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Urology/Nephrology

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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.

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.

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.

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.