Massive hematuria of nontraumatic renal origin in dogs

Massive hematuria of renal origin was diagnosed in 4 dogs. In all dogs, blood and blood clots were clearly visible in the urine. Serum urea nitrogen and urine concentrating ability were normal. All dogs were anemic, and results of coagulation and platelet function tests were within normal limits. Excretory urography indicated hydroureter and hydronephrosis in all dogs, with filling defects in the bladder attributable to large blood clots in 2 dogs. Cystotomy and catheterization of the ureters enabled identification of one kidney as the source of bleeding in 3 dogs. Unilateral nephrectomy and ureterectomy resolved their hematuria. The results of histologic examination were normal in 2 dogs. The 3rd dog had evidence of pyelitis. Cystoscopy of the 4th dog did not reveal hematuria from either ureter. The dog was not operated on and it continued to have intermittent hematuria.     

Treatment of cyclophosphamide-induced hemorrhagic cystitis in five dogs

Sterile hemorrhagic cystitis developed in 5 dogs after treatment with cyclophosphamide. Four dogs were being treated with various antineoplastic protocols, and the fifth dog had recurrent immune-mediated thrombocytopenia. In all instances, clinical signs of hematuria and stranguria persisted after cyclophosphamide administration was discontinued. Three dogs required cystotomy to remove necrotic mucosa and calculi. The other 2 dogs were treated with intravesicularly administered dimethyl sulfoxide to decrease inflammation and to inhibit fibroplasia of the bladder wall. In 4 dogs, clinical signs resolved after treatment. The fifth dog, treated surgically, continued to have intermittent urinary incontinence attributable to residual bladder wall fibrosis.     

Evaluation of a bladder tumor antigen test for the diagnosis of lower urinary tract malignancies in dogs

OBJECTIVE: To evaluate the use of a human bladder tumor antigen test for diagnosis of lower urinary tract malignancies in dogs. SAMPLE POPULATION: Urine samples from dogs without urinary tract abnormalities (n = 18) and from dogs with lower urinary tract neoplasia (20) or nonmalignant urinary tract disease (16). PROCEDURE: Test results were compared among groups and among 3 observers. The effects of urine pH and specific gravity, degree of hematuria, and storage temperature and time of urine samples on test results were also assessed. RESULTS: Test sensitivity and specificity were 90 and 94.4%, respectively, for differentiating dogs with lower urinary tract neoplasia from dogs without abnormalities. However, specificity decreased to 35% for differentiating dogs with neoplasia from dogs with nonmalignant urinary tract disease. In dogs with neoplasia, results were significantly affected by degree of hematuria. However, addition of blood to urine from dogs without hematuria had no significant effect on test results. Although intraobserver variation was significant, urine pH, specific gravity, or storage time or temperature had no significant effect on results. CONCLUSIONS AND CLINICAL RELEVANCE: Although this bladder tumor antigen test was sensitive for differentiating dogs with malignancies of the lower urinary tract from dogs without urinary tract disease, it was not specific for differentiating dogs with neoplasia from dogs with other lower urinary tract abnormalities. It cannot, therefore, be recommended as a definitive diagnostic aid for the detection of lower urinary tract malignancies in dogs.     

Fibromatous epulis and peripheral odontogenic fibroma in horses

Fibromatous epulis is a rare tumour in horses which is analogous to the same condition in dogs and peripheral odontogenic fibromas in man. The nomenclature is varied throughout the veterinary literature, but these tumours are most correctly known as peripheral odontogenic fibromas. Although these lesions are benign, they have a high recurrence rate in other species, so wide local excision is important to give the best possible prognosis.     

