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Cases Week 7

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Is the inability to urinate an emergency or should you tell Ms. Burd to continue to monitor Noodle for the rest of the day? - answer--Inability to urinate is an emergency and should be treated right away What does BUN stand for? What organ does a BUN test evaluate? - answer--BUN is Blood Urea Nitrogen - product of protein metabolism filtered out by kidneys. When glomerular filtration rate is decreased or urinary tract is obstructed, urea nitrogen will build up in blood stream. Kidneys are unable to fully filter out urea nitrogen out of the vascular system causing BUN levels to decrease. What other blood chemistry values may be altered in a patient with a urethral blockage, especially with longer-term blockage? - answer--It is important to monitor blood pH; potassium levels of many animals with urethral blockages will become hyperchloremic and acidotic which can be life threatening. What is urohydropulsion? - answer--Procedure used to clear urethra of foreign materials in male dogs. Urinary catheter is inserted and fluids injected into urethra while prepuce is closed shut. Urethra caudal to obstruction is also held shut rectally allowing fluid to expand urethra and hopefully flush the stone backwards into the urinary bladder. Why would cystocentesis be the best method to collect urine and partially empty Noodle's bladder? - answer--Cystocentesis is best method to collect urine. Noo

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Cases Week 7
Is the inability to urinate an emergency or should you tell Ms. Burd to continue to monitor Noodle for
the rest of the day? - answer--Inability to urinate is an emergency and should be treated right away



What does BUN stand for? What organ does a BUN test evaluate? - answer--BUN is Blood Urea Nitrogen
- product of protein metabolism filtered out by kidneys. When glomerular filtration rate is decreased or
urinary tract is obstructed, urea nitrogen will build up in blood stream. Kidneys are unable to fully filter
out urea nitrogen out of the vascular system causing BUN levels to decrease.



What other blood chemistry values may be altered in a patient with a urethral blockage, especially with
longer-term blockage? - answer--It is important to monitor blood pH; potassium levels of many animals
with urethral blockages will become hyperchloremic and acidotic which can be life threatening.



What is urohydropulsion? - answer--Procedure used to clear urethra of foreign materials in male dogs.
Urinary catheter is inserted and fluids injected into urethra while prepuce is closed shut. Urethra caudal
to obstruction is also held shut rectally allowing fluid to expand urethra and hopefully flush the stone
backwards into the urinary bladder.



Why would cystocentesis be the best method to collect urine and partially empty Noodle's bladder? -
answer--Cystocentesis is best method to collect urine. Noodle is blocked so catheters, free catch, and
expression are not viable. Cystocentesis will allow for emptying of the bladder and urine sample
collection.



Why should urine collection be done before starting urohydropulsion? - answer--After urohydropulsion,
bladder will have saline and lubricants in it which would alter the results of the urinalysis rendering
findings invalid.



What equipment is needed to perform urohydropulsion? - answer--Urohydropulsion requires urinary
catheter, large syringe with a catheter tip, sterile saline, exam glove, and lubricant. Ideally largest
urinary catheter possible is used because a tight fit is best for this procedure.

, Cases Week 7
Is this USG within normal range? What is the proper method for preparing a urine sample for a
microscopic sediment examination? - answer--Is slightly higher than average USG but still in the normal
range. To prepare urine sample for sediment you would take the urine and place into centrifuge tube
and centrifuge for 3-5 minutes and drop off most of the supernatant and leave ½ to 1 mL in the
centrifuge tube then suspend sediment in the fluid by flicking the tube carefully or mixing with a pipette.
Drop of mixed liquid is transported to a microscope slide and evaluated. Stain can be added if desired
and a cover slip is placed over the liquid.



What is a benefit of using a stain when examining urine sediment? What are some problems that are
associated with staining urine sediment? - answer--Staining urine sediment can improve differentiation
between cell types, however, it can introduce artifacts like bacteria or other precipitate material.



What are some other names for struvite crystals? Describe the appearance of struvite crystals. - answer-
-Struvite are frequently called triple phosphate or magnesium ammonium phosphate. Resemble coffin
lids and are generally 6-8 sided prisms with tapered sides.



Is Noodle's acidic, neutral, or alkaline? How does diet affect urine pH? - answer--Slightly alkaline;
alkaline urine most common in animals who have plant material based diet and acidic is mostly
commonly seen in animals with a meat or animal based diet. Omnivores can have neutral, acidic, or
neutral urine.



Name two crystals that form in acidic urine, two in alkaline urine, and two that form in varying pH. Give
descriptions of each of the crystal's microscopic appearance. - answer--Acidic Only

1) Amorphous urates: granular precipitate

2) Uric acid: many different shapes but usually rhomboid or diamond. Are yellow to yellow brown in
color.

3) Leucine: yellow or brown. Pin cushion or wheel shaped.

4) Tyrosine: dark refractive needle projections; clustered.

5) Cystine: thin, flat hexagons

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