Approach to haematuria and dysuria Flashcards
Define Haematuria
blood in urine
define Haemoglobinuria
haemoglobin in urine
define Myoglobinuria
myoglobin (in muscles) in urine
brown
define Bilirubinuria
bilirubin in urine - jaundiced animals
orange
define Dysuria
difficulty/ painful urinating
define Stranguria
straining to urinate
define Pollakiuria
increase in frequency of urination - generally small volumes
define Oliguria
reduced volume of urine
define Anuria
no urine at all
define Incontinence
lack of control of urination
Why are female animals typically more prone to urinary tract infections than their male counterparts?
Due to the proximity of the non-sterile reproductive tract
describe gross examination of urine
colour
smell
turbidity
how to test for RBCs in urine
Dipstick- blood/ Hb positive- dots supportive of blood- poorly specific
sediment exam- RBCs will precipitate
what does homogenous change on dipstick blood/ Hb positive supportive of
haemoglobin/ myoglobin present
describe the difference between RBC and haemoglobin on sediment exam
RBCs will precipitate, cytology confirms RBCs present.
Haemoglobin/myoglobin will not precipitate, cytology does not demonstrate RBCs
plasma likely to be red/pink with ……..
haemoglobinaemia
plasma likely to be clear with ……..
myoglobinaemia
list the 4 clinical findings of haematuria
RBCs on sediment exam
Clear (ish) plasma and centrifuged urine
Presence of regenerative anaemia may be supportive of haemorrhage- not always present
if you diagnose haemoglobinaemia what do you do
suggests haemolysis —> look into pre-hepatic jaundice and haemolytic disease
when do you generally see Myoglobinaemia
severe muscle damage
if you diagnose myoglobinaemia what do you look at further
AST/CK, history exam
physical causes- trauma/ burns/ strenuous exercise
non-physical causes- hypoxic/ischaemic/metabolic disturbances/infectious
Describe how to confirm trauma as cause of haematuria
history
exam- possible other signs e.g. fractured pelvis
Describe how to confirm urolithiasis as cause of haematuria
urine sediment exam
ultrasound
radiography (contrast)
Describe how to confirm UTI as cause of haematuria
Urine sediment exam
ultrasound
radiography (contrast)
Describe how to confirm inflammation as cause of haematuria
History- e.g. frequent urination
urinalysis
imaging to rule out other causes
Describe how to confirm neoplasia as cause of haematuria
CBC – chronic anaemia
Ultrasound and radiography
endoscopy and biopsy
Describe how to confirm coagulopathy as cause of haematuria
CBC
platelet count
PT, aPTT, TEG
Describe how to confirm idiopathic renal haematuria as cause of haematuria
rule out all other causes first
CBC for anaemia
Ureteroscopy
what dogs typically affected by Idiopathic Renal Haematuria
Typically large breed, young dogs
Uncommon
describe how to treat Idiopathic Renal Haematuria
ACEi (for proteinuria) and Angiotensin receptor blockers
Potentially interventional radiography – sclerotherapy
what can Idiopathic Renal Haematuria lead to
Anaemia
Renal pain
Ureteral pain and/or ureteral obstruction
UTI’s
what is idiopathic renal Haematuria
It is characterized by recurrent bleeding from the kidneys of unidentified cause
what do we see with dysuria
very variable because alot of causes - owner pic and videos helpful
stranguria or pollakiuria
what is dysuria typically related to
is due to lower urinary tract disease- bladder below
where is discoloured urine generally from
can be from anywhere on the urinary (or repro) tract
what is urge incontinence
involuntary bladder contractions voiding small amounts of urine regularly
functional problem
why is a blocked bladder an emergency
Bladder can rupture- this can cause uroabdomen - check via POCUS
Electrolytes and biochem- azotemia and hyperkalaemia - causes bradycardia and heart block
Urinary catheter placement to relieve an obstruction and allow drainage
what are the 2 main causes of a blocked bladder
obstructive disease
Neurological issue
how many layers make up bladder lining
3/4 layers
mucosa/submucosa together (hyperechoic)
muscle (hypoechoic)
serosa (hyperechoic)
Define hydronephrosis
the dilation (swelling) of one or both kidneys- dilated pelvis
