Vet: what seems to be the problem?

Client: well she had an accident outside of her litterbox and it was bright red

 

Uh oh! definitely not supposed to be red! Our pets can have red urine for a few reasons, all of them rooted in blood. So what is next? Well we should find out why, right??? Blood somewhere there isn’t supposed to be blood is concerning! Let’s check to see how big the bladder is? the size of a small tangerine. OK The next step is to use our lab tools. The two first diagnostic processes that will help narrow down what we should do next are urinalysis (we take a closer look at the urine through a microscope and through chemical analysis) and radiographs (X-RAYS!).

As we run the urinalysis we see that the urine is full of red blood cells, it also has the body’s defenders, the white blood cells.  In among these cells are smaller little grape like spots and light red/pink stick shaped things. None of it should be there but those grapes and sticks are cocci and rods, two types of bacteria! They have made their way from the outside, up the urinary tract and found their perfect home in the moist and warm environment of your pets bladder.  We like to quantify the how severe the infection is by counting the relative number of white blood cells, red blood cells and bacteria.

Well ok there is an infection, but why all the blood? Well as those bacteria grow they cause damage and irritation to the lining of the bladder wall resulting in the bleeding.  Normally this process can be pretty painful and usually we see pets with bladder infections either having accidents outside of litter boxes or multiple small urinations (in the case of cats) or multiple urinations and accidents in the house for our canine friends.  We can often notice them also licking their *ahem* private areas more often.  If we have a) a lot of bacteria b) a lot of white blood cells c) a history of urinary tract infections the best thing to do is send off the urine to a lab for a culture and sensitivity.  YES. I KNOW. another test but hear me out! For a long time we have been giving antibiotics without good proof that they are actually the ones that are most effective, this practice has lead to longer ineffective treatments and even some resistance!

Occasionally in cats we can have “idiopathic cystitis” (cystitis=bladder inflammation), meaning we don’t actually know what causes it, likely a stress component causing the lining of the bladder to flare up and cause bloody urine.

Once we have identified an infection is present and have sent it off for a culture and sensitivity (so we can ID the bugs and pick the appropriate antibiotic) we need to think about doing a radiograph.  WHY? ANOTHER TEST??? This will be covered in the second part of this post.