the following factors does NOT affect the prognosis of renal recovery?

    <p>Concentration of plasma proteins</p> Signup and view all the answers

    In the management of persistent oliguria after dehydration correction, what is the recommended action?

    <p>Stop diuretics and allow for natural healing</p> Signup and view all the answers

    Which nephrotoxic substance is linked with causing hypercalcemia and potential renal failure?

    <p>Calcipotriene</p> Signup and view all the answers

    Which condition results in the development of overhydration and is critical to monitor in renal failure scenarios?

    <p>Oliguria</p> Signup and view all the answers

    What is the role of early dialysis in the context of acute interstitial renal failure?

    <p>To improve prognosis for survival and renal recovery</p> Signup and view all the answers

    What effect does the use of aminoglycosides have on renal function, especially in dehydrated patients?

    <p>Enhances nephrotoxicity risk</p> Signup and view all the answers

    What should be done if medical dissolution therapy shows no improvement after 4 to 6 weeks?

    <p>Consider surgical intervention</p> Signup and view all the answers

    Which of the following is NOT a recommended preventive measure for urolithiasis?

    <p>Feed solely dry food</p> Signup and view all the answers

    What is indicated to favor the retrieval of uroliths smaller than the diameter of the urethra?

    <p>Nidus retention within the urinary tract</p> Signup and view all the answers

    Which of the following types of uroliths is formed from uric acid?

    <p>Amorphous urates</p> Signup and view all the answers

    What should be monitored closely following initial medical dissolution therapy?

    <p>Radiographic signs of urolith recurrence</p> Signup and view all the answers

    Which condition may predispose an animal to form calcium-containing uroliths?

    <p>Dehydration</p> Signup and view all the answers

    In which scenario might voiding urohydropropulsion be most effectively utilized?

    <p>For retrieving uroliths smaller than the urethra diameter</p> Signup and view all the answers

    Which substance forms ammonium biurate uroliths?

    <p>High protein diets</p> Signup and view all the answers

    What is a common metabolic condition that predisposes dogs to urinary tract infections (UTIs)?

    <p>Diabetes mellitus</p> Signup and view all the answers

    Which of the following is NOT a first-line choice for urinary antimicrobials?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which condition is associated with urinary retention that could complicate urinary sterilization?

    <p>Urethral stricture</p> Signup and view all the answers

    What is the typical duration of treatment with urinary antimicrobials for uncomplicated urinary tract infections?

    <p>2 to 3 weeks</p> Signup and view all the answers

    Which of these options is least likely to be a result of bacterial culture from voided samples?

    <p>Sterile results in all cases</p> Signup and view all the answers

    Which antibiotic class is typically reserved for highly resistant organisms in the treatment of UTIs?

    <p>Aminoglycosides</p> Signup and view all the answers

    What anatomical defect is specifically mentioned as a consideration when diagnosing UTIs?

    <p>Ectopic ureters</p> Signup and view all the answers

    Which factor is NOT associated with a higher risk of urinary tract infections in dogs?

    <p>Increased hydration</p> Signup and view all the answers

    What is the significance of the timing of penicillin administration in relation to leptospiral infection in dogs?

    <p>Most effective if started within 5 to 8 hours post-ingestion.</p> Signup and view all the answers

    What is the primary reason for the higher dosing requirement of 4-MP in cats compared to dogs?

    <p>Cats require higher doses due to their faster metabolism.</p> Signup and view all the answers

    Which statement accurately describes the effects of ethyl alcohol as an antidote before the development of 4-MP?

    <p>It can lead to respiratory depression and dehydration.</p> Signup and view all the answers

    What is the expected prognosis for dogs that are anuric without access to dialysis?

    <p>Prognosis for survival is near zero.</p> Signup and view all the answers

    What is an effect of giving the total daily dose of aminoglycosides once daily instead of in divided doses?

    <p>It reduces renal exposure to nephrotoxins.</p> Signup and view all the answers

    Why has aminoglycoside nephrotoxicity become less common in recent treatments?

    <p>The introduction of fluoroquinolones has provided alternative treatments.</p> Signup and view all the answers

    What is a common risk associated with intravenous antibiotics when administered rapidly at high doses?

    <p>Aminoglycoside-induced acute interstitial renal failure (AIRF).</p> Signup and view all the answers

    In the context of leptospirosis, what critical feature defines the disease in dogs?

