Haematuria in Cats
Dr. Sayed Nabil Abedin, Dr. Tadung Taku & Dr. Toshimongla Aier
Introduction
Hematuria is characterized as an abnormally high quantity of red blood cells (RBC) in the urine, which can be microscopic (occult) or macroscopic (visible). At high microscopic magnification, “pathological” hematuria is defined as five or more red blood cells per field. Although there are several causes of hematuria in cats, the most common is lower urinary tract disease (LUTD), which is a common presentation in small animal clinics. If urethral blockage occurs, the term LUTD refers to a set of diseases defined by particular clinical symptoms: hematuria, dysuria, stranguria, pollakiuria, and/or periuria, which can advance to encompass other systemic indicators. The key differential diagnoses for a cat with LUTD include feline idiopathic cystitis, urolithiasis, urethral plugs, and urinary tract infection. Even when adequate therapy is given, lower urinary tract diseases can recur: on average, 50% of cats who have had a LUTD episode will have a recurrence at some time.
Causes of haematuria
Bloody urine can be caused by urinary system abnormalities or disease processes elsewhere in the body that impact the urinary tract. Hematuria can be caused by a variety of factors, including:
- Infections of the urinary system, especially the prostate, caused by bacteria, fungi or viruses.
- Stones or crystals in the bladder and/or kidneys.
- Cystitis idiopathic (urinary bladder inflammation with unknown cause in cats).
- Polycystic kidney disease (PCKD) is a kind of kidney disease that affects (more common in cats) and is also responsible for haematuria.
- Problems with blood clotting (common with consumption of toxins, such as rat poison).
- Thrombocytopenia
- Tumors of the urinary tract
- Trauma to the abdomen or urinary tract
- Parasites of tract: a) Kidney worm: Diotophyma renale
- b) Bladder worm: Capillaria plica
- Clotting (bleeding) disorders: anticoagulant rat poison(Warfarin)
- Medication induced: e.g. Cyclophosphamide drug used to treat some types of cancer & immune
Symptoms
Urine can range in colour from clear to pink or reddish, and it can also contain visible blood and blood clots. The following are some of the clinical indicators of hematuria:
- Drinking more water and urinating more often
- Struggling to urinate
- Urinary accidents in the house/outside the litterbox
- Urinary incontinence (a medical emergency)
- Vocalizing in the litterbox
- Skin bruising
- Bleeding from the nose or gums
- Bleeding in the eyes
- Bloody vomit or faeces
Diagnosis
If blood is present at the start of urination, it may indicate bleeding from the lower urinary tract; if bleeding is present at the end of urination, it may indicate bleeding from the upper urinary tract; if blood is present throughout the urine, it may indicate bleeding from the kidneys, ureter, or bladder.
Diagnostic tests
- Urinalysis is used to check for WBC, RBC, crystals and germs in the urine.
- The presence of WBC is a sign of a urinary tract infection.
- Kidney disease is indicated by the presence of protein in the urine.
- Complete blood count (CBC): To check for systemic infections, anaemia, or a low platelet count.
- Biochemical profile: to assess kidney and liver function as well to detect electrolyte and acid-base imbalances.
Abdominal X-ray: to assess bladder and kidney size, as well as to locate stones thick enough to be seen on a plain x-ray.
Differential diagnosis
Haemoglobinuria: Haemoglobinuria occurs when the amount of haemoglobin released by red blood cells during a haemolytic crisis exceeds the liver’s ability to convert it to bilirubin. When a urine sample with hematuria is left to sit for 15-20 minutes or centrifuged, intact red cells settle out in the sediment and the supernatant becomes clear, but the supernatant with haemoglobinuria keeps its original colour.
Myoglobinuria: Myoglobinuria is characterised by generalised muscular discomfort, edema, weakness, and elevated muscle enzymes in animals (creatine kinase, lactate dehydrogenase etc.) An ammonium sulphate test can be used to confirm it. Hemoglobinuria, hematuria, or myoglobinuria are all symptoms of red urine. Hemoglobinemia is indicated by red staining of the plasma, which most likely caused the hemoglobinuria.
Treatment
The primary or linked disorders that are the underlying cause of the hematuria will determine how the condition is treated. Urinary tract infection might be linked to another urinary tract condition, such as cancer or urinary tract stones (urolithiasis). Hematuria can also be caused by a disorder that affects the entire body, such as an excess of hormones produced by the adrenal glands or diabetes. Before hematuria may be resolved, a systemic nonspecific problem must be addressed. Urinary tract stones, neoplasia, and severe damage to the urinary system may all require surgery. If the cat’s red blood cell count is extremely low, blood transfusions may be required.
Living and Management
Because hematuria can signal a dangerous underlying condition, the cat’s therapy will be determined by the primary or associated disorders that are present.
https://www.pashudhanpraharee.com/care-and-management-of-guinea-pigs-as-pets/
https://www.petmd.com/cat/conditions/urinary/c_ct_hematuria
