“UR in Luck”  Practical Updates in Kidney & Lower Urinary Tract Medicine.

Lecture 1.  Updates on the diagnosis and treatment options for IRIS Stage 1-2 Chronic Kidney Disease in dogs and cat.

Objectives.

To review the differences and possible causes and ramifications of chronic kidney disease (CKD) in cats vs dogs.

To discuss the use of established and newer tests to detect early CKD. 

To review diet and drug management in patients with early IRIS 1-2 CKD.

• Has SDMA  or AI become the preferred means of diagnosing CKD? 
• When and how should urine protein screening be used in geriatric patients? 
• When should a therapeutic renal diet be started in CKD patients? 
• Antihypertensive and antiproteinuric therapy preference – amlodipine, ACE-Is or ARBs? 
• When is immunosuppressive therapy indicated in dogs with PLN?
• When to consider vitamin D, calcium and PTH management in CKD?

Lecture 2.  Updates on treatment recommendations for IRIS Stage 3-4 Chronic Kidney Disease in dogs and cat.

Objectives.

To review and learn how to manage the common clinical issues associated with advancing (IRIS 3-4) chronic kidney disease.

To understand which drug, supplements and diet choices are most likely to improve life quality in CKD patients.

• This dog/cat doesn’t like the oral phosphorus binder.  How important is this drug and what are my choices? 
• Appropriate use of erythropoeitin analogs in anemic CKD patients. 
• Appropriate use of fluid therapy, antiemetics, antacids and appetite stimulants in hyporexic CKD patients. 

Lecture 3 and 4.  Updates on the diagnosis, rational antibiotic treatment and  prevention strategies of Bacterial Urinary Tract Infections in dogs and cats.

Objectives.

To discuss current diagnostic recommendations for examination of urine.

To review and distinguish the differences between bacterial urinary tract infection and subclinical bacteriuria.

To update current recommendations on the treatment of subclinical bacteriuria, sporadic and chronic recurrent urinary tract infections.

To review specific antibiotics used in the treatment of bacterial urinary tract infections. To discuss strategies to prevent reoccurrence of bacterial urinary tract infections.

• What is “asymptomatic” bacteriuria and why is it important?
• What are the preferred antibiotics, treatment length and follow up in uncomplicated UTI patients?
• How do I select an appropriate antibiotic in recurrent UTI patients? 
• What follow-up testing is recommended in monitoring UTI treatment success? 
• What predisposing disorders should I look for in patients with recurrent UTI?
• What prevention strategies should be considered for recurrent UTI? 
• Is oral cranberry effective? What about other drugs or supplements? 
• Does improving vulvar and vaginal health help reduce female UTIs?
• Feline bacterial UTIs  and pyelonephritis – is the approach different compared to dogs?

Lecture 5.  Lower Urinary Tract Potpourri  : Brief updates on Urinary Incontinence, FLUTD and Calcium Oxalate Uroliths.

Objectives.

To review accepted treatment options and introduce newer treatments for involuntary urinary incontinence in dogs.

To update current recommendations regarding diet, drug and environmental modification for cats with feline lower urinary tract disease.

To update diet, drug and additional treatment considerations for the specific management of calcium oxalate uroliths in dogs and cats.

Lower Urinary Tract Disorders

• How to use phenylpropanolamine in urinary incontinence management.
• How to use estrogen compounds in urinary incontinence management.
• When to consider collagen bulking agent therapy in urinary incontinence.
• When to consider surgical treatment in urinary incontinence management.
• Feline Interstitial Cystitis – is it a struvite-related or stress-related disease?
• Which works best in preventing FLUTD  reoccurrence – prescription urinary diets,
       environmental modifications or drugs ?
• Struvite stones can be dissolved but how do I get rid of those pesky Calcium
       Oxalate stones ?