    <p>It can cause acute to subacute air flow restriction failure.</p> Signup and view all the answers

    Study Notes

    Acute Renal Failure in Dogs

    • Increased serum phosphorus is common in the early stages of Acute Interstitial Renal Failure (AIRF), unlike Chronic Renal Failure (CRF), where elevated PTH helps lower serum phosphorus.
    • Calcitriol dosage should be tailored to the effects on ionized calcium and PTH levels.
      • Typical doses range from 2.5 to 3.5 ng/kg once daily.
      • Intermittent dosing with 9 ng/kg twice weekly (every 3.5 days) is also effective.
    • Control serum phosphorus to less than 6.0 mg/dL before starting Calcitriol therapy.
    • Control of systemic hypertension is crucial to prevent end-organ damage (eyes, brain, kidneys).
    • Uncontrolled hypertension can lead to glomerular capillary damage.
    • ACE inhibitors are the preferred hypertension medication for dogs, though higher than usual doses may be necessary (0.5 to 1.0 mg/kg twice daily).

    Ethylene Glycol (EG) Toxicity

    • 4-Methylpyrazole (4-MP) is effective as an antidote for EG toxicity up to 5 hours after ingestion in most dogs and up to 8 hours in many.
    • Cats require much higher doses of 4-MP compared to dogs. Sedation is a common side effect of high doses.
    • Ethyl alcohol can be used as an antidote for EG before the development of 4-MP.
    • Major side effects of ethyl alcohol: severe depression, dehydration, and respiratory depression.
    • Hemodialysis is sometimes effective in restoring renal function in anuric dogs.
    • The prognosis for survival in anuric patients without access to dialysis is poor.

    Leptospirosis

    • Leptospirosis is a systemic disease in dogs that can cause acute to subacute AIRF.
    • Penicillin therapy can be effective in treating leptospiral infection if started early.

    Parenteral Antibiotics and AIRF

    • Parenteral antibiotics, particularly aminoglycosides, can occasionally cause AIRF from ATN.
    • The incidence of aminoglycoside nephrotoxicity has decreased due to the development of fluoroquinolones for serious bacterial infections.
    • Administering the total daily dose of aminoglycosides once daily rather than in divided doses can reduce renal exposure and nephrotoxicity.

    Urethral Obstruction in Dogs

    • Structural urethral obstruction is caused by any physical blockage of the urethral lumen or compression from outside the urethra.
      • Examples: urethral calculi, neoplasia, mucus and crystal plugs, blood clots, strictures, and external trauma to the pelvis area or lymphadenopathy.
    • Functional urethral obstruction can be secondary to neurologic suprasacral spinal lesions (reflex dyssynergia), idiopathic, or related to pain and inflammation in the area.
    • Acepromazine and analgesics (buprenorphine) can help facilitate a more patent urethra in urethrospasm.
    • Cystotomy for stone removal is used to pass the stone back into the bladder via retropulsion.
    • Maintain an indwelling urinary catheter until azotemia and post-obstructive diuresis resolve and urethral swelling subsides.

    Post-Obstructive Diuresis

    • The magnitude of urine output typically parallels the degree of azotemia and decreases as azotemia diminishes.
    • Monitor urine output closely; with large urine output, potassium supplementation is needed to prevent hypokalemia.

    Uroabdomen in Dogs

    • Urine can enter the peritoneal cavity from tears in the bladder, urethra, or kidneys.
    • Bladder tears are the most common cause of uroabdomen, often occurring after blunt trauma.
    • Transient leakage of sterile urine into the abdomen following cystocentesis is usually self-limiting and resolves quickly without intervention.
    • Early on, BUN, creatinine, and phosphorus are normal, but they increase as uroabdomen develops (postrenal azotemia).
    • BUN and potassium elevate earlier than phosphorus and creatinine.
    • Sodium and chlorine decrease, and potassium increases as urine in the abdomen equilibrates with extracellular fluid.
    • Survey abdominal radiographs in urinary tract rupture: "Ground glass" appearance with loss of abdominal detail.
    • Use positive contrast cystography to document urine leakage from the bladder.
    • IVP is needed to document the site of urine leakage from the kidney or ureter.
    • If a bladder tear is small, an indwelling urinary catheter can be placed for a few days. Larger tears require surgical closure.
    • Rupture of the urethra usually requires primary surgical closure.
    • Ureteral rupture can sometimes be managed by reimplantation of the ureter into the bladder. Surgical closure of ureteral rupture can be performed, but stricture is common.
    • Peritoneal dialysis or drainage might be needed if urine flow cannot be adequately established with urethral catheterization.

    Urinary Bladder Neoplasia in Dogs

    • Transitional cell carcinoma (TCC) is the most common urinary tract tumor in dogs.
    • Urinary bladder neoplasia accounts for 1% of all canine neoplasms.
    • These tumors tend to occur in older animals and are rare in cats.
    • Other types of bladder tumors include: lymphoma, fibroma, rhabdomyosarcoma, papilloma, and squamous cell carcinoma.

    Progression After ARF

    • Chronic Kidney Disease (CKD) is a common outcome of ARF.
    • There is limited evidence on treating non-azotemic CKD cases.
    • Dietary therapy for azotemic CKD cases includes renal diets, phosphorus restriction, and omega-3 supplementation.
    • Protein restriction is ineffective in slowing CKD progression.

