Approach to haematuria and dysuria

Question 1

Define Haematuria

Answer 1

blood in urine

Question 2

define Haemoglobinuria

Answer 2

haemoglobin in urine

Question 3

define Myoglobinuria

Answer 3

myoglobin (in muscles) in urine
brown

Question 4

define Bilirubinuria

Answer 4

bilirubin in urine - jaundiced animals
orange

Question 5

define Dysuria

Answer 5

difficulty/ painful urinating

Question 6

define Stranguria

Answer 6

straining to urinate

Question 7

define Pollakiuria

Answer 7

increase in frequency of urination - generally small volumes

Question 8

define Oliguria

Answer 8

reduced volume of urine

Question 9

define Anuria

Answer 9

no urine at all

Question 10

define Incontinence

Answer 10

lack of control of urination

Question 11

Why are female animals typically more prone to urinary tract infections than their male counterparts?

Answer 11

Due to the proximity of the non-sterile reproductive tract

Question 12

describe gross examination of urine

Answer 12

colour
smell
turbidity

Question 13

how to test for RBCs in urine

Answer 13

Dipstick- blood/ Hb positive- dots supportive of blood- poorly specific
sediment exam- RBCs will precipitate

Question 14

what does homogenous change on dipstick blood/ Hb positive supportive of

Answer 14

haemoglobin/ myoglobin present

Question 15

describe the difference between RBC and haemoglobin on sediment exam

Answer 15

RBCs will precipitate, cytology confirms RBCs present.
Haemoglobin/myoglobin will not precipitate, cytology does not demonstrate RBCs

Question 16

plasma likely to be red/pink with ……..

Answer 16

haemoglobinaemia

Question 17

plasma likely to be clear with ……..

Answer 17

myoglobinaemia

Question 18

list the 4 clinical findings of haematuria

Answer 18

RBCs on sediment exam
Clear (ish) plasma and centrifuged urine
Presence of regenerative anaemia may be supportive of haemorrhage- not always present

Question 19

if you diagnose haemoglobinaemia what do you do

Answer 19

suggests haemolysis —> look into pre-hepatic jaundice and haemolytic disease

Question 20

when do you generally see Myoglobinaemia

Answer 20

severe muscle damage

Question 21

if you diagnose myoglobinaemia what do you look at further

Answer 21

AST/CK, history exam
physical causes- trauma/ burns/ strenuous exercise
non-physical causes- hypoxic/ischaemic/metabolic disturbances/infectious

Question 22

Describe how to confirm trauma as cause of haematuria

Answer 22

history
exam- possible other signs e.g. fractured pelvis

Question 23

Describe how to confirm urolithiasis as cause of haematuria

Answer 23

urine sediment exam
ultrasound
radiography (contrast)

Question 24

Describe how to confirm UTI as cause of haematuria

Answer 24

Urine sediment exam
ultrasound
radiography (contrast)

Question 25

Describe how to confirm inflammation as cause of haematuria

Answer 25

History- e.g. frequent urination urinalysis imaging to rule out other causes

Question 26

Describe how to confirm neoplasia as cause of haematuria

Answer 26

CBC – chronic anaemia Ultrasound and radiography endoscopy and biopsy

Question 27

Describe how to confirm coagulopathy as cause of haematuria

Answer 27

CBC platelet count PT, aPTT, TEG

Question 28

Describe how to confirm idiopathic renal haematuria as cause of haematuria

Answer 28

rule out all other causes first CBC for anaemia Ureteroscopy

Question 29

what dogs typically affected by Idiopathic Renal Haematuria

Answer 29

Typically large breed, young dogs Uncommon

Question 30

describe how to treat Idiopathic Renal Haematuria

Answer 30

ACEi (for proteinuria) and Angiotensin receptor blockers Potentially interventional radiography – sclerotherapy

Question 31

what can Idiopathic Renal Haematuria lead to

Answer 31

Anaemia Renal pain Ureteral pain and/or ureteral obstruction UTI’s

Question 32

what is idiopathic renal Haematuria

Answer 32

It is characterized by recurrent bleeding from the kidneys of unidentified cause

Question 33

what do we see with dysuria

Answer 33

very variable because alot of causes - owner pic and videos helpful stranguria or pollakiuria

Question 34

what is dysuria typically related to

Answer 34

is due to lower urinary tract disease- bladder below

Question 35

where is discoloured urine generally from

Answer 35

can be from anywhere on the urinary (or repro) tract

Question 36

what is urge incontinence

Answer 36

involuntary bladder contractions voiding small amounts of urine regularly functional problem

Question 37

why is a blocked bladder an emergency

Answer 37

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

Question 38

what are the 2 main causes of a blocked bladder

Answer 38

obstructive disease Neurological issue

Question 39

how many layers make up bladder lining

Answer 39

3/4 layers mucosa/submucosa together (hyperechoic) muscle (hypoechoic) serosa (hyperechoic)

Question 40

Define hydronephrosis

Answer 40

the dilation (swelling) of one or both kidneys- dilated pelvis