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Diagnostic approach to hematuria in dogs and cats

      Hematuria is the presence of abnormal numbers of red blood cells in urine; it may be microscopic (occult) or macroscopic (gross). Microscopic hematuria is characterized by small numbers of red blood cells in urine and is only visible during microscopic examination of urine sediment. Macroscopic hematuria occurs when the quantity of blood in urine is of sufficient magnitude to be visible by the naked eye; it may appear pink, red, or dark brown and may contain blood clots. Any disorder that damages the mucosal surfaces or vasculature of the urogenital tract may allow leakage of red blood cells into the urinary space and subsequent hematuria. Pathologic processes that cause hematuria include infection, inflammation, neoplasia, trauma, vascular disease, and coagulopathies.
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      References

        • Brown S.A
        • Barsanti J.A
        • Crowell W.A
        Gentamicin-associated acute renal failure in the dog.
        J Am Vet Med Assoc. 1985; 186: 686-690
        • Grauer G.F
        • Thrall M.A
        • Henre B.A
        • Grauer R.M
        • Hamar D.W
        Early clinicopathologic findings in dogs ingesting ethylene glycol.
        Am J Vet Res. 1984; 45: 2299-2303
        • Thrall M.A
        • Grauer G.F
        • Mero K.N
        Clinicopathologic findings in dogs and cats with ethylene glycol intoxication.
        J Am Vet Med Assoc. 1984; 184: 37-41
        • Crow S.E
        • Bell T.G
        • Wortman J.A
        Hematuria associated with renal hemangiosarcoma in a dog.
        J Am Vet Med Assoc. 1980; 176: 531-533
        • O'Brien R.T
        • Wood E.F
        Urinary bladder mural hemorrhage associated with systemic bleeding disorders in three dogs.
        Vet Radiol Ultrasound. 1998; 39: 354-356
        • Garon C.L
        • Scott M.A
        • Selting K.A
        • Cohn L.A
        Idiopathic thrombocytopenic purpura in a cat.
        J Am Anim Hosp Assoc. 1999; 35: 464-470
        • Batamuzi E.K
        • Kristensen F
        • Basse A
        • Dahl S
        Idiopathic renal haematuria in a dog.
        Vet Rec. 1994; 135: 603
        • Hitt M.E
        • Straw R.C
        • Lattimer J.C
        • Shaw D.P
        • Weide K.D
        • Smith C
        Idiopathic hematuria of unilateral renal origin in a dog.
        J Am Vet Med Assoc. 1985; 187: 1371-1373
        • Holt P.E
        Idiopathic renal haematuria in the dog.
        Vet Rec. 1995; 136: 52
        • Jennings Jr., P.B
        • Mathey W.S
        • Okerberg C.V
        • Langlinais P.C
        • Kim S.H
        Idiopathic renal hematuria in a military working dog.
        Mil Med. 1992; 157: 561-564
        • Kaufman A.C
        Benign essential hematuria in dogs.
        Compend Contin Educ Pract Vet. 1994; 16: 1317-1323
        • Hawthorne J.C
        • deHaan J.J
        • Goring R.L
        • Randall S.R
        • Kennedy F.S
        • Stone E
        • et al.
        Recurrent urethral obstruction secondary to idiopathic renal hematuria in a puppy.
        J Am Anim Hosp Assoc. 1998; 34: 511-514
        • Stone E.A
        • DeNovo R.C
        • Rawlings C.A
        Massive hematuria of nontraumatic renal origin in dogs.
        J Am Vet Med Assoc. 1983; 183: 868-871
        • Mishina M
        • Watanabe T
        • Yugeta N
        • Maeda H
        • Fujii K
        • Wakao Y
        • et al.
        Idiopathic renal hematuria in a dog; the usefulness of a method of partial occlusion of the renal artery.
        J Vet Med Sci. 1997; 59: 293-295
        • Adin C.A
        • Cowgill L.D
        Treatment and outcome of dogs with leptospirosis: 36 cases (1990–1998).
        J Am Vet Med Assoc. 2000; 216: 371-375
        • Birnbaum N
        • Barr S.C
        • Center S.A
        • Schermerhorn T
        • Randolph J.F
        • Simpson K.W
        Naturally acquired leptospirosis in 36 dogs: serological and clinicopathological features.
        J Small Anim Pract. 1998; 39: 231-236
        • Langston C.E
        • Heuter K.J
        Leptospirosis. A re-emerging zoonotic disease.
        Vet Clin North Am Small Anim Pract. 2003; 33: 791-807
        • Rentko V.T
        • Clark N
        • Ross L.A
        • Schelling S.H
        Canine leptospirosis. A retrospective study of 17 cases.
        J Vet Intern Med. 1992; 6: 235-244
        • Littman M.P
        Canine borreliosis.
        Vet Clin North Am Small Anim Pract. 2003; 33: 827-862
        • Grauer G.F
        • Burgess E.C
        • Cooley A.J
        • Hagee J.H
        Renal lesions associated with Borrelia burgdorferi infection in a dog.
        J Am Vet Med Assoc. 1988; 193: 237-239
        • Dambach D.M
        • Smith C.A
        • Lewis R.M
        • Van Winkle T.J
        Morphologic, immunohistochemical, and ultrastructural characterization of a distinctive renal lesion in dogs putatively associated with Borrelia burgdorferi infection: 49 cases (1987–1992).