    Urinary Tract Obstruction (UTO)

    • Uroliths (stones) form when urine is supersaturated with minerals.
    • Urinary bladder is the most common site for uroliths.
    • Risk factors for uroliths include urine pH, metabolic diseases (e.g., urate-containing calculi in dalmatians), and breed, gender, age, and diet.
    • Diagnosis usually involves exclusion and confirmation with urethral pressure studies.
    • Treatment typically involves surgical removal, especially if there is recurrent obstruction.

    Urinary Incontinence (UI)

    • Urinary incontinence is common in dogs, particularly golden retrievers, Labrador retrievers, Siberian husky, soft-coated wheaten terrier, poodles, and Newfoundlands.
    • Signs of UI can include variable degrees of urine leakage and normal voiding behavior.
    • Diagnosis is often based on history, clinical signs, and urethral pressure studies.
    • Treatment involves medications like phenylpropanolamine (PPA).

    Rupture of the Urinary Tract

    • Rupture of the bladder, urethra, or ureter can result from trauma.
    • Clinical signs may include hematuria, dysuria, stranguria, and abdominal enlargement.
    • Diagnosis is based on physical examination and diagnostic imaging.
    • Treatment may involve surgical repair, nephrectomy, or peritoneal dialysis.

    Urinary Bladder Neoplasia

    • Transitional cell carcinoma (TCC) is the most common bladder tumor in dogs.
    • Tumors are more prevalent in older animals and rare in cats.
    • Diagnosis is based on cytology and histopathology.
    • Treatment options include surgery, chemotherapy, and radiation therapy.

    Renal Diseases

    • Polycystic kidney disease: Affects Bull terrier, Cairn terrier, West Highland white terrier, Persian cat
    • Membranoproliferative glomerulonephritis: Affects Bernese mountain dog, soft-coated Wheaten Terrier, Brittany spaniel
    • Renal dysplasia: Affects Soft-coated wheaten terrier, Alaskan malamute, chow chow, golden retriever, Lhasa apso, shih-tzu, miniature schnauzer, standard poodle
    • Multiple renal cystadenocarcinomas: Affects German shepherd dog
    • Renal telangiectasia: Affects Pembroke Welsh corgi

    Diagnosis

    • Clinical signs: Azotemia, submaximally concentrated urine; reduction in kidney size, irregular kidneys, nephrocalcinosis, nonregenerative anemia, chronic failure to thrive, anorexia, vomiting, depression, weight loss
    • Renal biopsy: Findings are not specific
    • Renal biopsy: Not indicated in those with small kidneys

    Treatment

    • Dietary protein and phosphate restrictions: May be needed for adequate treatment
    • Intestinal phosphate binders: Often needed to achieve optimal control of serum phosphorus and serum PTH
    • Aluminum salts (hydroxide, carbonate): Mainstay treatment for intestinal phosphate binders
    • Calcium salts (carbonate, acetate): Developed to avoid aluminum accumulation toxicity, sometimes used
    • Newer-generation medications: Sevelamer HCl and lanthanum carbonate have not yet achieved mainstream use
    • Epakatin: Veterinary product marketed for use in cats with CRF

    Acute Interstitial Renal Failure (AIRF)

    • Increased serum phosphorus: Often occurs early in the development of AIRF, unlike CRF
    • Progressive azotemia: Develops as the result of vasoconstriction of the afferent arteriole, increased tubular pressure, tubular backleak, or failure to filter
    • Renal lesions of AIRF: Classically acute tubular necrosis (ATN) secondary to ischemic or nephrotoxic causes
    • Acute interstitial nephritis: Can create AIRF secondary to infectious causes, classically associated with leptospirosis

    Uroabdomen

    • Urine entry into the peritoneal cavity: Occurs due to tears in the bladder, urethra, or kidneys
    • Most common cause: Bladder tears following blunt trauma
    • Other causes: Penetrating wounds, overzealous expression of the bladder, passage of a urinary catheter, cystocentesis, abdominocentesis, surgical injury, breakdown of cystotomy closure, overdistension during contrast radiography and cystoscopy, prolonged urethral obstruction
    • Survey abdominal radiographs: “Ground-glass” appearance with loss of abdominal detail
    • Positive contrast cystography: Documents urine leakage from the bladder
    • Rupture of upper urinary tract: Loss of retroperitoneal detail, failure to observe the kidneys, and streaking of the retroperitoneal space

    Urolithiasis

    • Struvite uroliths: Formed from Mg, ammonium, and phosphate, primarily in alkaline urine
    • Risk factors: Diets high in protein, magnesium, and phosphorus
    • Treatment with portosystemic shunt: Surgical removal, feed low protein, alkalinizing diet
    • Other causes: Feed low-protein diet without fish or glandular organs, maintain urine pH at 7.0 to 7.5, increase water intake, treat with allopurinol
    • Calcium phosphate uroliths: Occur infrequently in dogs and cats

