Thursday, January 8, 2015

1172. An 11-year-old Shih Tzu passes blood in the urine again

Jan 8, 2015
Two dry eyes, right eye has irritating upper eyelid conjunctival growths. Passing blood in the urine for the past years. Generalised skin diseases.


"My dog had passed blood in the urine but had recovered," the lady owner said. "Now, he dribbles blood in the urine again!"

The dog peed fresh blood on the mat of the weighing machine. He weighs 9.3 kg and has dry eyes as well as a row of right upper eyelid tumours. He had a very itchy body and a painful right ear.
"Shih Tzus need regular grooming and are high maintenance dogs." I said to the owner.

I placed him on the consultation table and palpated his abdomen. There was a golf-ball sized lump in his bladder area. No pain. It was lower down and could also be an enlarged prostate since he had haematuria and dribbling of urine.

X-rays. It is important to have 2 views. The V/D view shows gas inside the almost empty bladder while the lateral view showed an opaque bladder.

So, is it a bladder neoplasia or chronic cystitis? There appeared to be no radio-dense bladder stones
but in a previous urine test done several weeks ago, there was calcium oxalate crystals in the urine.

The eyelid conjuntival growths on the right eye were electro-excised by Dr Daniel and medication for the generalised skin infections were prescribed. The bladder was empty and no urine could be collected. Antibiotics cleared the bladder infections as no blood was passed in the urine on follow up 2 days later.

Based on the clear contrast of the ventral-dorsal X-ray showing the thickened bladder wall and air, this is likely to be a chronic cystitis rather than a bladder tumour. Some bladder stones are not radio-dense and hence not visible on X-rays. The prostate enlargement may not be large and is not visible on X-ray. An ultrasound of the prostate to check for prostatic cysts or abscesses cannot be done owing to the need to reduce medical costs.  

A urine test is needed but no urine was available when the dog's bladder was catheterised. The owner wanted only the eyelid tumours to be removed. Electro-excision  was done by Dr Daniel. 


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