Clinical Course of Acute Canine Polyradiculoneuritis Following Treatment with Human IV Immunoglobulin

Treatment of dogs with acute canine polyradiculoneuritis (ACP) is restricted to physical rehabilitation and supportive care. In humans with Guillain-Barré syndrome, the counterpart of ACP, randomized trials show that IV immunoglobulin (IVIg) speeds recovery. The authors of the current study hypothesized that dogs with ACP would tolerate IVIg well and recover faster than dogs managed with supportive treatment only. Sixteen client-owned dogs with ACP were treated with IVIg, and 14 client-owned dogs served as a retrospective control group. Diagnosis was confirmed using clinical features, electrodiagnostics, cerebrospinal fluid analysis, and muscle/nerve biopsies. The duration of the initial progressive phase, the time from IVIg administration until the dogs were ambulating without assistance, and the duration of the complete episode were evaluated. Adverse reactions (anaphylaxis, mild hematuria) were observed in two dogs. Dogs treated with IVIg were ambulating without assistance after a median of 27.5 days (range, 15-127 days) from onset of clinical signs. The control group was ambulatory without assistance at a median of 75.5 days (range, 5-220 days). Even though this result is not statistically significant, there is a clear trend toward faster recovery in dogs treated with IVIg.     

Unusual urethral calculi in two male dogs

The clinical presentation and advanced size of the two calculi described in this report are both atypical and noteworthy. Both dogs were presented initially with signs of hematuria, stranguria, and perineal discomfort. Each calculus was visible on survey abdominal radiographs and was present in the region of the ischial arch. Both dogs underwent a perineal urethrotomy to retrieve the calculus. Resolution of clinical signs was obtained in one case, which was referred within 2 months of the onset of clinical signs. The second dog was medically managed for approximately 2.5 years before referral. Surgical intervention failed to restore urinary continence in this second dog. Early detection of similar cases may be important in optimizing clinical outcome following appropriate treatment.     

Vaginourethroplasty for Treatment of Urethral Obstruction in the Bitch

Vaginourethroplasty was performed in six bitches with infiltrative, obstructive urethral disease. The initial clinical signs included dysuria, hematuria, pollakiuria, and stranguria. Diagnosis was based on the clinical signs, plain radiography and contrast vagino-urethrogram examination, and urethral biopsy. Five dogs were diagnosed as having urethral neoplasia; the sixth dog had granulomatous urethritis. In all six dogs, up to 50% of the urethra and the urethral tubercle were resected to ensure adequate surgical margins. One dog was euthanatized 4 months after surgery for recurrence of a transitional cell carcinoma at the surgical site. Long-term resolution of the problem (minimum of 12 months) was achieved in the other five dogs. The frequency of serious complications, including urinary incontinence and ascending lower urinary tract infections, was low.     

Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987-2004)

OBJECTIVE: To evaluate pretreatment clinical and laboratory findings in dogs with naturally occurring primary hyperparathyroidism. DESIGN: Retrospective study. ANIMALS: 210 dogs with primary hyperparathyroidism and 200 randomly selected, age-matched control dogs that did not have primary hyperparathyroidism. PROCEDURE: Medical records for dogs with primary hyperparathyroidism were reviewed for signalment; clinical features; and results of clinicopathologic testing, serum parathyroid hormone assays, and diagnostic imaging. RESULTS: Mean age of the dogs with primary hyperparathyroidism was 11.2 years (range, 6 to 17 years). The most common clinical signs were attributable to urolithiasis or urinary tract infection (ie, straining to urinate, increased frequency of urination, and hematuria). Most dogs (149 [71%]) did not have any observable abnormalities on physical examination. All dogs had hypercalcemia, and most (136 [65%]) had hypophosphatemia. Overall, 200 of the 210 (95%) dogs had BUN and serum creatinine concentrations within or less than the reference range, and serum parathyroid hormone concentration was within reference limits in 135 of 185 (73%) dogs in which it was measured. Urolithiasis was identified in 65 (31 %) dogs, and urinary tract infection was diagnosed in 61 (29%). Mean serum total calcium concentration for the control dogs-was significantly lower than mean concentration for the dogs with primary hyperparathyroidism, but mean BUN and serum creatinine concentrations for the control dogs were both significantly higher than concentrations for the dogs with primary hyperparathyroidism. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that urolithiasis and urinary tract infection may be associated with hypercalcemia in dogs-with primary hyperparathyroidism, but that development of renal insufficiency is uncommon.     

