Structure of the urinary organs
The kidneys are the organs that produce urine. They
- Filter the blood and remove waste products, toxins and various minerals via the urine.
- Regulate the body’s water balance: if a very large amount of water is present, more is excreted in the form of urine. When rather less water is available to the body, the kidneys are able to concentrate the urine very highly and excrete only the necessary minimum volume of liquid.
- Are important for acid-base balance and blood pressure control.
The urine formed by the kidneys is transported thence through the ureters to the bladder. Here it is collected and stored. When a certain degree of bladder filling is reached, the need to empty it (pass urine) increases. Although this is a reflex, it can normally be consciously controlled. The urine is then passed through the urethra.
Urological diseases can be diverse, ranging from infectious diseases (nephritis, cystitis) to malformations (ectopic ureters) to metabolic problems (urinary stones, diabetes insipidus). Tumours (urothelial cancer) or incontinence also occur. The latter can have both organic causes (genuine incontinence) and be of behavioural origin (loss of house training).
If a urological disease is suspected, the veterinary surgeon will take a detailed history, that is, he or she will ask you a lot of questions about your pet. Apart from the usual questions about the symptoms and their duration, they will ask you particularly about your pet’s eating and drinking habits as well as about how it is passing faeces and urine. The answers will suggest where the problem is coming from. Besides primary urological diseases such as cystitis, there are also secondary diseases such as poisoning or a shock situation. They influence the urinary system without arising there.
As in other areas of medicine, there is a variety of possible investigations and treatments in urology:
- Blood and especially urine tests are often done to find out the cause of the disease. Are the renal function tests in the blood altered? Are there bacteria, blood or crystals in the urine?
- The pelvic region is palpated. The bladder in particular can be felt. Is it full and bulging or slack and empty, does the animal show a pain reaction? All of this is evidence that is important for the vet. The urethra, penis and possibly the vagina are examined. The prostate can also be felt by a rectal examination.
- The bladder and kidneys can be shown well by ultrasound. Any urinary stones will be visible.
- An X-ray is also sometimes helpful in identifying the state especially of the bladder.
- If the urine has to be tested and the animal does not and perhaps cannot pass any urine because the urethra is blocked, an attempt can be made to obtain urine using a catheter. This means that a small plastic tube is passed through the urethra into the bladder. The bladder can also be reached through the abdominal wall: in a procedure known as cystocentesis, a fine needle is inserted into the bladder, naturally under sterile conditions. Urine can not only be obtained for testing, but the bladder can also be emptied if the urine is unable to drain out.
- Cystoscopy is the minimally invasive examination of the bladder by means of an endoscope.
- “Conservative” treatments are those that do not involve a surgical procedure. For instance, cystitis is treated with plenty of liquid and an antibiotic if needed.
- An attempt is made in breeding animals at least to anticipate urinary tract malformations by a breeding soundness examination beforehand.
- Urinary stones often pass into the urethra, causing severe pain and preventing passage of urine. If this has happened, an operation is usually necessary. If the stones are still in the bladder, on the other hand, they can often be dissolved with medicines or by a change of diet. In specialist practices, they can also be shattered by laser during cystoscopy.
- The treatment of incontinence can be a real challenge. As in all diseases, it is important to find out the exact cause so that appropriate treatment can be selected. If it is not a behavioural disorder, there are various possible surgical procedures that can abolish or at least improve incontinence due to an organic cause.
This list is naturally not exhaustive but it should give you an initial overview of possible urological problems and their treatments. Urological treatments can also be provided in clinics that specialise in urology. Apart from expertise in this area, these clinics have additional equipment that is often not available in other clinics. There are not many such clinics, however, so you may have to allow for a longer journey to get there.