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antibodies engineered with affinity for binding to a specific target, allowing a focused biological effect.
They are themselves foreign proteins, which can insight an immune reaction that destroys or mitigates the action of the therapeutic agent
Anaphylactic forebody reaction
Adverse reaction related to the biologic process of the targeted site
Vet = veterinary
mab = monoclonal antibody
Trade name = cytopint
Target = Interleuken 31
Treats allergy especially atopy
Antipruritic
works within 24 hrs
last 4 to 8 weeks
2nd injection more effective
Trade name = Librella
Target = canine nerve growth factor (NGF)
Treats canine osteoarthritis
Analgesis - inhibits pain neuro paths
Should have at least two doses. Monthly injections recommended
Pregnancy and lactation
pre-existing neuroloogic disease
breeding dogs
rapidly progressive osteoarthritis (RPOA)
Trade name = Solensia
Target = feline nerve growth factor (NGF)
Treats feline osteoarthritis
Analgesic - inhibitis pain neuro paths
contraindicated in cats that are pregnant, lactating, or breeding
Treat and prevent Parvovirus
Treatment = 0.2 ml.kg IV
Prevention = 0.1 ml kg SQ
Must extend legnth of immunization > Needs one or two more vaccines
No. It should be frozen,
immune checkpoint inhibitor.
Prevents tumor-induced suppression of T-cell responses and supports the immune system’s ability to fight cancer.
Cancer
Mast cell tumor
Melanoma
10 mg/kg IV as an IV infusion over 30 minutes; repeat every 2 weeks for up to 10 treatments.
Not great. A little
Diphenhydramine - ward off anaphylactic reaction
Emptied the anal sacs
Flushed anal sacs with physiologic saline
packed anal gland with antibiotic/steroid otic preparation.
Repeat every two weeks
butorphanol and dexmedetomidine
Anal sac abscessation, particularly cellulitis extending into surrounding tissues
Rupture with significant surrounding cellulitis
Marked tissue inflammation extending beyond the sac
Fever, lethargy, or other systemic signs
Immunocompromise or other circumstances that make local treatment less likely to succeed
Add fibre to diet
Weight reduction diet if dog is over weight?
Weight loss (if dog is overweight)
Keep the perianal hairs clipped short
Short, five minute warm soaks help. Place the dog butt in a bathtub of lukewarm water and have the dog sit.
Moderate exercise
5-HT3 receptor antagonist
amti emetic
anti nausea
Poor bioavailability.
Why --- extensive first-pass metabolism
Intravenous
Yes
peripheral 5-HT3 receptor antagonism within the GI tract
Maropitant (cerenia)
Metoclopramide (Reglan)
Ondansetron (Zofran) - very good anti nausea. Oncoloogist use this
Anticholinergics (e.g. atropine)
Antihistamines (diphenhydramine)
Phenothiazines (acepromazine)
475
Hypercalcemia
False
The overwhelming percentage of anal gland tumors are malignant
Anal sacculitis
Impacted anal gland
Anal gland abscess
Ruptured anal gland, abscess with cellulitis
lumbo sacral pain
Urethral mass
urethral stone
foreign material (sand, grass)
perineal hernia
Yes
Antech CADET BRAF offers a urine-based molecular test that looks for the canine BRAF mutation associated with urothelial carcinoma and prostatic carcinoma. It uses free-catch urine, making it noninvasive.
In most cases, I would NOT.
But I also believe that 75% of the dogs we see our big enough tolerant enough to do a rectal. It's a lot easier in most cases than doing a pedicure. (my opinion)
mirtazapine
capromorelin
cyproheptadine
Causes enhanced noradrenergic and serotonergic transmission.
Renal - sid > q2d
hepatic - sid to q2d or q3d
geriatric
Yes
Serotonin syndrome (especially when used together with other drugs that increase serotonin)
cutaneous contact reaction (with topicals)
0.6 mg/kg PO every 12 hours
Half-life is shorter in dogs than in cats.
.
Entyce
ghrelin-receptor agonist that causes the sensation of hunger and stimulates feeding behavior.
triggers pituitary release of growth hormone
hepatic release of insulin-like growth factor 1 (IGF-1), which reduces growth hormone
hypersalivation,
GI upset
abdominal discomfort
hypersalivation
GI upset
behavior changes (eg, lethargy, hiding)
transient decreases in heart rate and blood pressure, which may be clinically significant in older or debilitated cats.
