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Lower urinary tract infections - Coggle Diagram
Lower urinary tract infections
objectives
Understand which clinical signs verify and localize disease to the lower urinary tract
Understand the clinical significance of localizing disease to the bladder and urethra
Recognize urethral obstruction
Determine the source of red urine
definitions
dysuria
difficult, painful, abnormal, painful
stranguria and pollakiuria observed
stranguria
slow, painful urination
taking longer to urinate
remaining in a voiding posture after urine has been evacuated
underlying mechanism
partial to complete outflow obstruction
inflammation
pollakuria
excessive frequent urine voiding
small urinary volume
reduced storage capacity
periuria
voiding urine in multiple locations
voiding inappropriately
urge incontinence
behavioral periuria
structurally normal
urinary obstruction
characterized by attempts to urinate
unable to pass urine
usually mechanical
uroliths
intraluminal occlusion
neoplasia
blood clots
extraluminal compression
sometimes funcitonal/neurologic
bladder displacement (perineal hernia)
intervertebral disc disease
steps to diagnosis
verify
important b/c
urethral obstruction CS often = wnon-obstructive dysuria
trying to unobstruct an animal w/o obstruction is awful
attempting manual expression of blocked animal is dangerous
:forbidden: diagnosing obstruction by catheterizing
unreliable
dangerous
assess bladder size
localize
rectal exam
urethra
pelvic canal
reflex evaluation
perineal
tail
hindlimb proprioception
palpation of perineum and distal urethra
abdo rads
retrograde/antegrade contrast urethography
disease process
biopsy
differentiate
neoplasia
granulomatous urethritis
special dynamic procedures
urethral pressure profilometry
voiding contrast cystourethography
hematuria timing
end of urination
focal lesion in ventral or ventrolateral aspect of urinary bladder
uroliths
polyps
intermittent renal hematuria
throughout urination
coagulopathies
disorders of
kidneys
ureters
diffuse bladder lesions
independent of urination
hemorrhage independent of urination
can be confused with hematuria
distal urethral dz
prostatic disease
vaginal disorders
initial hematuria
dz or urethra or genital tract
verifying and localizing bloody urine
occult blood dipstick
negative
dyes
food
drugs
positive
urine sediment exam RBCs?
No
hemoglobin
myoglobin
Yes
hematuria
lower UTI signs?
no
coagulation profile
2 more items...
yes
neoplasia
1 more item...
inflammation
3 more items...
infection
5 more items...
trauma
6 more items...
common presenting concerns and locations
outside of UT
rarely
asking to go out frequently
abrupt increase in voiding frequency
:forbidden:
leaking urine independent of voiding
straining to urinate
excessive licking/rubbing of perineum
biting/scratching/rubbing central flank
voiding in inappropriate location
genital tract
biting/scratching/rubbing central flank
asking to go out frequently
rarely
voiding in inappropriate location
leaking urine independent of voiding
abrupt increase in voiding frequency
straining to urinate
excessive licking/rubbing of perineum
lower UT
biting/scratching/rubbing central flank
asking to go out frequently
abrupt increase in voiding frequency
voiding in inappropriate location
straining to urinate
excessive licking/rubbing of perineum
leaking urine independent of voiding
upper UT
:forbidden:
abrupt increase in voiding frequency
voiding in inappropriate location
straining to urinate
excessive licking/rubbing of perineum
biting/scratching/rubbing central flank
asking to go out frequently
leaking urine independent of voiding
all can present with red/bloody urine