Pigmenturia

visible discoloration of urine with presenting complaint of "bloody" or dark urine

macroscopic pigmenturia/hematuria

1 multiple choice option

no visible discoloration of urine but >5rbcs/hpf and a positive "blood" on dipstick

microscopic pigmenturia/hematuria

1 multiple choice option

how do you differentiate hematuria from hemoglobinuria?

centrifuge urine sample

How can you differentiate hemoglobinuria and myoglobinuria?

centrifuge blood sample because urine will look the same

which type of pigmenturia results in both pigmented urine and blood after spinning it down?

hemoglobinuria

2 multiple choice options

What are the differentials for hematuria?

1. LUT disease

2. Upper urinary tract disease

3. Coagulopathy

if hematuria is caused by upper urinary tract disease, is it more likely to be from the kidney or ureters?

kidney

1 multiple choice option

most common cause of hematuria?

LUT disease

What are the differentials for hemoglobinuria/?

abnormal amounts of RBCs or pigments in urine

pigmenturia

abnormal amounts of RBCs in urine

hematuria

differentials for pigmenturia?

Hemolysis

Severe muscle trauma

Hepatic disease

Drugs

Food dyes/colorings

important history questions for presenting pigmenturia/hematuria?

-Dysuria/stranguria?

-Pollakiuria?

-Where in stream?

-When seen?

-Reproductive status?

-Drugs?

hematuria with dysuria/stranguria localization?

LUT disease

Examples of LUT disease that can cause hematuria with dysuria/stranguria?

Cystitis

Urolithiasis

Prostatitis

BPH

Neoplasia

Trauma

hematuria without dysuria localization?

Upper urinary tract disease or systemic disease

differentials for hematuria without dysuria ?

Renal neoplasia

Trauma

Heat stroke

Coagulopathy

Polycystic kidneys

Nephroliths

Pyelonephritis

Glomerulonephritis

Idiopathic renal bleeding

Hematuria that occurs at the beginning of urination or is independent of urination can usually be localized to the ? in male dogs

prostate

Important aspects of physical exam for pt presenting with hematuria/pigmenturia?

Kidney palpation

Bladder palpation

Rectal exam

Prepuce/penis exam

Observe urination

+/-Vaginal exam

most common cause of hematuria without dysuria?

renal neoplasia

What are radiographs used to survey in patients with urinary tract disease?

Uroliths

Kidney size and shape

Prostate size and shape

Lymph nodes

What are abdominal ultrasounds used to survey in patients with urinary tract disease?

Cysts, masses, abscesses +/- stones in the kidneys, bladder and prostate

Types of contrast radiography?

Double contrast

Retrograde urethrogram

Excretory urogram

most common cause of hemoglobinuria in the dog?

IMHA

differentials for hemoglobinuria?

IMHA

DIC

Heat stroke

Caval syndrome (D. immitis)

Other causes of hemolysis

cystitis is more likely to be ? in cats

inflammatory

1 multiple choice option

cystitis is more likely to be ? in dogs

infectious

1 multiple choice option

Do nephroliths/ureteroliths commonly cause gross hematuria?

no

1 multiple choice option

can you trust the dipstick readings (e.g. bilirubin, protein etc.) if urine is red?

no

1 multiple choice option