Acromegaly
Diabetes mellitus
It must be given intravenously, which is not practical
Hepatic necrosis
Palliative care
They do increase appetite, but there are many side effects.
Rare
acquired
thin skin that easily tears following minimal trauma.
dermatologic emergency.
minimal bleeding
difficult to manage.
Demodex cati may be present.
Yes!!!!
Endocrinopathy
hyperadrenocorticism ± diabetes mellitus,
Iatrogenic (topical or systemic glucocorticoid, progestogens, phenytoin)
Infectious (FIP),inflammatory/infectious (cholangiohepatitis),
Metabolic (anorexia ± hepatic lipidosis),
Neoplastic (cholangiocarcinoma and multicentric lymphoma)
Sedation
Grave
Robert Jones is bigger, heavier, bulkier. It has more layers of cotten.
A modified Robert Jones has less cotton, but frequently uses a splint as additional support and to immobilize the injury
Primary - contact skin / wound
Secondary - soft, absorbent layer. Usually roll cotton and gauze
Tertiary - rubberized taoe to hold interior layers in place
It can damage the skin and lead to postoperative infection.
No. This can irritate the skin..
Best to cut the end near the toe tip and place a new stirrup over it.
Tourniquet effect
Slippage
Irritation / damage from unequal pressure
Cylindrical
Above the joint of interest
Usually above the stifle or elbow
movement in which a limb rotates so that the palm (or paw) faces upward/anteriorly.
Think - "holding a bowl of soup".
Six to eight
Distal to proximal
Place over ther conforming gauze.
To monitor for e xcessive swelling and discharge.
They tend to lose weight, particularly in the terminal stages.
Puppies with congenital heart issues do not thrive intend to be small
Right to left shunting
reverse patent ductus arteriosus,
atrial septal defect
ventricular septal defect
Caudal mucosa is cyanotic (not oxygenated)
Cranial mucosa is pink
Reverse patent ductus arteriosis
Dogs that get myxomatous mitral valve disease also tend to get tracheal disease. Most importantly, tracheal collapse.
30 breaths per minute
pulmonary edema - crackles
plueral fluid - muffled lung soounds
allergic bronchitis - wheezes
Stress and nervousness
aortic regurgitation
patent ductus arteriosus
severe bradycardia
hyperthyroidism
fever
anemia.
Tachycardia
fast atrial fibrillation
ventricular premature beats
Pulse deficits can occur with cardiac tachyarrhythmias in which beats occur so rapidly that the ventricle does not have time to fill with an adequate amount of blood before ejection
40% the circumference of the limb or tail
S1 - closing of mitral tricuspid valves
S2 - closing of aortic and pulmonic bounds
Dogs with chronic valvular disease
Vibrations that occur when chordae tendineae and the mitral leaflets suddenly resist further stretching and protrude into the left atrium
The heart rhythm is faster on inspiration and slower on expiration
The ventricles don't have time to fill
Less blood pumped into the arterial system
Smaller pulse
Aortic regurgitation
Pulmonic regurgitation
Mitral stenosis
Endocarditis
Patent ductus arteriosus (PDA)
The valve area at which the murmur is heard loudest
5/6
Change in blood viscosity, most commonly anemia
Ascites
Transconjunctival
Transpalpebral
Baloon pillow
Retrobulbar
splash block
irrigate gelfoam with lidocaine or bivipocaine
2 mm
Medial ocularis
excise conjuctiva with blunt dissection
cut muscular attachments
cuct optic nerve
No
Pack with gauze or gelfoam for three minutes
Gelfoam
Two
conjunctival
skin (cut eyelid margin)
Elizabethean collar for two weeks
Lameness – usually hind limb, but can be front limb
Pulmonary edema
A. Predisposed, but no evidence of cardiomyopathy
B1. Cardiomyopathy present, no clinical signs, low risk
B2. Cardiomyopathy present, no clinical signs, higher risk
C Current or previous CHF or ATE Has had a clinical complication, even if currently controlled
D Refractory CHF
clopidogrel or Plavix (18.75 mg/cat PO administered in the morning every 24 hours)
rivaroxaban or Xarelto (2.5 mg/cat PO administered in the evening every 24 hours)
rapamycin = sirolimus
Slows disease progression by targeting the underlying pathogenic mechanisms
cats with subclinical, nonobstructive hypertrophic cardiomyopathy.
Catsa that are NOT in CHF.
This is an opinion question.
