Veterinary Medicine - July 2008 - (Page 388)

Hematuria PEER-REVIEWED TABLE 1 Causes of Hematuria Based on Algorithm Findings and Localization of Urogenital Source Algorithm Findings Coagulopathy (patients with a coagulopathy and concurrent urogenital disease may more readily develop hematuria) Trauma Upper Urinary Tract Source Lower Urinary Tract Source bocytopathy—acquired or congenital • Coagulation factor deﬁciencies—inherited or acquired • Vitamin K1 antagonism or deﬁciency Trauma to the lower urinary tract, including exerciseinduced hematuria Genital Tract Source thrombocytopathy— acquired or congenital • Coagulation factor deﬁciencies—inherited or acquired • Vitamin K1 antagonism or deﬁciency Trauma to the genital tract • Thrombocytopenia or thrombocytopathy—acquired or congenital • Coagulation factor deﬁciencies— inherited or acquired • Vitamin K1 antagonism or deﬁciency Trauma to the upper urinary tract • Thrombocytopenia or throm- • Thrombocytopenia or Mass, neoplastic changes (diffuse inﬁltration or nodules), or conditions that may resemble neoplastic changes • Metastatic or primary renal tumors • Granuloma • Metastatic or primary bladder or urethral tumors • Polyps of the bladder, usually benign • Granuloma • Urethral prolapse (males— may look like a red mass at the distal end of the penis) Calculi in decreasing order of incidence: • Struvite or calcium oxalate (dogs and cats) • Urate (dogs and cats) • Cystine (dogs and cats) • Silica (dogs) • Benign or malignant tumors of the penis, prostate, testicle, epididymis, or vagina • Prostatic hyperplasia • Granuloma Calculi Usually calcium oxalate or struvite with calcium (dogs and cats) Usually found only in the penile urethra of the genital tract Cysts or anatomical defects Inﬂammatory, toxic, embolic, or congestive changes • Perirenal pseudocysts (feline) • Polycystic kidneys • Renal dysplasia or hypoplasia • Renal telangiectasia • Renal infection—bacterial, fungal, or parasitic (Dioctophyma species, Diroﬁlaria species microﬁlariae) • Renal toxins (e.g. arsenic, ethylene glycol)* • Glomerulopathies • Renal infarction • Congestive heart failure Primary renal hematuria • Persistent urachal diverticulum • Fistula of the bladder or urethra Paraprostatic cyst (dogs) • Bladder and urethral infection—bacterial (including Mycoplasma species), fungal, or parasitic (Capillaria species) • Toxins or drugs (e.g. cyclophosphamide can cause hemorrhagic cystitis) • Feline lower urinary tract disease • Prostatitis (dogs) • Prostatic abscess (dogs) • Pyometra complex Idiopathic Miscellaneous • Proestrus • Uterine subinvolution *Source: Forrester SD. Diagnostic approach to hematuria in dogs and cats. Vet Clin North Am Small Anim Pract 2004;34(4):849-866. 388 July 2008 VETERINARY MEDICINE

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Veterinary Medicine - July 2008 Contents Leading Off Practical Matters Idea Exchange Clarification Dental Corner The Diagnostic Approach to Hematuria Guidelines for Evaluating Hypercalcemic Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - July 2008

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