Hematuria Flashcards
How many RBCs per ml is associated with macroscopic hematuria?
(> 2.5 million/ml, anywhere from 10k-2.5mil is microscopic, anything under 10k is normal)
You cannot see microscopic hematuria by gross inspection, what can you do to diagnose it?
(See > 10 RBC/hpf when you examine the sediment and/or get a trace to 3+ reaction on dipstick analysis)
What portion of the urinary system would be the site of the lesion in the following scenarios:
- There is blood at the beginning of urination
- There is blood at the end of the urination
- There is blood throughout urination
- There is blood at the beginning of urination (Distal urethra)
- There is blood at the end of the urination (Proximal urethra or bladder)
- There is blood throughout urination (Kidneys, ureters, or bladder)
What are some of the types of neoplasia that affect the distal urethra?
(SCC, fibrosarcoma, sarcoid, and papillomas)
When will hematuria be noted (beginning, throughout, or end) when there is a urethral rent and why?
(Will be at the end because that is when the muscles contract and forces blood through the rent; tx is PU or corpus spongiotomy both with the goal to minimize pressure on the rent site)
Where do urethral calculi tend to get lodged?
(The ischial arch)
Where are you most likely to find stones in the equine urinary tract?
(The bladder)
What are some of the types of neoplasia that affect the bladder in horses?
(SCC, TCC, lymphosarcoma, and leiomyosarcoma)
What is the goal of treatment for bladder neoplasms?
(Prolonging survival time by improving patient comfort; can attempt surgical resection, intravesicular instillation of 5-FU, or using COX-2 selective NSAIDs but successful long term outcomes have not been reported)
Bacterial cystitis occurs infrequently in horses and is most often associated with certain neurological syndromes, why is that?
(Bc with those neuro syndromes (such as EHV-1, lesions of S3-caudal) there is an inability to completely evacuate the bladder which results in sabulous cystitis)
What is the typical treatment for bacterial cystitis?
(TMS)
How is traumatic hematuria diagnosed?
(By not diagnosing anything else → diagnosis of exclusion)
What do you expect to see on ultrasound of a horse with idiopathic hemorrhagic cystitis?
(A thickened bladder wall)
What do you expect to see on a biopsy of the bladder wall in a case of idiopathic hemorrhagic cystitis?
(Suppurative, proliferative cystitis; if send to histopath may suggest a neoplastic process but not in every case and no bacteria present)
Why might a horse with bilateral ureteroliths be dull, inappetant, and lose weight?
(Because they will be azotemic, I specify both because affected horses typically remain asymptomatic until both ureters are obstructed; this is the same for nephroliths)
What might you expect to feel on rectal palpation of a horse with a ureterolith?
(Calculi in the ureter, ureteral dilation, and nephromegaly (of the left kidney if it is affected))
What are some of the primary neoplasms of the kidneys?
(Adenocarcinoma, nephroblastoma, TCC, and SCC; secondary are lymphosarcoma, hemangiosarcoma, melanoma, and adenocarcinoma)
What is the treatment of choice for renal neoplasms?
(Nephrectomy but they are usually very large and adherent to surrounding organs at the time of diagnosis so surgical removal is very difficult or impossible, also removing the kidney of a horse is just not as reasonable of a choice as removing the kidney of a small animal)
What type of kidney necrosis is caused by aminoglycosides or NSAIDs respectively?
(Aminoglycosides = tubular, NSAIDs = papillary)
(T/F) You can usually diagnose tubular or papillary kidney necrosis with gross examination of urine.
(F, tubular or papillary necrosis usually causes microscopic hematuria so you’ll need to examine the sediment or use a dipstick to diagnose the hematuria)