But my experience, very few owners will keep a cat on medication's forever in which they feel the cat is doing well. So I totally agree with the recommendation. It is appropriate medicine. But my expectation is that the owner will not do this forever.
Rivaroxaban is a factor Xa inhibitor that prevents conversion of prothrombin to thrombin during the clotting cascade.
5 to 7 days
Radiography
B lines
plueral fluid
pericardial fluid
elevated left atrial filling pressue
Butorphanol
Concentric
The wall thickening is inward obliterating the left ventricular space. Importantly, this is not seen with radiography.
Vetmedin
Treat congestive heart failure in dogs
Stave off congestive heart failure
Hypertrophic cardiomyopathy
Basically anything that produces concentric hypertrophy. This can include aortic stenosis two
GI upset
Potential increased risk for arrhythmias
Calcium antagonists (eg, verapamil, diltiazem)
β antagonists (eg, propranolol, atenolol) can lessen pimobendan-induced increases in heart contractility
Yes
As an objective way of diagnosing cardiomegaly via thoracic radiography.
Once a year
Pelural fluid
Lateral is preferred
9.4 to 10.3
Boxer
bulldog (French and English)
Boston terrier
Cavalier King Charles spaniel
Labrador retriever
Pug
Pomeranian
Whippet
6.7-8.1
1. Using the calipers, measure the long axis of the heart from the carina to the apex of the heart at its most ventral point.
2. Starting at the cranial aspect of the fourth thoracic vertebrae (T4), transfer this measurement (ie, heart length) to extend caudally along the thoracic vertebrae.
3. Measure the heart at its widest point (ie, the short axis) perpendicular to the line drawn for long axis.
.
4. Starting at the same point on T4, transfer this measurement to extend caudally along the thoracic vertebrae at mid-body position and add the number of vertebrae it traverses
5. Add these two measurements. This is your VHS.
Hemivertebrae (common in Bulldogs)
Anemia
Pericardial fluid
<25 m. Hg
>50mm Hg
At >100 mm Hg they become severe and life-threatening
Exercise intolerance
Respiratory distress
Syncope
West Highland White carriers
They get pulmonary fibrosis
Left sided heart failure
Chronic pulmonary disease (fibrosis, bronchitis)
Heartworm disease
Polycythemia
Older dogs
Dogs living at high altitude - >6000 feet
Recognized more with widespread use of echocardiography
A split or, less commonly, loud S2
mild-to-moderate tachycardia.
Signs of right-sided heart failure (eg, jugular venous distension, hepatomegaly, ascites).
Speed (m/sec) of the tricuspid or pulmonary regurgitant jet and calculation of PAP using Bournulli equation.
Paradoxical septal motion
enlarged right heart
volume-underloaded (small) left heart.
.
Laboratory testing is typically unremarkable
Evaluate lung parenchyma
Determine if pulmonary thromboembolism is present.
Evaluate liver for hepatic Venus congestion, which is suggestive right sided heart failure
Search for other conditions
Oxygen
sildenafil (1-3 mg/kg orally 2 to 3 times a day)
Volume overload of the right side of the heart
Furosemide
Nitrates (Nitroglycerin) - may lower systemic blood pressure without adequately reducing pulmonary vascular resistance.
Poor
Pulmonary hypertension is relentless and ultimately proves fatal.
Exercise restriction
Carry small dogs up and downstairs
Supplemental oxygen - easy for people. Not so easy for dogs.
erythema
salivary staining - ruust colored
Endocrine (Hypothyroid)
Demodex
Pyoderma
Atopy
Pododermatitis - presumably, the dog is allergic to something it's walking on like grass or carpet
onset
severity of pruritus
whether pruritus preceded lesion development,
seasonality
indoor/outdoor lifestyle
ectoparasite prevention status for all animals in the home
whether any other animals or humans in the home have similar lesion
concurrent medications
known diseases
travel history
dietary history.
Aspirate and cytology
abnormal thickening of the skin’s outer layer (epidermis)
Break the itch cycle
Take care of infection
Barrier - physically prevent dog from self mutilation
Psychogenic - address compulsive disorder with appropriate drugs
Visualize bacteria and fungi,
Yes
Yes
No
Mixed - both expiratory and inspiratory
I would've done these. First of all it's part of routine wellness care. Secondly you generally get the results faster than with bronchoalveloar lavage with interpretation.. At least this is the case with most primary care facilities
Urine antigen test
Itraconazole 5mg/kg sid x 2 to 6 months
In cases with severe respiratory distress, it decreases inflammation, making it easier for the lungs to function. However, the steroid, usually prednisalone, should be taper rapidly
Hepatoxicity
I always like to get three views of the chest on initial radiographic examination. However, I'm not so strict when it comes to monitoring, to see if things are improving. In this case, I think one view would've sufficed. I would've chosen VD.
