Monday, February 20, 2012

880. Sunday's interesting cases at Toa Payoh Vets

Feb 19, 2012
Bright sunshine day

CASE 1.
"My guinea pig has UTI. He passes blood in his urine," the young lady's GP carrier had two large spots of blood spread onto the white tissue paper. "He had passed blood before and recovered after antibiotics," she had the GP treated by 2 vets elsewhere a few weeks ago. The GP of one year old had excellent appetite and was bright.

"Was urine collected for analysis?" I asked as I shared the case with Dr Daniel. Seldom do vets collect urine from a GP. It is just not the thing to do. I mean, how do you collect urine from a 500g GP? Male dogs can be catheterised to collect urine. But a GP?
"No," she said.
"A urine analysis is most important," I said. "I need to ward the GP for 2 days to observe and collect urine."
How to do it? I used two clean plastic tray covers under the grated floor. See image.
Fresh red blood. Bright red as if there was some bleeding internally inside the bladder. Or kidney? More passed. I wondered if the GP would bleed to death.

1. UTI? That's the primary diagnosis. The other vets had diagnosed UTI and so the owner assumed UTI.
2. Certain types of food causing reddish blood. But this was pure red blood.
3. Coagulopathy? Dr Daniel suggested.

The GP passed more than 10 ml of blood. I collected 1.5 ml from the tray and sent to the lab.

URINE ANALYSIS
Blood+++. pH=9.0. Negative for bacteria, crystals, WBC.

The GP did not pass blood after 24 hours. He ate only fresh apples and vegetables.

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