Evaluation of laparoscopy for obtaining renal biopsy specimens from dogs and cats

Laparoscopic direction of renal biopsy was evaluated in 37 dogs and 1 cat suspected of having renal disease. Specimens adequate for morphologic diagnosis were obtained in 37 cases (97%). Eleven of the 38 animals were necropsied and the biopsy diagnosis was confirmed in 10 of the cases (91%). Excessive pericapsular hemorrhage and severe hematuria developed in 1 dog. Three dogs (8%) had macroscopic hematuria for 24 hours after biopsy.     

Effects of urinary tract inflammation and sample blood contamination on urine albumin and total protein concentrations in canine urine samples

BACKGROUND: Urinary tract inflammation and hemorrhage are believed to be common causes of proteinuria in dogs based on results of studies that measured total urine protein concentration. A method to quantify urine albumin (UAlb) concentration in dogs recently has become available; however, the effect of inflammation on albuminuria is unknown. OBJECTIVES: The goals of this study were to determine the effects of urinary tract inflammation, as indicated by pyuria and sample blood contamination, on UAlb concentration and on urine protein:creatinine (UPC) ratio in dogs. METHODS: Urine samples were obtained from dogs with pyuria that were presented to a veterinary teaching hospital or were part of a laboratory colony. To mimic the effects of hematuria, canine whole blood was added to a microscopically normal canine urine sample that had baseline albumin and total protein concentrations below the limits of detection. UAlb concentration was measured using a canine albumin-specific competitive ELISA. UPC ratio was determined using routine methods. RESULTS: Of 70 samples with pyuria, 67% had negligible UAlb concentrations and 81% had normal UPC ratios. UAlb concentration but not UPC ratio was significantly higher (P < 0.05) in samples with concurrent hematuria or bacteriuria. When whole blood was added to normal urine, UAlb concentration did not exceed 1 mg/dL until the sample became visibly pink; the UPC did not exceed 0.4 at any dilution. CONCLUSIONS: Many dogs with pyuria do not have albuminuria or proteinuria; however, albuminuria may be more likely in dogs with pyuria and concurrent hematuria or bacteriuria. Hematuria may not cause an increase in UAlb concentration until it becomes macroscopic and even then may not increase the UPC ratio.     

Comparative aspects and clinical outcomes of canine renal hemangiosarcoma

BACKGROUND: Hemangiosarcoma (HSA) is a common solid tumor of the spleen, heart, and skin of dogs. Renal HSA represents an uncommon anatomic variant, with little reported about its biologic behavior and clinical outcome. HYPOTHESIS: That renal HSA is associated with longer survival than other visceral forms of HSA. ANIMALS: 14 dogs with renal HSA. METHODS: Medical records from 1999 to 2004 were searched for dogs with histopathologically confirmed renal HSA, and data relevant to clinical signs, treatments, and outcomes were abstracted. RESULTS: Clinical signs were nonspecific, and the median duration of clinical signs before diagnosis was 60 days. Two dogs presented in cardiovascular collapse secondary to hemoperitoneum. Common hematologic and biochemical abnormalities were anemia (9/14), hematuria (7/14), and proteinuria (7/14). One dog had pulmonary metastasis at diagnosis. All dogs had evidence of a renal mass visualized by abdominal radiography (14/14), ultrasound (9/14), or both. All dogs underwent nephrectomy, and 4/14 dogs also received adjunctive chemotherapy. Median survival time of all dogs was 278 days (range 0-1,005 days), and dogs with hemoperitoneum had significantly shorter survival times than dogs without hemoperitoneum (62 days versus 286 days, P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: These results indicate that hemoperitoneum and distant metastasis at diagnosis appear to occur less frequently in dogs with renal HSA compared with other visceral forms of HSA. Furthermore, dogs with renal HSA have protracted disease progression, with improved 1-year survival rates and longer median survival time compared to dogs with splenic, cardiac, and retroperitoneal HSA.     

Evaluation of the association between microalbuminuria and the urine albumin-creatinine ratio and systemic disease in dogs

OBJECTIVE: To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria. DESIGN: Prospective study. ANIMALS: 408 dogs. PROCEDURES: Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis. RESULTS: 48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays. CONCLUSIONS AND CLINICAL RELEVANCE: Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.     