Off the record suggestion: when it comes to radiographic monitoring, you could take three views, but only charge for one. With Digital radiography it's not that hard.
Viral
Bacterial
Infectious pneumonia
Non-infectious pneumonia
Neoplasia
Interstitial disease
Pulmonary edema
Pulmonary thromboembolism
Neurological involvement
Ocular involvement
Who has better penetration to these anatomic sites?
Every three months
50%
local lymph nodes
Lungs
> 80%
One side at a time. Give 2 to 4 weeks for this to heal and do the other side..
Doing both at the same time result in difficult heal (excessive tension on neutral line), Pain, and respiratory distress
Yes
Humane - animal welfare
improve immune function and limit tumor spread
Bupivacaine liposome injectable suspension along incision
All tissue should be removed down to the rectus fascia
The rectus fascia and muscle should not be removed.
An elliptical incision is made from the most cranial nipple to the most caudal nipple so that the medial extent of the ellipse is at midline and the lateral extent of the incision is equidistant on the lateral side of the nipple line
It will pick up ready loosen stones, like cysteine and urates that will be missed by radiography.
recurrent episodes of idiopathic urethral obstructions,
caudal urethral strictures
obstructive uroliths that cannot be retropulsed (blocked cat)
Pelural fluid
anastomosis of the naturally wider postprostatic portion of the urethra to the skin to make a new urinary stoma.
Reduces the risk for recurrent urethral obstructions
most cats have an excellent quality of life postoperatively
Bulbourethral glands
Located it on either side of the urethra on the dorsal aspect
ventral penile ligament
ischiocavernosus muscles
retractor penis muscle
Once these are dissected way, the urethra can be pulled out much more easily
Insert 1 blade of an iris scissors into the urethral opening, and cut on the dorsal midline cranially to the level of the bulbourethral glands. This is a longitudinal cut.
If a catheter is inserted into the urethra, a scalp plate can be used to in size
Take bites of the urethral mucosa that are less than one-third of the diameter of the urethra.
Use cotton-tipped applicator to gently remove any blood
Use small needle holders (eg, Castreviejo, Derf) for suturing.
If grasping urethral mucosa directly, use fine tissue forceps (eg, DeBakey).
Stricture (5%-12%)
bacterial UTIs (23%)
No. And I only keep some from getting obstructed.
A lot - 68.4%
The complication is 3.42 times that with just soft material
Monitor very close
Clients frequently like bandaging or splints as an option because it is less expensive and perceived as less invasive.
Not very. Symptomatic treatment is essentially the same, and the vast majority of cases resolve.
I often consider acute diarrhea, a human social disease. People don't like it, particularly if they have company coming over. But more often than not - the dogs can care less.
Concern for salicylate intoxication
Effect on the intestinal mucusal border
Usually not.
The only exception is in cases of sepsis, which is rare, and the dog would be very sick
Spread meals out
Highly digestible, low fiber
Moderate fiber
Probiotics and probiotics added
Veterinary Oral Health Council (VOHC)
Products that meet preset standards of plaque and/or tartar control in dogs and cats. Basically a seal of approval determined by experts qua;ified tyo make this call.
Two. And they must be done by independent groups.
No. It just means it hasn't proven itself yet.
No. Periodontal disease is relentless. Diligent home care will slow down the destructive periodontal process, but it will not stop it. Nothing will.
Friction points
No
C reactive protein
Nondegenerate neutrophils
sparse, mixed, mostly free (rather than phagocytosed) bacteria within a granular eosinophilic background.
No acantholytic keratinocytes were found.
High-dose glucocorticoids and mycophenolate mofetil
To protect the gut from anticipated side effects of the immunotherapy
Male
medetomidine and vatinoxan hydrochlorides injection
sedative and analgesic in dogs
alpha 2 agonist-antagonist
medetomidine alpha 2 agonist that crossed blood brain barrier
vatinoxan - alpha 2 antagonist that crossed blood NOT brain barrier
Antisedan - atipamezole HCL
• Zenalpha® has a shorter time to onset (5-15 mins) and a shorter duration of sedation in most dogs
• Patients recover more rapidly
• There is minimal vomiting with Zenalpha®
• Zenalpha® resulted in fewer severe cardiovascular side effects
cardiac disease
respiratory disorders,
shock
severe debilitation
hypoglycemia
stressed due to extreme heat, cold or fatigue.
