Objectives for the Urogenital System in Small Animal Medicine
Urogenital System
The primary objective of this course is for you to be able to apply basic
concepts you have already studied to the diagnosis of, treatment of and
determination of prognosis for diseases of the urogenital system. I advise
you to briefly review the gross anatomy and physiology of the urinary system
using previous veterinary class notes or standard text books prior to this
lecture series. Understand the processes of ultrafiltration, tubular
reabsorption, tubular secretion, and the counter current system. You will be
expected to know the following:
Functions of the kidney
Understand the diverse functions of the kidneys
Neonatal nephrology
Understand why the neonate is more susceptible to fluid imbalance than the
adult animal.
Diuretics
NOT COVERED IN CLASS
Know the general classes of diuretics, how each works and what side effects
may occur with their use. Understand the indications for and side effects of
diuretics in general.
Major concepts defined
Given a clinical scenario or laboratory data be able to differentiate
prerenal, renal and post renal azotemia, and ARF and CRF
Diagnosis of diseases of the urinary tract
This section should serve both as an introduction and as a review
after completion of the lecture series. Most of this information will be
presented again in another section. Understand the significance of renal
function tests. Be able to calculate values such as creatinine clearance,
fractional phosphate excretion, 24 hour protein, etc. if given the raw data
and the formulas. Also know what the results mean. Do not memorize formulas,
techniques or normal values.
Congenital diseases of the urinary tract
Know which diseases may be congenital and the most frequent breeds involved.
Acute renal failure
Understand how a patient may develop ARF, how to diagnose, treat and
determine the prognosis for a patient with ARF. Do not memorize drug doses.
Prevention of ARF
Understand the general measures that can be undertaken to reduce the
likelihood of a patient developing ARF.
Ethylene glycol Poisoning
Know the steps in ethylene glycol metabolism at which treatments are
directed. Know the clinical signs of E.G. intoxication. Know how to diagnose
E.G. poisoning and the importance of rapid diagnosis and treatment. Know
which drugs are used in treating E.G. poisoning, why they are used and what
their side effects are.
Chronic renal failure
Understand the pathogenesis of CRF and the factors which lead to its
development. Understand the metabolic derangements which may be present in
the patient with CRF. Be able to diagnosis, treat and determine the
prognosis for the patient with CRF.
Proteinuria
Understand how to determine if a proteinuria is significant. Know how to
quantitate urine protein. Know the sources of urine protein and the types of
proteinuria.
Glomerulopathy
Be able to give examples of diseases which may lead to GN. Understand how
circulating immune complex and anti GBM GN occur. Know the individual
clinical findings as well as the syndromes which may occur in a patient with
GN. Know how to diagnose, treat and determine prognosis for a patient with
GN.
Amyloidosis
Know the types of amyloid. Know the difference between amyloidosis in the
dog and cat. Be able to diagnose, treat and determine prognosis of a patient
with amyloidosis.
Polyuria/polydipsia
NOT COVERED IN CLASS
Be able to formulate a list of differential diagnoses for the patient with
PU/PD. This section is required reading.
Urinary Tract Trauma
Know which structures of the urinary system are most susceptible to trauma.
Neoplasia of the urinary tract
Know the common types, behavior of and prognosis for neoplasms of the
urinary system.
Miscellaneous disorders
Know the causes and signs of hydronephrosis. Understand the renal
manifestations of hypercalcemic states, which diseases may result in
hypercalcemia and how hypercalcemia is treated.
Urinary tract infection
Know which etiologic agents are frequently involved in lower urinary tract
infections and pyelonephritis. Understand the host defense mechanisms which
prevent UTI and how these mechanisms may be altered to result in UTI. Be
able to diagnose, treat and determine prognosis for the patient with lower
UTI and pyelonephritis.
Urolithiasis
Be able to diagnose, treat and determine prognosis for a patient with any
type of urolithiasis. Understand what factors predispose a patient to the
development of each type of calculus. Know which breeds and sex are most
likely to develop each type of calculus. Understand the rationale of
calculolytic diets.
Feline urologic syndrome
Understand that FUS (LUTD) is not one disease but a group of diseases with
heterogeneous causes. Know factors which might be contributory to the
development of FUS. Be able to diagnose, treat and determine prognosis for a
cat presented with signs of LUTD (obstructed or non-obstructed). Know the
frequently used prophylactic methods used to reduce frequency of recurrence
of FUS and their rationale.
Disorders of micturition
Understand the innervation of the bladder and the physiology of storage,
emptying and control of micturition. Be able to diagnose, treat and
determine prognosis for a patient with neurogenic or non neurogenic
incontinence. Understand the difference between UMN and LMN bladders.
Understand the types of drugs used to treat neurogenic incontinence by their
mechanism of action. For example, know that a cholinergic agonist will
increase tone of an atonic bladder. It is not necessary to memorize drug
names (i.e. bethanechol) although it will be helpful to know them at a later
date (in clinics and in practice). The article included in section 23 is
required reading: Frenier S & Dhein C: Uncovering the cause of urinary
incontinence in pets, Veterinary Medicine, May 1990, 500-508
Reproductive disorders:
female | male
The Genital tract disorders presented for both sexes are those most commonly
seen in a typical small animal practice. The following reference is an
excellent source of information on other reproductive tract disorders of the
dog and cat: Canine and Feline Endocrinology and Reproduction. Feldman and
Nelson (eds), Saunders.
You will be responsible for knowing the definition of medical terms used
in lecture and in the notes.
An online glossary is available
http://www.vetmed.wsu.edu/glossary/glossary.asp?c=17
Last Edited: Feb 14, 2008 10:58 AM