    Lily Intoxication

    • Specific syndrome of AIRF: Occurs only in cats, not in dogs
    • Toxicity: All parts of the lily are toxic, only a small amount needs to be eaten
    • Severe azotemia and oligoanuria: Can be seen in this form of AIRF, some cats have recovered with medical treatment

    Raisin or Grape Ingestion

    • AIRF in dogs: With or without hypercalcemia; toxicity not reported in cats
    • Risk factors: Diets high in protein, magnesium, and phosphorus

    Leptospirosis

    • Vaccination: Against serovars canicola and icterohemorrhagiae has lessened clinical disease
    • Clinical syndromes: Usually due to “atypical” serovars, in which vaccines have not been administered
    • Exposure: Encroachment of wildlife into suburban living spaces, exposure to farm animals
    • Changes in liver enzymes: Classically occur with serovars canicola and icterohemorrhagiae

    Acute Renal Failure

    • Acute renal failure (ARF) in small animals can have multiple causes ranging from toxins and infections to obstruction, neoplasia, and other conditions.
    • NSAIDs can cause ARF as they inhibit the production of vasodilatory prostaglandins, leading to vasoconstriction, which can cause damage to the kidneys.
    • Ensuring adequate hydration (euvolemia) can help prevent ARF due to NSAID toxicity.

    Hypercalcemia

    • Sudden, severe hypercalcemia can lead to ARF.
    • Hypercalcemia can be caused by exposure to vitamin D or its metabolites.
    • Ingestion of rat poison with cholecalciferol or psoriasis creams with calcipotriene can cause hypercalcemia.

    Upper Urinary Tract Infections (UTI)

    • Pyelonephritis is a type of upper UTI.
    • Pyelonephritis is more commonly chronic than acute.
    • Escherichia coli is the most common causative agent of upper UTIs in dogs and cats.
    • Common presenting signs include: fever, renal pain, leukocytosis, leukocyturia, positive urine culture, and dilation of the renal pelvis.

    Obstructive Nephropathy

    • Obstructive nephropathy refers to anatomical and functional effects of blockage in the kidneys.
    • Obstruction of the ureter from lesions in the bladder trigone is common, leading to hydroureter and hydronephrosis.

    Renal Neoplasia

    • Primary renal tumors are more common than metastatic tumors.
    • Malignant tumors are more prevalent than benign tumors.
    • Adenocarcinoma of the renal tubules is the most common renal neoplasm in dogs.
    • Renal Lymphosarcoma (LSA) is the most common renal neoplasm in cats, often bilateral.
    • Transitional cell carcinoma can arise from the renal pelvis and cause obstruction or hematuria.
    • Renal Lymphoma is usually bilateral in cats and may be the only organ showing signs of the tumor initially. Half of affected cats are feline leukemia virus positive.
    • Bilateral renal cystadenoma occurs in German Shepherds and is associated with generalized nodular dermatofibrosis and uterine leiomyoma. It is an autosomal dominant trait.
    • Painless hematuria is a common clinical sign of renal neoplasia.
    • Nephrectomy is the treatment of choice for unilateral renal neoplasia.
    • LSA can respond well to standard chemotherapy protocols.

    Lower Urinary Tract Disorders (LUTD)

    • Escherichia coli accounts for more than half of UTIs in dogs and cats. Staphylococcus and Proteus spp. are common in dogs, while Enterococci, Enterobacter, Klebsiella, and Pseudomonas spp. are less common.
    • Incontinence is often associated with urine culture, while other clinical signs are not.
    • Older male dogs are more commonly affected by UTIs, while younger cats are less likely unless they have underlying conditions.

    Urinary Urolithiasis

    • Uroliths are formed when minerals precipitate from the urine and form stones within the urinary tract.
    • Factors influencing their formation include: urine pH, concentration of minerals, presence of nidus (center of formation), and dietary factors.
    • Urolith formation is dependent on the presence of a nidus within the urinary tract and conditions that favor continued growth.
    • Predisposing factors that increase the risk of uroliths include: breed, diet, and medical conditions.
    • Diagnosis involves: radiography, ultrasonography, urine analysis, and urolith retrieval and analysis.
    • Treatment aims to dissolve the uroliths or surgically remove them. Medical dissolution is the preferred method for struvite uroliths.
    • Prevention of uroliths involves increasing water intake, dietary modifications, and medical management.

    Canine Urethral Obstruction

    • Urethral obstruction is a life-threatening condition in male dogs, especially those prone to uroliths.
    • Causes of urethral obstruction include: uroliths, trauma, tumors, or inflammation of the urethra.
    • Clinical signs include: straining to urinate, hematuria, abdominal pain, and lethargy.
    • Treatment aims to relieve the obstruction and prevent further complications.
    • Emergency care includes: catheterization, surgical removal of the obstruction, and fluid therapy to support renal function.