1.6 ml IM
Xylazine (Rompun)
Dexmedetomidine (Dextomidor)
• Radiographic examination
• Diagnostic imaging
• Ear examination and treatment
• Eye examination and treatment
• Dermatological examination
and procedures
• Dental examination
• Dental biopsy
• Minor tooth extraction
• Nail trimming
Fine needle aspiration/
superficial biopsy
• Anal sac treatment
• Minor surgery to remove
dermal masses
• Seroma or abscess drainage
• Intravenous catheter placement
• Coat grooming
• Venous blood
https://www.youtube.com/watch?v=hOIV200BivM
Dog has ancestry from multiple different breeds, but the amount of DNA inherited from those breeds is very small - small that it can no longer be confidently assigned to any one particular breed.
Yes
Genetic ancestry and purebred status are two different things.
No
Genetic predisposition is not the same as pre-existing condition
By measuring their DNA methylation
Fecal
DNA sequencing of the bacteria in the feces to characterize the intestinal microbiome and compare it with their healthy-dog reference population.
No. The veterinary report is more detailed and provides information for which action can be taken or at least suggested.
Approximately three (3) out of four (4) dogs will have a notable result or be carriers of a genetic disease and roughly one (1) in four (4) dogs will be at an increased risk for a genetic disease.
Genetic testing has the potential to let you know about a disease risk before symptoms arise which blood work cannot do.
For New York
Embark result saying a dog is partly or predominantly American Pit Bull Terrier cannot, by itself, be used by a homeowners insurer to deny, cancel, nonrenew, or increase the premium for the policy.
No. We want to get a sample of the dogs DNA not the DNA that might be in the treat. The dog should eat. Nothing for 30 minutes prior to the test.
Up to eight weeks for the health check.
Addisons disease
zona reticularis (inner)
zona glomerulosa (outer zone)
zona fasiculata (middle)
Yes
Glucocorticoid secretion is absent but serum sodium concentration ([Na]) and potassium concentration ([K]) are normal prsumably indicating sufficient aldosterone.
Mitotane -- o,p′-DDD (mitotane)
Vetoryl -- (trilostane)
pituitary or hypothalamic failure which can lead to impaired secretion of pituitary adrenocorticotropic hormone (ACTH) or hypothalamic corticotropin-releasing hormone (CRH).
Female
Young to middle age.
Weakness
Anorexia
Weight loss
Vomiting
Diarrhea
collapse
PU/PD
dehydration
hypotension
bradycardia
weak pulses
weakness
underweight body condition
abdominal pain
hypovolemic or hypotensive shock
ACTH response test
Lymphocyte > 2.0
High eosinophils
Higj neutrophils
Azotemia
Hyperkalemia
'Hypokaelima
Hypochloremia
Acidemia
Hypercalcemia
ALP and AST elevation
High urine Na drags water with it
Reduced kidney Na gradient
Microcardia - due to hypovolemia
Bradycardia
PR prolongation
absent p waves
wide QRS complexes
Take a blood sample (T = 0 hr)
Administer cortrosyn (ACTH) IM or IV is ok. SQ is not good in a dehydrated animal.
Take post cortrosym sample in 1 hr
Up to 6 months
Addison = No response or minimal response to ACTH injection
Normal - cortisol >2 mcg/dL (>55 nmol/L)
A single value above 2 mcg/dL (>55 nmol/L) rules out Addison
IV fluids
Note: animals can be severely dehydrated, which makes IV catheterization challenging
0.9% saline
Best to avoid any solution that has potassium
Fatal osmotic fluid shifts in brain
Glucose causes the release of insulin. Insulin drives extracellular potassium into cells.
The serum potassium levels normalize, and this improves the arrhythmia
At last 24 hours. Easy to make adjustments.
Start at a high dose (0.5mg/kg bid) and rapidly lower it to a physiologic dose (0.1-0.2 mg/kg q12-24h).
Once maintenance dose is reached (my opinion 10 days) instruct the owner that the dose should be increased when encountering stressful events (travel, thunderstorms, vistors, etc.)
