Urology/Nephrology

Don't fall prey to 6 oft-repeated urinalysis myths.

It's not a glamorous title, but polishing your communication skills can help attract business from clients whose cats experience litter box problems.

Direct visualization of the lower urinary tract can be important for the diagnosis and treatment of many disease processes. Evaluation of the urinary bladder, ureters, and proximal urethra is possible via surgical exploration; however uroendoscopy is a minimally-invasive technique which allows assessment of the lower urinary and distal reproductive tract.

Recurrent and resistant urinary tract infections (UTIs) are among some of the most frustrating challenges veterinarians tackle in small animal practice.

There are many misconceptions regarding the significance of crystals found on routine urine sediment examination in dogs and cats. There is a large amount of information about the impact of diet, water intake, urine handling, breed, and many other possible contributing factors on the formation of crystals and stones.

Protein in the urine, particularly when it is of renal origin, can be an indicator of renal damage, and has been found to be associated with progression of renal disease. There are several reasons that protein can enter the urine, through a damaged glomerulus, through lack of reuptake by tubular epithelial cells, and through exudation into the tubular lumen.

One of the simplest and most cost effective diagnostic tools is at our disposal every day in practice, however we often overlook it and the large amount of data that it provides us. Urinalysis, including fresh sediment examination, can provide additional important information that complements and enhances the diagnostic information we gain from other diagnostic modalities such as serum chemistry, CBC, and the all-important physical examination.

Dogs and cats frequently present for signs related to the urinary tract. These signs may be due to inappropriate urination (house soiling or urinary incontinence) or may relate to the act of voiding itself.

Urinary incontinence is a common problem affecting up to 20% of spayed female dogs and 30% of those > 20 kg. In most of these patients it occurs within 3 years of spaying, although in many it may not become a major problem until later in life when it can be complicated by diseases that increase water intake and urine production.

Most cats with kidney uroliths have no clinical signs.

Urolith in the urethra, most commonly composed of calcium oxalate.

Dr. Valarie Tynes helps a client with a dog that has an unusual habit when visiting friends.

Why did this type of urolith increased in occurrence from 2003 to 2007?

You're taking "BizQuiz: Should you share this gossip?" Good luck!

This is an answer in "BizQuiz: Should you share this gossip?"

Can you solve the problem behind this dog's frustrating behavior in this interactive case?

Why some uroliths have more than one mineral type.

How reliable are bilirubin reagent pads in dogs and cats?

A Q&A with nephrology and veterinary urology specialist Jody Lulich

Study results indicate possible need for testing in these patients.

I had several banana split containers, so I brought the extras to the hospital to be used for urine collection.

In dogs, leptospirosis most commonly results in acute renal failure (ARF) with or without concurrent (or subsequent) hepatic disease. Although leptospirosis can cause ARF along with acute liver disease (or liver failure), ARF without liver disease has become the most common clinical presentation of the predominant serovars of leptospirosis affecting dogs in the US.

Diagnosis and management of the majority of cases are routine; however, treatment of refractory urinary incontinence cases are frustrating for both the veterinarian and owner. The diagnostic approach to dogs with refractory urinary incontinence should include a thorough history (drugs, age of onset, and timing during the day of incontinence), physical examination (including rectal and neurologic examination), serum biochemistry profile, urinalysis, urine culture, abdominal radiographs and ultrasonography.

Recurrent urinary tract infections (UTI) are a common problem in dogs. There are 2 major types of UTI recurrence: relapse and reinfection. The implications of relapse versus reinfection are important for diagnosis and management of recurrent UTI. Relapses are defined as UTI recurrence of the same species and serologic strain of microorganisms within several weeks of withdrawal of therapy.

Nephroliths are uroliths (calculi) located in the renal pelvis and/or collecting diverticula of the kidney and ureteroliths are calculi located in the ureter. Although only 5 to 7% of all feline uroliths submitted to stone centers for analysis are nephroliths, the true incidence of nephroliths may be higher because many animals with nephroliths are asymptomatic.

Chronic kidney disease (CKD) is the term used to replace the older terms of chronic renal failure and renal insufficiency. This recognizes that CKD has a spectrum of severity from asymptomatic kidney disease to end stage uremia. Although CKD tends to be stable over the short term, it tends to progress to end-stage renal failure over months to years in most animals with CKD.

Successful treatment of complicated urinary tract infections (UTI) requires adjustments to be made in the typical therapeutic plan for UTIs. Identification of complicated UTIs and other urinary tract-related circumstances requiring special therapeutic considerations will be reviewed.

Although standard, mainstream, accepted therapy should always play a prominent role in treating patient problems, alternative therapeutic approaches can be valuable as adjunctive treatment options. Chronic or recurring urinary tract disease may benefit from alternative treatment options as discussed below.

Urolithiasis is common in the cat, causing morbidity and, occasionally, mortality. Diagnosis is based on clinical signs, imaging, gross physical characteristics of the uroliths, and quantitative analysis of the urolith.

One of the common clinical scenarios that may present a diagnostic challenge is dogs or cats with urine retention without an obvious cause. The fundamental question in these cases is: "Does this patient have functional urinary retention or mechanical urinary obstruction?"