Please enable JavaScript.

Coggle requires JavaScript to display documents.

Urinary Obsrtuction - Coggle Diagram

- - - - Organ displacement
        
        Bladder displacement
        
        Retroflexion (perineal rupture)
        
        Displacement (abdominal wall ruptures/pelvic fractures)
        
        Bladder torsion
      - Intra-urethral lesions
        
        Tumours
        
        Inflammatory disease (proliferative urethritis)
        
        Calculi
      - Extra-urethral
        
        Bladder masses
        
        Pelvic masses
        
        Prostatic disease
        
        Trauma
        
        Penile
        
        Pelvic
        
        Iatrogenic
        
        Perineal rupture repair
        
        Triple pelvic osteotomy (TPO)
    - - Reflex dyssynergia
        
        Rare condition, dogs>cats
        
        Dysuric
        
        No anatomic reason for obstruction
        
        Between detrusor contraction and urethral relaxation
        
        Medical management
  - - - UMN
        
        Firm, tense bladder that is difficult to express
        
        Lesions cranial to sacral nerve segments
        
        Intervertebral disc disease, tumours, luxations, fractures
      - LMN
        
        Flaccid, over-distended bladder that is easy to express, urine leakage
        
        Cauda equina syndrome
        
        Lumbo-sacral disease
        
        Vertebral fractures and dislocations
        
        Congenital (i.e., Manx cats)
- - - - Azotaemia (ONLY if bilateral)
    - - Primary
        
        Calculi
      - Secondary
        
        Trauma
- - - - Flush urethral calculi back into bladder
      - Removed via cystotomy/minimally invasive cytsotomy
      - Preferred method in male cats and dogs
      - If unable to pass catheter > cystocentesis (can't fill already distended bladder)
      - Bladder lavage with warm saline
      - Place indwelling catheter and closed collection system
  - - - Phenoxybenxamine
      - Prazosin
      - Tamsulosin
    - - Dantrolene
      - Diazepam
    - - Aid with hypokalaemia and post-obstructive diuresis
    - - Not always necessary; may worsen urethral spasm, never well tolerated
      - Ideally: soft and flexible, retained by sutures or inflatable bulb, placed aseptically, closed collection system
      - Antibiotics should NOT be used until catheter is removed (if at all)
    - - Hypokaemia
    - - Allows stabilisation of patient = effective relief of obstruction
      - Reduced hydrostatic pressure within bladder - facilitates catheterisation
      - Obstructed cats almost always have sterile urine > very low risk of septic peritonitis
      - May need to be repeated
    - - Does not alter potassium concentration
      - Stabilises myocardium + improves arrhythmias