Urology/Nephrology

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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.

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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.

It's not enough to take radiographs if you don't take the views that you need to provide essential information. A series of radiographs will be reviewed that demonstrate the pitfall of omitting key information. Other examples of omission of key information will also be examined.