The case of the bloody urine.

Let’s check your knowledge today and see what you can come up with for this case I had a few weeks ago.

Patient is a canine (dog), female, spayed, five-year-old schnauzer.  The owner brought the dog in because she was urinating all over the house. The owner said that Snickers had been urinating in the house, very frequently and struggling a little when urinating.

What do you think so far?

Exam

I examine Snickers and she is bright, alert and healthy.  Everything about her physical exam appeared normal except for a little pain in her abdomen. 

Immediately, I start thinking about what could cause these clinical signs:  
1.     urinary tract Infection
2.     urinary bladder stones
3.     kidney disease
4.     cancer

These are just a few things running through my head I as finish up my exam.

Diagnostics

Diagnostics are so important when it comes to diagnosing your pet’s problem.  Even though I may see a lot of the same cases every day, I also have some weird stuff thrown in the mix and I don’t want to miss something!  In order to properly diagnose Snickers, I wanted to take a sample of her urine to test and do a radiograph (x-ray) to check for bladder stones. 

Ah ha! I love it when a plan comes together. There were some pretty bad looking stones in Snickers bladder that I could see on the radiograph.

Treatment

To remove the stones, we have to operate on Snickers, but before we can operate we must do pre-operative blood work

Have you ever had surgery? Did they draw your blood to be checked before surgery? Of course, but why? Doing blood work allows us to look for any red flags with the patient’s kidneys, liver, glucose, protein, etc. This helps to adjust what we need to do under anesthesia and warn us of various scenarios during surgery. 

Snickers blood work came back fantastic.

We proceeded with a cystotomy.  This is a fairly straight-forward surgery in which we open up the urinary bladder and remove the stones.  Snickers had one GIANT urinary bladder stone and I was able to successfully remove it! 

Post-operative care

Snickers was sent home the next day with antibiotics and anti-inflammatories. We also changed her diet to one that will help to prevent stones in the future. She is doing great!