Prolonged Urethral Obstruction

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Prolonged Urethral Obstruction

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Kidney Ureter and Bladder
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Urinary System

• Upper urinary tract
• Kidney
• Ureter
• Lower urinary tract
• Urinary bladder
• Urethra

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Renal process

• Filtration
• Reabsorption
• Secretion

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Filtration
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Glomerular Filtration
Glomerilar hydrostatic pressureCapsular
hydrostatic pressureGlomerular osmotic pressure
Glomerular Filtration Rate
The total of filtrate formed by the kidney
perminite

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Glomerular Filtration
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Ion transport
Blood vessel
K
Na
Tight junction
glucose
Tubular lumen
Interstitial tissue
Tubular cell
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Proximal Convoluted Tubule
K
Na
glucose
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Ion transport
Na
glucose
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Ion transport
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Thin Descending Loop of Henle
Na
H2O
Tubular lumen
Interstitial tissue
Interstitial tissue
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Ascending loop of Henle and early Distal
Convoluted Tubule
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Ascending loop of Henle and early Distal
Convoluted Tubule
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Ascending loop of Henle and early Distal
Convoluted Tubule
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Late Distal Convoluted Tubule and Collecting Duct
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Late Distal Convoluted Tubule and Collecting Duct
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Late Distal Convoluted Tubule and Collecting Duct
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Late Distal Convoluted Tubule and Collecting Duct
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Micturition
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Micturition
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Causes of urethral obstruction

• Congenital
• Acquired
• Intrinsic
• Extrinsic

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Case study

• Title Prolonged urethral obstruction
• Signalment 2 year-old castrated male domestic
  shorthair cat, 4 kg.
• Chief complaint collapse, unresponsive
• History lethargic, anorexic, bradycardic,
  hypothermic, dehydrate, mucous membranes were dry
  but pink, capillary refill time was prolonged,
  turgid bladder

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????????????????????? blood gas
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Interpretation

• Dehydrate
• Metabolic acidosis
• Hyperkalemia
• Hypochloremia
• Hyperphosphatemia
• Hypocalcemia
• Azotemia
• Collapse

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Hyperkalemia
acidosis
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Hypochloremia
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Hyperphosphatemia and hypocalcemia
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Hyperphosphatemia and hypocalcemia
Glomerular filtration rate
Elimination of phosphorus
plasma phosphorus
Metabolism of vitamin D
Gastrointestinal Absorption of calcium
plasma calcium
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Urethral obstruction
urine in urinary bladder
hydrostatic pressure in proximal tubule lumen
urine production
efferent arteriole vasoconstriction
glomerular capillary hydrostatic pressure
glomerular capillary oncotic pressure
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glomerular capillary oncotic pressure
GFR
uremia
Postrenal azotemia
Acute renal failure
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Acute renal failure
Inability to regulate electrolytes
acid retention
collapse

• Hypocalcemia
• Hypochloremia
• Hyperphosphatemia
• Hyperkalemia

metabolic acidosis
high plasmaPco2
respiratory acidosis
mixed acidosis
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Mixed metabolic acidosis and respiratory acidosis
postrenal uremia
semicomatose
metabolic acidosis
Impaired ventilation
Respiratory acidosis
Mix metabolic acidosis and respiratory acidosis
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treatment

• for temporary relief of obstruction.
• Corrected acid-base disorder
• Corrected dehydration condition

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Retrograde urohydropropulsion of urethral calculi
in male cat for temporary relief of obstruction.
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Retrograde urohydropropulsion of urethral calculi
in male dog for temporary relief of
obstruction. From Osborne CA et al. Vet Clin No
Amer 29267, 1999.
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