Urinary System

Description: Disorder of the kidneys, kidneys use 20% cardiac output for filtering and urine production. 

Causes: Ethelene glycol, leptospirosis, IV gentamicin, sepsis, diabetes, hypovolaemia, hypoalbuminaemia, deep anaesthesia, low BP

Clinical Signs: V++, anorexia, lethargy, dehydration, uraemia, anuria/ oliguria, renal pain/ renomegaly (swollen kidney). 

Diagnosis: Blood test (azotaemia = high serum urea), urinalysis, (high Na+, casts, high PH, proteinuria, glucosuria), US.

Treatment: IVFT, Diuretics (Frusemide, mamitol), anti-emetics

Description: Gradually progresses, clinical signs appear after 75% loss of function

Causes: Chronic nephritis, chronic pyelonephritis, nephrotoxins, hydronephrosis, chronic glomerulonephritis, renal lymphomsarcoma

Clinical Signs: Anorexia, inappetance, V++, PU, PD, D++, Pale MM, oral ulceration, halitosis, depression, low kidney function.

Diagnosis: Biochemistry, Azotaemia, hyperphosphataemia, hypokalaemia, urinalysis, low USG, proteinuria

Management: Maintain hydration, renal diets, phosphate binders (renalzin), benazpril (fortekor)

Nephrotic Syndrome:

• Genetic, end stage disease
• Breakdown of filtration process- proteinuria, hypoalbuminuria, oedema.
• Management: protein rich diet, anabolic steriods, plasma expanders

Pyelonephritis:

• Kidney bacterial infection (rare)
• Clinical Signs: pyrexia, lethargy, depression, inappetance, renal pain.
• Treatment: ABs (fluoroquinolones/ cephalosporins

Hydronephrosis:

• Swelling and distention of kidney because urethral obstruction
• Causes: ligation during Sx, neoplasia, uroliths, narrowing and scarring
• Clinical signs: renal failure
• Treatment: nephrectomy or removal of obstruction

Polycystic kidney disease:

• Common in persion and exotic breeds/ hereditary
• Fluid filled cysts
• Diagnosis: screening via US, blood tests
• Clinical Signs: CRF

Renal Neoplasia:

• Kidney cancers - renal lymphoma and renal cell carcinoma
• Clinical Signs: Renal failure, swollen and painful kidneys
• Treatment: supportive or chemo

Description: ureter enters bladder caudal to bladder sphincter, urine produced bypasses bladder.

Causes: damage during spays

Clinical Signs: urinary incontinence

Diagnosis: Urography (contrast medium xray) = if not stored in bladder, bypass present

Treatment: Surgical relocation of ureters

Urolithiasis/ FLUTD (Feline Lower Urinary Tract Disease):

• Description: uroliths form by change in PH/ bacterial infection/ stress
• Causes: uroliths, indwelling catheters, diabetes mellitus, neoplasia
• Clinical Signs: cystitis, oliguria, dysuria, haematuria, depression, urinary tenesmus
• Diagnosis: Urinalysis
• Treatment: Dietary manipulation, oral therapy (allopurinol), anti inflammatories, antibiotics

Urethral obstruction:

• Causes: Calculi (stone)
• Clincial Signs: anuria, dysuria, pain, depression, lethargy, shock, collapse
• Diagnosis: presentation, palpation of the bladder, radiography, bloods
• Treatment: Cystocentesis, catheterisation (retrograde hydropulsion), cystotomy

Bladder Neoplasia:

• Transitional Cell Carcinoma
• Clinical Signs: cystitis
• Diagnosis: urinalysis, radiography w/ contrast

Urinary Incontinence:

• Cause: sphincter mechanism incompetance (SMI), cystitis, detrusor muscle atrophy, neutogenic, nerve damage, ectopic ureters

SMI:

• Cause: lower oestrogen in blood = deterioration in urethral closure
• manage by oestrogen subs (Urilin and propalin