Concurrent diabetes mellitus and hypoadrenocorticism in the dog: Diagnosis and management of eight cases

Eight cases of concurrent diabetes mellitus and hyperadrenocorticism are described. In all but one dog diabetes mellitus was the first condition recognised and, in these, clinical signs attributable to hyperadrenocorticism developed further while the dogs received replacement insulin therapy. The most common signs were resistance to exogenous insulin with daily insulin replacement dosage requirements exceeding 2 iu/kg, erratic insulin requirements, continuing polydipsia/polyuria and weight loss. Lethargy and muscle weakness were variable and dermatological abnormalities were present in only four cases. Six dogs were treated with op'DDD and clinical signs resolved with improvement of glycaemic control.     

Treatment of urinary incontinence in dogs by endoscopic injection of Teflon

Twenty-two dogs with urethral sphincter incompetence, nonresponsive to phenylpropanolamine administration, were treated by urethral submucosal injection of Teflon. Urinary continence was achieved in all dogs for at least 2 months. Urinary incontinence recurred in 14 dogs (64%) and was controlled by a second Teflon injection in 11 of 12 dogs (92%). Minor complications included transient stranguria, with or without hematuria, after 4 of 35 injection procedures. One dog had temporary partial urethral obstruction after treatment.     

Detection of canine microalbuminuria using semiquantitative test strips designed for use with human urine

Background — Commercial testing for microalbuminuria in human urine is often performed with point-of-care semiquantitative test strips followed by quantitative testing when indicated. An ELISA that quantifies canine urine albumin concentration has been developed, but semiquantitative test strips for use in the dog are not available.
Objective — The purpose of this study was to prospectively determine the concordance of canine urine albumin concentrations measured by a commercial human test strip and by ELISA.
Methods — Urine samples were obtained from 67 dogs evaluated for a variety of clinical conditions. Dipstick urinalyses were performed on all samples; clinician discretion determined method of urine collection and performance of urine sediment examination and/or urine culture. Urine albumin concentration was determined using test strips (Clinitek Microalbumin, Bayer Corporation, Elkhart, Ind, USA), and results were compared with those obtained by ELISA.
Results — The Clinitek strips correctly determined albumin concentration in 42 of 67 (63%) urine samples tested. Concordance was lowest (48%) for dogs with microalbuminuria (10–300 μg/mL by ELISA). Clinitek strip sensitivity and specificity for correct identification of microalbuminuria were 48% and 75%, respectively. Concordance was lower in dogs with urinary tract infection or hematuria and in samples collected by catheterization. Sensitivity and specificity for correct identification of microalbuminuria after exclusion of dogs with urinary tract infection or hematuria were 59% and 83%, respectively.
Conclusion — These results suggest that the Clinitek strips lack sufficient concordance with results obtained by ELISA to be reliable screening tests for microalbuminuria in the dog. A reliable semiquantitative point-of-care test for canine urine albumin concentrations below those detected by standard urine dipsticks is still needed.     

Evaluation of a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs

OBJECTIVE: To evaluate a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs. ANIMALS: 6 healthy mixed-breed dogs. PROCEDURE: Dogs were anesthetized, and cystitis was induced by infusing a solution of salicylic acid in ethanol into the bladder, followed by an inoculum containing field isolates of P. mirabilis and P. aeruginosa. Dogs were examined daily for 21 days after induction of cystitis. On day 21, dogs were euthanatized, and urinary bladder, renal pelvis, and prostate specimens were submitted for bacterial culture. RESULTS: After induction of cystitis, all dogs had evidence of thickening of the bladder wall, dysuria, tenesmus, and hematuria. Urinalysis revealed proteinuria, hematuria, and pyuria. All urine samples obtained on day 21 yielded growth of P. mirabilis, but P. aeruginosa was not cultured from any of these samples. Proteus mirabilis was isolated from bladder, renal pelvis, or prostate specimens from 4 dogs; P. aeruginosa was not isolated from any of the tissue specimens. CONCLUSION: Results suggest that the method used in the present study fails to induce dual infection of the urinary bladder with P. mirabilis and P. aeruginosa. The inability to establish a persistent dual infection with this method may have been a result of insufficient pathogenicity of the Pseudomonas isolate or an inadequacy of the experimental design.     

