Whats your DAIGNOSIS? Otto, a 6-year-old, 10-kg, castrated miniature schnauzer, was presented for stranguria and hematuria. History Otto was presented following 2 days of stranguria and hematuria. The owners noted no other clinical signs and stated that the dog always had a calm disposition and a healthy thirst. Routine vaccinations and parasitic preventive medications were up-to-date. Examin Otto was quiet but bright and alert. His BCS score was 5/9, although he was small for his breed. All physical examination parameters were within normal limits. Diagnostics Urinalysis revealed isosthenuria (urine specific gravity, 1.012), hematuria (RBCs too numerous to count), pyuria (10–20 WBCs per high-power field), bacteriuria (2+ rods), and ammonium biurate (1+) crystalluria. CBC was normal. Serum chemistry panel showed a mild increase in alanine transaminase (129 U/L; normal, 0.65). The PV/CVC ratio notes the luminal diameter of the portal vein to that of the aorta; with shunts, the portal vein becomes smaller, and thus the ratio decreases.Figure 1. Ultrasound changes suggestive of CPSS, including the presence of larger kidneys (ie, upper limit of normal; a PV/CVC ratio less than 0.54 and bladder stones .The liver was slightly small with decreased portal markings; the kidney/aorta ratio was 9.2 (range, 5.5–9.1), indicating that kidney size was at the upper limit of normal. Mineralized sediment noted in the bladder indicated the presence of multiple small uroliths.Pre- and postprandial bile acids were 20 and 120 µM/L, respectively (range,
Posted on: Tue, 21 Oct 2014 12:17:07 +0000
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