Thursday, July 4, 2013

1505. Blood in the urine - efficiency and systematic examination

I had not seen this Silkie Terrier since 2005 when she was a puppy.  On Jul 3, 2013, she was presented with complaint of blood in the urine for the last 3 days. A systematic process is best for haematuria and the following is done by me.

1. History of blood in the urine recently.
2. Examination. Dog, 5.7 kg active but rectal temp is 39.8C. Palpation of bladder - no big stones, no abdominal pain or mass.
3. Urine sample collected by the owner in a clean fruit bottle as requested from me, to save time on  catherisation.
4. Dipstick to test urine pH, protein, blood, and SG.
5. No X-ray advised pending urine test to lower medical costs. This ought to be done.
6. Blood test

7. Antibiotic inj and pain killer.


DIPSTICK
Sometimes I don't do the urine dipstick but send the urine sample to the lab for a comprehensive testing. This time I did.
pH=8, SG=1.010, protein 3+, blood 3+

URINE TEST
Yellow turbid
pH = 9, SG=1.034, Protein +, Blood 3+, White blood cells = 0, Red blood cells 126, Bacteria 3+, Crystals triple phosphate +, Amorphous phosphate 3+

ADVICES
"Did you feed dry dog food?"
"No, I feed rice and meat usually. The dog disliked dry food many years ago." the wife said. "But the dog had been greedy and I fed a lot of dog treats."

1. S/D diet for 3 months.
2. Urine test monthly
3. X-rays advised.
4. Stop all treats and home-cooked food when feeding S/D diet.

Will the owner comply? Are there bladder stones inside the bladder and kidneys?
This case will be followed up. A systematic process will be efficient and productive.

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