21. Equine Hematuria Flashcards
What is hematuria?
Blood in the urine
What is the difference between microsopic and macroscopic hematuria?
Amount of blood in urine
Where can blood originate that is found in the urine?
Kidney, bladder, urethra, ureters
What is the normal amount of blood in the urine?
5000RBC/ml (2000-10000/ml
-Can’t see grossly
Less than 5 RBC/hpf on sediment
Negative on dipstick
What is the numerical definition of microscopic hematuria?
Increase RBC (10,000-2.5 million/ml urine
-Cant see gross
>10RBC/hpf on sediment
3+ trace dipstick
What is the numerical definition of macroscopic hematuria?
RBC 2.5-5 million/ml urine
-Can seen gross
-RBC pellet and clearing of supernatant after centrifugation
Timing of blood in the urine may help to localize the lesion:
Beginning:
End:
Throughout:
Beginning: Distal urethra
End: Proximal urethra or bladder
Throughout: Kidney, ureter or bladder
How do you know if you have urethral hematuria and what are some causes of it?
Bleeding at the beginning or urination
Neoplasia
calculus
rents
harbornemiasis
What types of tumors like the distal urethra and external genitalia?
SSC, fibrosarcoma, sarcoid, papilloma
What is the most common neoplasm of the penis?
SSC
-depigmentation, ulceration, foul odor and discharge
-Diagnose with biopsy
-Treatment - surgical removal, hyperthermia, 5FU, cisplatin
What gets urethra rents and what are they?
Gleding and stallion
See end of urination
tear in pelvic, dorsal urethal mucosa
Surgical treatment
Who gets urethreal calculus and where do they occur?
Stallions and geldings
Ischial arch
-Colic and stranguria
-See ultrasound,
What is harbronemiasis?
Proliferative lesion on distal aspect of penis, close to external orifice
-Biopsy
-Treat - ivermectin, steroid, surgery
When does vesical hematuria occur? What causes it?
End of urination and throughout
Calculus, neoplasia, bacterial cystitis, trauma, idiopathic hemorrhagic cystitis
Cystic calculus commonly occurs in the vesicle, what kind of dysuria do they experience?
hematuria (exercise)
Stranguria
Pollakiuria
Pyuria
Urinary Incontinence
How do you diagnose cystic calculus?
Rectal palpation or ultrasound
Cystoscopy, non-surgical removal photofragmentation, surgical removal and perineal urethrotomy
What are some tumors of the urinary bladder?
SSC, transitional cell carcinoma, lymphosarcoma, leiomyosarcoma
How do you diagnose bladder neoplasm?
Rectal palpation, ultrasonic exam, cystoscopy and biopsy, IMH
How do you treat neoplasms of the bladder?
Prolong survival
-Surgical resection, 5FU, NSAID
No long term sucess
How common is bacterial cystitis in horses?
Not very common
-inability to evacuate bladder - sabulous cystitis
How do you diagnose bacterial cystitis in a horse? How do you treat?
Urine sediment with RBC, WBC, bacteria
Systemic antimicrobials
How does trauma from exercise cause hematuria?
strenuous exercise abdominal content compress bladder against pelvis
-micro or macro
-Exclusion diagnosis
How do you diagnose idiopathic hemorrhagic cystitis?
Rule out
-hematuria with pollakiuria and stranguries
-thickened wall
cystoscopy and biopsy
-Hisoty may say TCC (recheck 2-4 weeks)
-No growth urine culture
How do you treat idiopathic hemorrhagic cystitis?
Potentiated sulfonamides
