Blood and nitrites in urine

RE: Blood and nitrites in urine

Andrew Kent — Tue, 30 May 2023 19:34:26 GMT

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine/241658#241658"]I did not do the ultrasound, out machine was broken, so that was done at other clinic where they also did Cystocentesis and sent for culturing. But this was done at a time the dog was`nt showing symptoms, and after an antibiotic course. [/quote]

sounds like it might be helpful to get more info on what was seen or not examined and the actual results.

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine/241658#241658"]I figured the fact I saw phagocytocis in the microscopy could indicated the cocci seen there are more than just pollutants.[/quote]

it should make a contaminant less likely but doesn't mean the inflammation is within the bladder - if you had a purulent vaginal discharge you would see this as well.

I think reviewing as above would be a good next step.

Andy

RE: Blood and nitrites in urine

Stigen — Tue, 30 May 2023 19:13:50 GMT

Thanks for answer ; owner has not mentioned discharge, just discoloured/bloody urine, and sometimes strained micturition. I did not do the ultrasound, out machine was broken, so that was done at other clinic where they also did Cystocentesis and sent for culturing. But this was done at a time the dog was`nt showing symptoms, and after an antibiotic course.
I just got the results from the owner who said the culture had been done, and nothing was found. But if it is lower Uti then cysto would bypass the problem.

The dog is not,and have not shown any generalized lethargy/pyrexia/inappetance or anything like that ,just the bloody urine noticed by owner. I did a superficial vaginoscopy today , but did not have time,or acess to a proper speculum at the time, but I saw no reasons for concern in the parts I could visualize.
I figured the fact I saw phagocytocis in the microscopy could indicated the cocci seen there are more than just pollutants. I had also instructed her to catch mid-stream, and in a sterilized jar.

RE: Blood and nitrites in urine

Andrew Kent — Tue, 30 May 2023 14:46:11 GMT

Hi Stigen,

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine"]Pu/pd and owner has seen blood and mucous in urine.[/quote]

Blood and mucus mixed with the urine? or a vulval discharge?

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine"]Urine stix shows high amount nitrites +++, protein ++, blood +++, ph 6,5 . Microskopy many immune cells, and lots of cocci.[/quote]

was this a free catch sample? Remember nitrites are largely useless in our patients so doesn't count for much.

it would be useful to collect a cystocentesis sample to compare as I wonder if the purulent discharge may be coming from the reproductive rather than urinary tract?

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine"]Ultrasound was ok, maybe little thickened walls.[/quote]

were you able to assess the uterine stump?

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine"]Cystocentesis and culture was done from urine , but no findings. (but I don`t know if they used Boric acid tubes). At that time dog had no symptoms. [/quote]

by no findings do you mean that the urine was normal? again this might suggest the disease is lower down.

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/30672/blood-and-nitrites-in-urine"]I find the findings kinda weird. Stix and microskopy findings pretty clearly show bacterial infection , but blood samples and cultivation all normal. My common sense tells me to restart antibiotics course, but maybe 2-3 weeks instead of one week. But I am also wondering to wait for cultivation(which will take a week) or to just put it on something right away - synulox...and then wait until results for the big cannons (enrofloxacin) if there is resistance. Any suggestions? [/quote]

If the dog is now clinical I would take a sample by cysto as well as a free catch and compare. If this is not coming from the bladder then we may need further imaging to look at the reproductive tract or a vaginoscopy.

If the dog is well I would not give antibiotics yet as you've tried that and it returned.

Andy