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Urine: hematuria

Clapis

Synonym(s): Blood in the urine


Introduction

  • Cause: hematuria is the presence of blood in the urine and is an important sign of pathologies of the urogenital tract. In rabbits, it is important to distinguish between hematuria and porphyrin pigmented urine. The latter is a normal condition in rabbits. In a centrifuged urine sample, the sediment is red in the case of hematuria, while the supernatant is red in the case of pigmented urine. Hematuria can be caused by several conditions that affect the urinary and genital tracts. The main causes are uterine adenocarcinoma, uterine polyps, endometrial aneurysm, renal infarction, urolithiasis, urethral obstruction, hemorrhagic and chronic cystitis, disseminated intravascular coagulation, bladder polyps, pyelonephritis, infections and trauma.
  • Signs: presence of blood in urine. The urine can be tinged with blood or have a red-brown color. Red staining of the fur around the genital area may also be present. Depending on the cause of hematuria, other clinical signs may be present such as pain and discomfort, a distended bladder and enlarged abdomen.
  • Diagnosis: urinalysis is performed to confirm or rule out hematuria. To then diagnose the cause of hematuria several diagnostic tests may be performed, such as physical examination, hematological and biochemical evaluation, radiographic and ultrasonographic examination and post-mortem examination.
  • Treatment: depends on cause.
  • Prognosis: depends on cause and response to treatment.
Print off the Owner factsheet on Red urine to give to your clients.
 

Presenting signs

  • Change in urine color: urine may be tinged with blood; blood clots may be visible, or the urine has a uniform red-brown color.
  • Dysuria.
  • Distended abdomen due to, eg distended bladder caused by urethral obstruction Urinary tract obstruction, or enlarged uterus due to uterine adenocarcinoma Uterine adenocarcinoma.

Acute presentation

  • Collapse or death due to disseminated intravascular coagulation, or severe urethral obstruction.

Age predisposition

Sex predisposition

Breed predisposition

  • Giant rabbit breeds may be more predisposed to urolithiasis Urolithiasis.

Cost consideration

  • Costs depend on the etiology, the level of investigation and medical or surgical treatment.

Special risks

  • Urethral obstruction can be a life-threatening condition if not treated properly.
  • Uterine adenocarcinoma can metastasize to the lungs and other organs; thoracic radiographic Radiography: thorax examination should be performed before surgical treatment.

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bray M V, Weir E C, Brownstein D G et al (1992) Endometrial venous aneurysms in three New Zealand White rabbits. Lab Anim Sci 42 (4), 360-362 PubMed.
  • Garibaldi B A, Fox J G, Otto G et al (1987) Hematuria in rabbits. Lab Anim Sci 37 (6), 769-772 PubMed.

Other sources of information

  • Mancinelli E & Lord B (2014) Urogenital System and Reproductive Disease. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK. pp 191-204.
  • Oglesbee B (2011) Hematuria. In: Blackwell’s Five-Minute Veterinary Consult: Small Mammal. 2nd edn. Wiley-Blackwell, UK. pp 434-435.
  • Pare J A & Paul-Murphy J (2006) Disorders of the Reproductive and Urinary Systems. In: Ferrets, Rabbits & Rodents Clinical Medicine & Surgery. Eds: Quesenberry K E & Carpenter J W. Saunders, USA. pp 183-193.
  • Harcourt-Brown F (2002) Urinogenital Disease. In: Textbook of Rabbit Medicine. Butterworth-Heinemann, UK. pp 334-351.

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