    Sphincter Mechanism Incompetence

    • Primary sphincter mechanism incompetence (PSMI) is the most common and important acquired cause of canine incontinence.
    • It is typically seen in spayed female dogs, and sometimes before ovariohysterectomy.
    • It is related to a decrease in maximal urethral closure pressure and functional urethral length.
    • Increased risk of developing PSMI is associated with: older age, bodyweight over 20 kg, and specific breeds like Boxers, Dobermans, and Giant Schnauzers.
    • Treatment involves: pharmacological management with medications like phenylpropanolamine, surgical procedures like collagen injection and urethral bulking, and lifestyle modifications.

    Ureteral Ectopia

    • Ureteral ectopia (EU) is the most common congenital cause of urinary incontinence in female dogs.
    • It involves malformation of the ureter, leading to its opening in an abnormal location, such as the urethra, vagina, or bladder trigone.
    • Signs vary depending on severity and location of the ectopia.
    • Treatment involves: surgical correction to reposition the ureter.

    Progression After ARF

    • Once a certain nephron mass is lost from CKD, a progressive self-destructive cascade of events happens in the remaining healthier kidney leading to further nephron damage.
    • The chronically damaged kidney involves glomerular hypertension and glomerular hyperfiltration.
    • Other mechanisms for progressive destruction include renal mineralization and damage from uncontrolled renal secondary hyperparathyroidism.

    CKD Treatment

    • There is little evidence for treatment of CKD cases that are not yet azotemic.
    • Dietary therapy includes renal diets, phosphorus restriction, and omega-3 supplementation.
    • Protein restriction alone does not protect the kidney from progression or extend the life of the dog or cat with CRF.
    • Angiotensin-converting enzyme (ACE) inhibition is proven beneficial in treatment of protein-losing nephropathy.
    • Amlodopine is the drug of choice for control of systemic hypertension in cats.
    • Azodyl is a probiotic given daily to maintain a population of colonic bacteria that metabolize nitrogenous waste.

    Ischemic Causes Of ATN And AIRF

    • Systemic hypotension is not necessary for the development of tubular lesions.
    • Causes include dehydration, trauma, anesthesia, sepsis, heat stroke, pigment nephropathy, ACE inhibitors, shock, hemorrhage, surgery, burns, hypothermia, nonsteroidal anti-inflammatory drugs (NSAIDs), and acute papillary necrosis.

    Nephrotoxins

    • A true nephrotoxin is a compound capable of creating renal tubular cell membrane injury directly.
    • A nephrotoxicant describes acute renal injury or AIRF following the effects of a chemical compound, whether the injury is direct or indirect from the agent.

    Urinary Tract Infection (UTI)

    • Metabolic conditions predisposing for UTI include diabetes mellitus, hyperthyroidism, hyperadrenocorticism, exogenous steroids, and immunosuppressive medications.
    • Anatomic defects should be excluded.
    • Functional defects in the emptying capacity of the bladder should be excluded.
    • Urinary antibacterial treatment should be based on susceptibility testing results.
    • First-line choices for urinary antimicrobials include amoxicillin, potentiated sulfa (trimethoprim or ometoprim), and first-generation cephalosporins.
    • Treatment success is based on sterile quantitative urine culture results 3 to 5 days after stopping urinary antimicrobial treatment.

    Ethylene Glycol (EG) Intoxication

    • EG intoxication occurs following ingestion of 4 to 13 mL/kg in dogs and 1.5 mL/kg in cats.
    • EG is transformed to cytotoxic metabolites in the liver by alcohol dehydrogenase.
    • Diagnosis is based on observation of ingestion, finding a source for possible ingestion, and acute onset of alcohol-like inebriation.

    UTI Treatment

    • For more resistant organisms, fluoroquinolones (enrofloxacin, marbofloxacin, difloxacin, orbi­floxacin) and clavulanate-potentiated amoxicillins are used.
    • For highly resistant organisms, fluoroquinolones, ticarcillin, piperacillin, aminoglycosides, imipenem, and meropenem are used.
    • Urinary antimicrobial treatment is usually prescribed for 2 to 3 weeks for uncomplicated UTI.

    Urinary System Disorders

    • Upper urinary tract consists of the renal parenchyma, renal pelves, and ureters.
    • Lower urinary tract consists of the bladder and urethra.
    • Upper urinary tract disorders include: chronic renal failure (CRF), acute renal failure (ARF), upper urinary tract infection (UTI), renal neoplasia, renal pelvic or ureteral obstructions, and renal bleeding.
    • Lower urinary tract disorders: bacterial UTIs, idiopathic cystitis of cats, urethral obstruction, urinary incontinence, and neoplasia of the bladder and urethra.
    • Animals are more likely to be sick from upper urinary tract disorders compared with those of the lower urinary tract unassociated with urinary obstruction.