Infiltrative urethral disease in female dogs: 41 cases (1980-1987)

Forty-one cases of infiltrative urethral disease in female dogs were reviewed. The cause was epithelial neoplasia in 29 dogs, granulomatous (chronic active) urethritis in 10 dogs, and leiomyoma in 2 dogs. Clinical signs of disease were similar in dogs with neoplastic and inflammatory disease and included strangury (36/41), hematuria (30/41), pollakiuria (20/41), vaginal discharge (16/41), and complete urinary obstruction (7/41). Results of aspiration biopsy of the urethra correlated with those of surgical biopsy in 11 of 15 dogs. In 4 of 15 dogs, results of cytologic and histologic examinations differed. Granulomatous (chronic active) urethritis is an infiltrative urethral disease in female dogs. Clinical findings are similar, but the prognosis is more favorable than that in dogs with urethral epithelial neoplasia.     

Polypoid cystitis in 17 dogs (1978-2001)

Polypoid cystitis is a rare disease of the urinary bladder in dogs characterized by inflammation, epithelial proliferation, and development of a polypoid mass or masses without histopathologic evidence of neoplasia. Medical records of 17 dogs with polypoid cystitis were reviewed to determine the clinical and laboratory features of this disorder and to assess treatment and outcome. Most affected dogs (15/17) were female and presented for evaluation of hematuria or recurrent urinary tract infection (UTI). Proteus spp were the most common bacterial isolates (12/52 or 23.1%) identified when all urine samples obtained for culture at any time during the course study were considered. Other commonly isolated organisms included Escherichia coli , Staphylococcus spp, and Enterococcus spp. Several dogs (7/17) also had cystic calculi at some time during the course of their disease. Most of the masses (11/14) were located cranioventrally in the bladder as opposed to transitional cell carcinoma, which has a predilection for the bladder neck or trigone area. It is unknown whether persistent or recurrent UTI predisposes to polyp formation or if polyps predispose to UTI. Surgery and removal of all polyps was the most efficacious treatment in dogs of this study. The question of whether or not polyps represent preneoplastic lesions remains unanswered and constitutes an area for future investigation.     

Fungal urinary tract infections in the dog and cat: a retrospective study (2001-2004)

Thirty-five animals (23 dogs, 12 cats) with fungal urinary tract infections (UTIs) were retrospectively studied. Dysuria, hematuria, increased frequency of micturition, anorexia, depression, and pyrexia were the most common clinical signs noted. Seven species of fungi were identified in the affected animals. Candida albicans was the most common isolate. Most animals diagnosed with fungal UTI also had other concurrent urinary tract or medical problems. Lower urinary tract diseases, diabetes mellitus, neoplasia, and renal failure were the most common concurrent or preceding diseases identified. Resolution of fungal UTI occurred in 12 animals that received specific antifungal treatment.     

Comparison of clinical and pathological diagnoses in dogs

Clinical and pathological diagnoses were compared in a prospective study of 145 dogs. A diagnostic work up had been performed on all dogs of which 36 (24.8%) died and 109 (75.2%) were euthanatized. In 119 dogs (82.1%) both a clinical and patholical diagnosis was made, in 20 dogs (13.8%) no pathological diagnosis could be made and in 6 dogs (4.1%) no clinical diagnosis was established. In the 119 dogs the agreement level between clinical and pathological diagnosis was scored by the referring veterinarian together with a pathologist. Total agreement was found in 61 cases (51.3%) and disagreement in 31 cases (26.0%). In the remaining cases (27=22.7%) the pathological diagnosis further specified the clinical diagnosis. Consecutive submission appeared difficult to achieve by the participating veterinarians. However, no major differences in agreement level was present between the veterinarian which succeeded in almost consecutive submissions and the other veterinarians. At necropsy 42 cases were diagnosed as neoplasia, of which 52.4% had been diagnosed clinically. As to infectious diseases 55.0% of these diseases diagnosed at necropsy had been diagnosed clinically. In about 20% of the cases the differences were of clinical significance according to the referring veterinarians. In addition, it was indicated by the clinicians that about 50% of the necropsies revealed findings which could amend future patient care. The results of the study stress the relevance of postmortem examination as crucial part of continuing education and of quality monitoring and assurance in veterinary medicine.