Urogenital Flashcards
Pollakiuria
increased frequency of urination
stranguria
Straining to urinate
Dysuria
difficult/painful urination
Nocturia
Peeing at night
relevant for animals that don’t have access to outdoors
Urinary incontinence
Inability to prevent voiding
Azotaemia
Increased concentration of non-protein nitrogenous substances particularly we think of creatine and urea in blood
ureamia
Combination of adverse effects from severe or sudden onset of azotaemia (clinical consequences of disease)
urinary calculi
Stones, uroliths
Myoglobinuria
Brown
indicative of severe muscles damage (rhabdomyolsysis)
“tying up” in greyhounds
Snake invenomation
Haemoglobinuria
Excess haemoglobin in the blood
Likely indicative of intravascular haemolysis therefore; anaemia, agglutination, underlying cause
How would you prove that it is haemoglobinuria
Centrifuge the urine w/ microhaematocrit tube
what are some of the DDX for haemoglobinuria `
IMHA with intravascular haemolysis Zinc, onions, cu, venal caval syndrome DIC microangioapthy Inherited RBC defect Snake enevenomation
Haematuria - Very common
Blood in urine
Locate where the blood is coming from
Check the urogenital structure for local bleeding lesions
if none found, and perhaps bleeding is occurring elsewhere, consider a haemostatic disorder as the root of cause
e times of urination
what are your DDx for haematuria
Bleeding from genital structure
Bleeding from the urinary tract
Underlying haemostatic disorder
Is the bleeding only at the beginning or end of the urine stream ?
indicative that not in the bladder i.e lower down
Urethral lesion
Does bleeding from the prepuce or vulva occur at times other than urination
if bleeding occurs at times other than urination it indicates something towards the end of the urinary tract
Is bleeding associated with a lot of straining and increased frequency of urination?
Indicative of lower urinary tract issue
Straining anf increased frequency - think lower urinary tract - think bladder and urethra
Are RBC cast present in the urine sediment?
Cast of the kidney tubules - blown out by the next urine made by that nephron- if they are present in the urine it indicates an urinary tract issue
Is blood found in voided, but not in cystocentesis-derived urine samples?
The lesion could be urethra and beyond - could be genital - lower or further distal than the urinary bladder
if the cystocentesis sample is normal means that there is no lesions in the bladder of the animal
Otto occ has blood at the start of his urine stream. From time to time he also drips blood from his prepuce at time other than urination otherwise he is well. Where is the bleeding coming from
Prostate, urethra, VWB, bleeding lower down structure
3 year old red pembroke welsh corgi has blood mixed through with his urine. urine sediment exam show red blood cell cast, few RBC and no bacteria . There is no straining or increased frequency of urination. where is the blood coming from
Kidneys
what are the causes of straining
Obstruction and inflammation (more common)
what are the DDx for urethral obstruction
signs: pollakiuria, stranguria, dysuria
- stone lodged in caudal aspect of os penis
- Calculi
Mucous, struvite pulgs
neoplasia
Functional
Lower urinary tract inflammation
Cats are much less prone then dogs Bacterial infection F more than M
Sterile idiopathic urethrocystitis
Bladder (or cystic) calculi
Neoplasia
what is your approach to a patient with pollakiuria/stranguria/ dysuria
Palpate the bladder and do a rectal exam, ideally before and after the animal is allowed to void urine. Feel for calculi, masses, thickening, bladder enlargement
obtain urine by cytocentesis for UA, culture and sensitivity
consider imaging studies
How much does a normal dog drink
40ml/kg/day
what is the official definition of polydipsia
100ml/kg/day
Urine specific gravity
Hypothenuria SG < 1.008(less strong more dilute than plasma)
Isothenuria SG >1.008-1.012 (Not particularly concentrated or dilute- same as plasma
HYperthenuria - SG > 1.012
Dogs with substantial chronic kidney disease (CKD) typically produce urine that is
Isosthenuric
what are the DDX for primary polydipsia
Psychogenic Hepatic insufficiency/disease Hypothalamic disorder Some drugs - chlorpromazine Hyperthyroidism
Primary polyuria
Renal tubule cells set up counter current multiplication = anti diuresis
Antidiuretic hormone interacts with receptors on tubule cells = anti diuresis
Compromised blood flow will cause tubule damage
proteinuria
Excessive protein in the urine ( hyperproteinuria)
Overt proteinuria
Dipstick detectable excessive protein in urine
Microalbuminuria
Mildly excessive albumin in the urine. The concentration is abnormally high but is below the limit of detection of most conventional urine dipsticks
what are some reason for false positives when using a dipstick
Antiseptic contamination
Damp reagent strips
Very alkaline; very concentrated urine
what are the 3 categeories of proteinuria
Preglomerular
Glomerular (most important) - can be high protein leakage
Postglomerular