    Excretory Renal failure

    • Azotemia: Blood urea nitrogen (BUN) and serum creatinine are above the upper normal range.
    • Prerenal azotemia: Reduced perfusion and nitrogenous waste accumulates in the blood.
      • Causes include dehydration, shock, congestive heart failure (CHF).
      • Urine should be highly concentrated, with a urinary specific gravity (USG) greater than 1.030 in dogs and 1.040 in cats.
      • Urine sediment is usually normal.
    • Postrenal azotemia: Leakage of urine into retroperitoneal or peritoneal cavities, or obstruction of outflow from both kidneys.
      • USG is variable.
      • Urinary sediment may show casts, WBCs, and proteinuria.
    • Metabolic conditions predisposing for UTI: Diabetes mellitus, hyperthyroidism, hyperadrenocorticism; exogenous steroids and immunosuppressive medications.
    • Anatomic defects: Ectopic ureters, loss of urethral tone due to sphincter mechanism incompetence, urachal diverticulum, urethral stricture, and excessive hooding of the vulva.
    • Functional defects: Urinary retention after voiding, making it impossible to permanently sterilize urine.

    Chronic Renal Failure (CRF)

    • Permanent loss of at least 75% of functional nephron mass due to chronic lesions.
    • Increased serum phosphorus is observed after 85% of nephron mass becomes nonfunctional.
    • Cause is usually idiopathic, likely due to glomerular injury.
    • Any age, breed, or sexual status can be affected. Risk is higher for older animals.
    • Causes of CRF in dogs and cats:
      • Chronic tubulointerstitial nephritis (TIN) of unknown cause (most common).
      • Chronic pyelonephritis.
      • Chronic glomerulonephritis.
      • Amyloidosis (familial in shar-pei dogs and Abyssinian cats).
      • Polycystic kidney disease (familial in Persians).
      • Hypercalcemic nephropathy.
      • Chronic obstructive uropathy (hydronephrosis).
      • Familial renal disease.

    Treatment of CRF

    • Urinary antibacterial treatment: Based on susceptibility testing results.
    • First-line urinary antimicrobials: Amoxicillin, potentiated sulfa (trimethoprim or ometoprim), and first-generation cephalosporins.
    • For more resistant organisms: Fluoroquinolones (enrofloxacin, marbofloxacin, difloxacin, orbifloxacin) and clavulanate-potentiated amoxicillins.
    • For highly resistant organisms: Fluoroquinolones, ticarcillin, piperacillin, aminoglycosides, imipenem, and meropenem.
    • Urinary antimicrobial treatment is typically prescribed for 2 to 3 weeks for uncomplicated UTI.
    • Treatment success: Based on sterile quantitative urine culture results 3 to 5 days after stopping urinary antimicrobial treatment.

    Uroliths

    • Stones must be 3 mm or greater in diameter to be seen on radiographs.
    • Uroliths form when urine is oversaturated with minerals.
    • Location: Urinary bladder is the most common site.
    • Risk factors: Urine pH, promoters or inhibitors of crystal formation, metabolic disease, breed, gender, age, and diet.

    Struvite Uroliths

    • Most common urolith in dogs.
    • More likely to form in alkaline and infected urine.
    • Urine culture positive for urease-producing organisms (Staphylococcus spp., Proteus spp., Streptococcus spp., Klebsiella spp.) is necessary for infection-induced struvite uroliths.
    • Increased risk in breeds such as Miniature Schnauzer, Shih Tzu, Bichon Frise, Lhasa Apso, Miniature Poodle, Cocker Spaniels, Ragdoll, Foreign Shorthair, Domestic Shorthair, Oriental Shorthair, Chartreux, and Himalayan.
    • Decreased risk in breeds like Rex, Burmese, Abyssinian, Russian Blue, Siamese, and Birman cats.

    Ammonium Urate Uroliths

    • Increased urates in urine due to increased dietary intake of purines (precursors of uric acid), usually in acidic urine.
    • Occurs secondary to impaired purine metabolism.
    • More likely in Dalmatians, and cats such as Persian, Himalayan, Ragdoll, British Shorthair, Foreign Shorthair, Exotic Shorthair, Havana Brown, and Scottish Fold.
    • Birman, Abyssinian, and Siamese cats are at decreased risk.

    Treatment of Uroliths

    • Surgical removal: If there is repeated urethral obstruction, or owners prefer to avoid medical dissolution.
    • Struvite uroliths: Avoid acidifying diets, diets restricted in phosphorus or magnesium; avoid vitamins C and D and calcium supplements.
      • Maintain urine pH between 6.5 and 7.0.
    • Ammonium urate uroliths: Avoid high-purine diets, maintain adequate hydration, and consider allopurinol administration.

