Canine and Feline Nephrology and Urology

Dennis J. Chew, Stephen P. DiBartola, Patricia Schenck

• Editorial: Saunders
• Año: 2010
• ISBN:
  9781437723595
• Edición: 2
• Categoría: Medicine
• Categoría: Veterinary Medicine

The prevalence of urinary tract diseases and disorders in small animal practice is higher than ever. The 2nd edition of Canine and Feline Nephrology and Urology makes it easy to find the information you need to accurately diagnose and manage diseases and disorders of the urinary tract in dogs and cats. Its concise outline format features practical clinical content, line drawings that clearly illustrate the initiation and progression of disease, photographs that demonstrate the clinical appearance of various lesions, and tables and boxes that offer essential information at a glance. Expert authors Dennis J. Chew, Stephen P. DiBartola, and Patricia Schenck keep you current with revised and brand-new content based upon the latest studies and evidence-based medicine, helping you prevent and most effectively manage kidney, bladder, and related conditions.

• Outline format with concise, clinically focused content helps you quickly and easily find the information you need to accurately diagnose and effectively manage urinary tract diseases and disorders.
• Practical clinical tips and guidelines including algorithms, FAQs, and case management recommendations.
• Special boxes highlight key information at a glance.
• Concise, need-to-know information about renal and lower urinary tract pathophysiology provides essential background for clinical application.

• Evidence-based coverage of hot topics such as the relationship between behavioral stressors and urinary tract disease, treatments for idiopathic cystitis, and dietary modifications for the prevention and treatment of urinary tract problems helps you provide the latest and best care for your patients.

Chapter 1 Urinalysis

Introduction

A. Routine urinalysis is simple and inexpensive.

B. Urinalysis not only is helpful in evaluation of patients with urinary tract disease but also in those with systemic disease affecting many other body systems.

C. Results of serial urinalyses can reflect progression or resolution of disease.

D. Abnormalities on urinalysis often occur before changes occur in serum biochemistry (i.e., urinalysis can be very sensitive).

E. Urine should be submitted for analysis at the same time blood is submitted for biochemical analysis.

F. Complete urinalysis consists of three parts: Physical properties, chemical properties, and urine sediment findings.

Collection of Urine

A. Urine collection technique influences interpretation of the results. Urine specimens should be placed in containers that are clean and free of chemical contaminants (e.g. detergents, disinfectants, bleach). Ideally, collect 10 to 12 mL of urine for analysis. At a minimum, 3 mL should be submitted.

Midstream Voided Sample

1. The goal of this approach is to allow the initial stream of urine to flush contaminants from the urethra and genital tract.

Technique

DOGS

(1) Male dogs may be more difficult to collect due to short duration of voiding (i.e. “marking”).

CATS

(1) Use non-resorbable cat litter.

(2) Cellophane wrap over a tilted litter pan containing a gradient of cat litter.

Advantages

a. No risk of complications for the patient.

b. Client can collect the sample.

c. Suitable for initial screening.

d. Method of choice to evaluate hematuria (other collection methods may result in addition of red blood cells [RBCs] to the urine from trauma).

Disadvantages

a. Subject to contamination by the urethra and genital tract despite precautions.

b. Subject to contamination from the environment.

Manual Expression of Urine by Digital Palpation of the Bladder

Technique

a. Gradually increase pressure in the bladder, compressing the bladder wall by abdominal palpation until urine is expelled.

b. Many times the animal will void urine after bladder palpation failed to produce a urine sample. Thus, the clinician should be prepared to collect a voided sample.

Advantages

a. Ease of use in anesthetized patients.

Disadvantages

a. Not recommended except in anesthetized animals.

b. Red blood cells (RBCs) and protein may enter the urine sample as a result of the force required to expel urine.

c. Collection of urine by manual expression carries a risk of bladder rupture.

d. Infected bladder urine can reflux into the ureters during manual expression thus increasing the risk of upper urinary tract infection (UTI).

Catheterization

Technique

a. Maintain sterile technique while using a catheter, gloves, and proper patient cleansing and disinfection. A gentle approach is necessary to minimize trauma to the urinary tract. The catheter should never be advanced by force, and a ruptured urethra or bladder can be a consequence of poor technique.

(1) Male dogs (Figure 1-1): Catheter types include polypropylene, polyvinyl, and balloon-tipped ureteral catheters for use in humans. Softer catheters are chosen for indwelling urinary catheterization. A catheter size of 3.5 to 10 French (1 French unit = 0.33 mm) is recommended, depending on the size of animal. The appropriate length of catheter to insert is chosen by estimating the length from the exter...