Use clinical signs of steroid excess to help guide prednisone dosage
1.5mg / Kg by SQ injection once a month.
28-30
Yes - grest fun.
You take an animal that is really sick and going to die and fix him or her essentially back to normal
Pyometra (my favorite)
Dog or cat choking from obstruction so long as you remove obstruction in time
Feline infectious peritonitis (FIP)
Tick born diseases because they usually respppond rapindly to treatment
Removing a sticks lodged between the upper dental arcade. I was encoutered a dog screaming in pain that was rushed into my veterinary hospital. I noticed the dog had such a stick losgeed in his mouth. I grabbed a hemostat and was able to remove the stick. The dog immediately felt better and started licking my face. The people in the waiting room startd to applaud. I can't remember if I got paid.
Others
Antivirals > nucleoside analogues
Remdesivir — a prodrug of GS-441524
HE GRADE CLINICAL SIGNS
0 Asymptomatic
I Mild decrease in mobility, apathy or both
II Severe apathy, mild ataxia
III Combination of hypersalivation, severe ataxia, head pressing, blindness, circling
IV Stupor/coma, seizures
Yes
2 hrs after a meal (especially high protein)
No - it remains a clinical diagnosis.
Intestine - enterocytes using amino acids especially glutamine
intestinal microbiome
Liver - converts ammonia to urea
Kidneys - eliminate ammonia through the urine
Yes
False - inflammation does play a role in producing clinical signs
No - they are elevated
Surgery if possible as in PSS.
In case cases due to hepatic parenchymal disease we need to do medical treatment.
If hypoglycemic give dextrose
If infection or inflammation, give appropriate antibiotics (e.g. UTI)
Enema to get rid of ammonia producing bacteria
Bad idea. Lactate is metabolized but liver, and we want to avoid having to use the liver.
Lead to short-chain fatty acids (SCFAs)
SCFAs favors more bacteria that utilize ammonia.
SCFAs can acidify colonic content, trap ammonia as non-absorbable NH4+, and provide an ammonia “sink.”
SCFAs act as osmotic laxatives, speeding removal of trapped ammonia, urease-producing bacteria, and nitrogen present in colonic content and in bacterial protein.
Pre hepatic
Post hepatic
Hepatic
pre-sinuoidal, sinusoidal, or post-sinusoidal
Increase portal, hypertension
Overall increase in systemic vascular volume because of alterations in the renin aldosterone system
Hypoalbuminemia associated with liver failure
Aldosterone
Furosemide
Abdominocentesis
Yes
There can be both hemorrhage and thrombosis. Thrombosis occurs more often than hemorrhage, particularly in chronic cases.
platelets <50,000 mcL
PT or aPTT >1.5 times upper limit
fibrinogen <100 mg/dL (<1 g/L),
vWF activity <50%,
BMBT >5 minutes
PCV <30% is also “high risk” due to the effect of anemia on platelet function and decreased resilience against hemodynamic instability if there is hemorrhage.
Fresh frozen plasma
Anemia - especially acute
Complete Valerie obstruction.
Occurs because there's no bilirubin moving to the intestine that would otherwise be converted to the brown pigment stercobilinogen.
Training Title 3
Short description
Benign prostatic hyperplasia
Prostatic cyst
Prostatiic abscess
Prostatitis
Prostatic metaplasia
Prostatic Neoplasia
Better internal images
Easier to see regional lymph nodes
Easy to see fluid pockets
Empty bowel - NPO for 12 hours. Let dog defecate before exam..
Full urinary bladder, which access a landmark and acoustic window. Don't walk dog before examination.
In real practice, it may be difficult to tell the dog to defecate but not urinate
Yes
CT - faster than MRI. Less expensive.
MRI - better image quality (but not by much). Takes longer.
Semen collection
Prostatic massage
Traumatic urethral catheterization
FNA
Biopsy
Third fraction
The second.
Digitail rectal palpation
Yes
Seeding tissue with bacteria orneoplastic cells
1. With an empty bladder, perform a sterile catheterization.
2. Flush the urinary bladder with sterile saline.
3. Aspirate it back to obtain the first sample
4. Retract the catheter to the level of the membranous urethra, guided by rectal palpation. Perform transrectal prostatic massage for about 1 minute.
5. Occlude the urethral orifice and slowly inject the second sterile saline to wash the urethra.
6. Advance the catheter into the bladder and aspirate the fluid back to obtain the second sample
To visualize and avoid the urethra
Training Title 3
Short description