    Management of Urinary System Disorders

    • Preventative care: Monitor urine output, USG, and any changes in behavior, such as increased thirst, urination, or blood in urine.
    • Consider regular urine analysis and urine culture.
    • Early detection and intervention are key to improving outcomes.

    Ethylene Glycol Toxicity

    • The early diagnosis of ethylene glycol intoxication relies on observing oligo- or anuria, a high anion gap, and an elevated osmole gap. A positive colorimetric reaction using the EG test kit provides strong evidence for the diagnosis.
    • In cases of ethylene glycol intoxication, there is often an initial period of polyuria and polydipsia, followed by oliguria and then anuria that can persist despite treatment.
    • Azotemia associated with renal lesions may take longer than 24 hours to develop, while prerenal azotemia can be apparent earlier due to vomiting and polyuria caused by EG excretion.
    • 4-methylpyrazole (4-MP) is the definitive antidote for treating ethylene glycol toxicity before complete metabolism. It works by inhibiting alcohol dehydrogenase, preventing the formation of toxic metabolites.

    Leptospirosis

    • Leptospirosis causes a multi-systemic infection. Renal failure, acute interstitial nephritis, and acute tubular necrosis are commonly observed.
    • Leptospirosis infection is characterized by fever, depression, anorexia, vomiting, lethargy, renal injury, and icterus.
    • Penicillin is the drug of choice for eliminating leptospiral organisms from most of the body. Doxycycline is the treatment for removing the renal carrier state in dogs.
    • Supportive intravenous fluids are vital for 1 to 2 weeks in addition to penicillin treatment.
    • Short-term dialysis may be necessary for dogs with oliguria or anuria and high-level azotemia.
    • The prognosis for acute interstitial renal failure secondary to leptospirosis is generally good, dependent on the extent of kidney involvement by neoplastic cells.

    Cholecalciferol and Calcipotriene Toxicity

    • Cholecalciferol toxicity can be confirmed by high levels of 25-hydroxyvitamin D in the blood.
    • Calcipotriene toxicity is diagnosed based on history as there is no available test for its presence.

    Upper Urinary Tract Infections (UTI)

    • Pyelonephritis is most commonly a chronic condition rather than acute.
    • Escherichia coli is the most common and important organism causing pyelonephritis in dogs and cats.
    • Signs of pyelonephritis include fever, renal pain, leukocytosis, leukocyturia, positive urine culture, dilatation of the renal pelvis, or diverticulae.

    Obstructive Nephropathy

    • Obstructive nephropathy refers to the anatomical and functional effects on the kidneys caused by obstruction.
    • Obstruction of the ureter and kidney from lesions in the bladder trigone is a common cause.

    Lower Urinary Tract Disorders (LUTD)

    • Escherichia coli accounts for over half of UTIs in dogs and cats.
    • A UTI is usually present in dogs and cats when urine culture reveals more than 1000 CFU/mL. Larger quantities of growth (greater than 100,000 CFU/mL) are observed in many dogs with UTIs.
    • For a definitive diagnosis of feline idiopathic cystitis (FIC), urine cultures should be negative, and anatomic defects should be ruled out with imaging studies.
    • UTI is an uncommon cause of urinary tract signs (hematuria, dysuria, pollakiuria, stranguria) in young cats without underlying causes.
    • Environmental modification or enrichment can be a powerful treatment for cats with FIC, including proper litter box management, vertical climbing spaces, increased human interaction, good water management, and access to the outdoors.

    Urolithiasis (Bladder Calculi)

    • Struvite, calcium oxalate, and calcium phosphate are the types of radiopaque uroliths visible on radiographs.
    • Crystalluria does not guarantee the presence of stones, and stones may be present without crystalluria, making crystalluria inconclusive for diagnosis.
    • Hypercalcemia is present in 4% of dogs and 35% of cats with calcium oxalate uroliths.

    Upper Urinary Tract Disorders

    • Risk of upper urinary tract disorders is low for younger animals and high for older animals.
    • Incidence increases in those older than 10 years.
    • Renal failure can be classified into: prerenal, primary renal, or postrenal.

