I write this case of contrasting urine colours for vet undergraduates who may be struggling to remember so much information for their 4th year examinations. I hope the following cases will bring veterinary medicine alive to students who unfortunately don't have the opportunity to see many interesting cases (being students)!
More details of the following cases are at:
Dog 1 - Miniature Schnauzer, 2 years, male, not neutered. Dog was groomed one week ago but the house-call groomer prohibited the owner to see. However, he recommended one "shampoo" for the dog. The daughter applied directly onto the legs the "shampoo" to make the hair silky and not tangled up. However the dog licked off the "shampoo" and started shivering and vomiting after 1 day.
Dog 2 - Shih Tzu, 10 years, male, recently neutered and repair of right perineal hernia. 4 days ago, had fever and urinary tract infection was diagnosed. Dog was given medication of antibiotics.
Dog 1 - Shivering for 2 hours yesterday. Vomited twice after consultation.
Dog 2 - Cannot control bladder. "Bites when backside is touched" the mother said. Tongue pale. Vomited once after consultation during hospitalisation.
Dog 1 - shivering
Dog 2 - urinary incontinence
Coincidental cases. Mum
and young adult daughter
Miniature Schnauzer, 2 years male, shivers for 1 hour yesterday. Working daughter brought in the dog. Why? Had a history of shivering after tick wash. A home groomer had come 2 weeks ago to the apartment as the dog had tick infestation frequently. But the groomer refused to let the mum and daughter watch.
"He never humps or climbed our legs when we are around," the daughter said. I noted that the penile tip is red and inflamed. Slight pain in the right ear horizontal canal and L/S spinal area. Allergy to shampoo or environment? Excessive ear hairs trapping dirt and "ticks" inside the ear canal? Head shaking for the past 3 months, the daughter volunteered the new info. Fits of unknown cause? Distemper encephalitis? So what is he problem?
The urine was orange brown in colour.
The mother brought in the dog. "A vet cannot predict whether the dog will die or not." I said. "Blood tests and urine tests are important in the aid to diagnosis." The daughter messaged from the school while she was in clinic. The Shih Tzu keeps licking penile area. Urine incontinence. Had been treated for UTI and right perineal hernia repair.
The mum said: "The Shih Tzu had been taking the antibiotics and medication for the past 4 days. Yet he is not OK. Why?" the mum asked. I said: "I need to do blood test and urine test again." I used a catheter to collect the urine. It was light yellow in colour.
I took pictures of the two urine samples in bright sunlight as they were contrasting in colours.
"I thought he had died," the mum said. The Shih Tzu, male, neutered, 10 years old was motionless. He had a right perineal hernia repair and then neutering 2 weeks ago on 5.8.10 and went home on 16.8.10. He was Ok for a few days at home. Then he stopped eating for a few days and collapsed as if he had died pm 20.8.10.
Bladder felt firm and enlarged. Urine was collected by catherisation. Urine test indicated a Urinary Tract Infection. He had a high fever and was given antibiotics and sent home. The dog went home the next day but came back again on 23.8.10 as he could not control his bladder and "bites when his back is touched."
I found that he had a high fever and was pale. He was licking his private parts and urine kept leaking out. I noted that the urine was chalky white in colour.
Palpation: Bladder felt firm and a painful hard globular lump was felt in the bladder area. It could be an enlarged bladder wall, bladder tumour or prostrate enlargement.
2. I emptied the bladder using a catheter and syringe to draw out the urine. 15 ml of urine came out. Then I palpated the bladder. A little amount of urine came out but a rounded lump of 3 cm x 3 cm was distinctly felt. This was the enlarged prostate and the dog reacted painfully..
3. Rectal digital palpation when the bladder is emptied. This confirmed that the prostate was enlarged.
Diagnosis: I diagnosed this as prostatitis and enlargement. Also epithelial cells seen in urine test.
23.8.10 Creatinine was below normal. Red cell below normal. Total White Cell above normal. Neutrophils 97% (Absolute 17.2 x 10^9/L), Lymphocytes 2.5% (Absolute 0.45X 10^9/L). During the first evening of hospitalisation on 23.8.10, I noted that the tongue was pale. The mother noted that too.
URINALYSIS BY THE LAB