    Renal Failure

    • Excretory renal failure occurs when blood urea nitrogen (BUN) and serum creatinine are above the upper normal range (azotemia).
    • Prerenal azotemia occurs when perfusion is reduced and nitrogenous waste accumulates in blood.
      • Causes of prerenal azotemia include dehydration, shock, congestive heart failure (CHF).
      • Urine should be highly concentrated.
      • Urinary specific gravity (USG) is expected to be greater than 1.030 in dogs and 1.040 in cats.
      • Urine sediment is normal; kidney size normal.
    • Postrenal azotemia occurs when urine leaks into retroperitoneal or peritoneal cavities or due to obstruction to outflow from both kidneys.
      • USG is variable.
      • Urinary sediment may be abnormal.
    • Chronic Renal Failure (CRF) in young animals: Usually familial nephropathy or renal injury from infection or toxins.
      • Cats rarely have familial nephropathy except for renal amyloidosis in Abyssinians and Oriental shorthairs.
    • Causes of CRF in dogs and cats:
      • Chronic interstitial nephritis (TIN) of unknown cause (most common pathologic diagnosis).
      • Chronic pyelonephritis (can be difficult to distinguish histologically from TIN).
      • Chronic glomerulonephritis (can be difficult to distinguish histologically from TIN).
      • Amyloidosis (familial in shar-pei dogs and Abyssinian cats).
      • Polycystic kidney disease (familial in Persians).
      • Hypercalcemic nephropathy.
      • Chronic obstructive uropathy (hydronephrosis).
      • Familial renal disease.
      • Nephrotoxic causes of ATN.

    Acute Renal Failure (AIRF)

    • Three classic phases of AIRF: latent or incipient phase, maintenance, and recovery
    • Effective after ingestion of a lethal dose up to at least 5 hours in most dogs and up to 8 hours in many.
    • After 8 hours following ingestion, most ethylene glycol (EG) has been transformed to its toxic compounds
    • Cats require much higher doses of 4-MP than dogs.
    • Ethyl alcohol is the antidote of choice before 4-MP was developed in both dogs and cats.
    • Hemodialysis of dogs for 6 to 9 months has been effective for recovery of renal function in some dogs that were anuric.
    • Prognosis for survival in anuric patients without access to dialysis is near zero

    Leptospirosis

    • Leptospirosis is a systemic disease of dogs that can cause AIRF.
    • Leptospirosis can cause acute to subacute urinary concentrating defect from renal or endocrine disease.

    ### Urinary Tract Infections (UTI)

    • A UTI is an infection in the urinary tract.
    • UTIs are more likely to occur in animals that have: undergone urethral catheterization, or have a perineal urethrostomy, have voided samples that are often positive for bacterial growth, or have a perineal urethrostomy.
    • Dogs can develop a UTI without underlying anatomic, functional, or metabolic risk factors, depending on exposure to a virulent uropathogen.
    • Metabolic conditions predisposing for UTI: diabetes mellitus, hyperthyroidism, hyperadrenocorticism; exogenous steroids and immunosuppressive medications also create increased risk.
    • Anatomic defects should be excluded: ectopic ureters, loss of urethral tone due to sphincter mechanism incompetence, urachal diverticulum, urethral stricture, and excessive hooding of the vulva with overlying skin.
    • Functional defects in the emptying capacity of the bladder should be excluded.
    • Urinary retention after voiding can make it impossible to permanently sterilize the urine.
    • Treatment of a UTI should be based on susceptibility testing results.
    • First-line choices for urinary antimicrobials: Amoxicillin, potentiated sulfa (trimethoprim or ometoprim), and first-generation cephalosporins.
    • For more resistant organisms: Fluoroquinolones (enrofloxacin, marbofloxacin, difloxacin, orbifloxacin) and clavulanate-potentiated amoxicillins.
    • For highly resistant organisms: Fluoroquinolones, ticarcillin, piperacillin, aminoglycosides, imipenem, and meropenem.
    • Urinary antimicrobial treatment is usually prescribed for 2 to 3 weeks for uncomplicated UTI.
    • Treatment success is based on sterile quantitative urine culture results 3 to 5 days after stopping urinary antimicrobial treatment and again 1 to 2 weeks after completing antimicrobial therapy.

    Uroliths

    • Uroliths are stones that form in the urinary tract
    • Most uroliths can recur; therefore, preventive measures should be instituted.
    • Increase water intake: Feed canned food or add water to dry food. Provide additional water bowls, good water bowl hygiene, and different sources of water.
    • If uroliths are present, they can be treated with medical dissolution or surgical removal
    • If there is no improvement after 4 to 6 weeks of therapy, surgery should be considered.

    Prevention of Uroliths

    • Increase water intake: Feed canned food or add water to dry food. Provide additional water bowls, good water bowl hygiene, and different sources of water.

    Types of Uroliths

    • Different types of uroliths can be found in urine, including:
      • Leucine
      • Tyrosine
      • Cystine
      • Amorphous urates
      • Uric acid (dihydrate and monohydrate)
      • Sodium urate
      • Calcium oxalate
      • Dicalcium phosphate
      • Triple phosphate
      • Calcium carbonate
      • Amorphous phosphate
      • Ammonium biurate

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    Description

    This quiz covers critical aspects of Acute Interstitial Renal Failure (AIRF) and Ethylene Glycol (EG) toxicity in dogs. Learn about serum phosphorus control, the role of Calcitriol, and the importance of managing hypertension. Additionally, explore the use of 4-Methylpyrazole as an antidote for EG toxicity.

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