        Vet Pathol. 1997; 34: 85-96
        • DiBartola S.P
        • Myer C.W
        • Boudrieau R.J
        • DeHoff W.D
        Chronic hematuria associated with renal pelvic blood clots in two dogs.
        J Am Vet Med Assoc. 1983; 183: 1102-1104
        • Eddlestone S
        • Taboada J
        • Senior D
        • Paulsen D.B
        Renal haemangioma in a dog.
        J Small Anim Pract. 1999; 40: 132-135
        • Henry C.J
        • Turnquist S.E
        • Smith A
        • Graham J.C
        • Thamm D.H
        • O'Brien M
        • et al.
        Primary renal tumours in cats: 19 cases (1992–1998).
        J Feline Med Surg. 1999; 1: 165-170
        • Klein M.K
        • Cockerell G.L
        • Harris C.K
        • Withrow S.J
        • Lulich J.P
        Canine primary renal neoplasms: a retrospective review of 54 cases.
        J Am Anim Hosp Assoc. 1988; 24: 443-452
        • Seaman R.L
        • Patton C.S
        Treatment of renal nephroblastoma in an adult dog.
        J Am Anim Hosp Assoc. 2003; 39: 76-79
        • Wang F.I
        • Su H.L
        A renal hemangiosarcoma causing hematuria in a dog.
        Proc Natl Sci Counc Repub China B. 2001; 25: 187-192
        • Moore F.M
        • Thornton G.W
        Telangiectasia of Pembroke Welsh Corgi dogs.
        Vet Pathol. 1983; 20: 203-208
        • Grauer G.F
        • Twedt D.C
        • Mero K.N
        Evaluation of laparoscopy for obtaining renal biopsy specimens from dogs and cats.
        J Am Vet Med Assoc. 1983; 183: 677-679
        • Jeraj K
        • Osborne C.A
        • Stevens J.B
        Evaluation of renal biopsy in 197 dogs and cats.
        J Am Vet Med Assoc. 1982; 181: 367-369
        • Weisse C
        • Aronson L.R
        • Drobatz K
        Traumatic rupture of the ureter: 10 cases.
        J Am Anim Hosp Assoc. 2002; 38: 188-192
        • Moroff S.D
        • Brown B.A
        • Matthiesen D.T
        • Scott R.C
        Infiltrative urethral disease in female dogs: 41 cases (1980–1987).
        J Am Vet Med Assoc. 1991; 199: 247-251
        • Buffington C.A
        • Chew D.J
        • Kendall M.S
        • Scrivani P.V
        • Thompson S.B
        • Blaisdell J.L
        • et al.
        Clinical evaluation of cats with nonobstructive urinary tract diseases.
        J Am Vet Med Assoc. 1997; 210: 46-50
        • Brearley M.J
        • Thatcher C
        • Cooper J.E
        Three cases of transitional cell carcinoma in the cat and a review of the literature.
        Vet Rec. 1986; 118: 91-94
        • Burnie A.G
        • Weaver A.D
        Urinary bladder neoplasia in the dog: a review of seventy cases.
        J Small Anim Pract. 1983; 24: 129-143
        • Esplin D.G
        Urinary bladder fibromas in dogs: 51 cases (1981–1985).
        J Am Vet Med Assoc. 1987; 190: 440-444
        • Norris A.M
        • Laing E.J
        • Valli V.E
        • Withrow S.J
        • Macy D.W
        • Ogilvie G.K
        • et al.
        Canine bladder and urethral tumors: a retrospective study of 115 cases (1980–1985).
        J Vet Intern Med. 1992; 6: 145-153
        • Wimberly H.C
        • Lewis R.M
        Transitional cell carcinoma in the domestic cat.
        Vet Pathol. 1979; 16: 223-228
        • Martinez I
        • Mattoon J.S
        • Eaton K.A
        • Chew D.J
        • DiBartola S.P
        Polypoid cystitis in 17 dogs (1978–2001).
        J Vet Intern Med. 2003; 17: 499-509
        • Collins R.L
        • Birchard S.J
        • Chew D.J
        • Heuter K.J
        Surgical treatment of urate calculi in Dalmatians: 38 cases (1980–1995).
        J Am Vet Med Assoc. 1998; 213: 833-838
        • Crow S.E
        • Thielen G.H
        • Madewell B.R
        • Weller R.E
        • Henness A.M
        Cyclophosphamide-induced cystitis in the dog and cat.
        J Am Vet Med Assoc. 1977; 171: 259-262
        • Peterson J.L
        • Couto C.G
        • Hammer A.S
        Acute sterile hemorrhagic cystitis after a single intravenous administration of cyclophosphamide in three dogs.
        J Am Vet Med Assoc. 1992; 201: 1572-1574
        • Laing E.J
        • Miller C.W
        • Cochrane S.M
        Treatment of cyclophosphamide-induced hemorrhagic cystitis in five dogs.
        J Am Vet Med Assoc. 1988; 193: 233-236
        • Lulich J.P
        • Osborne C.A
        • Carlson M
        • Unger L.K
        • Samelson L.L
        • Koehler L.A
        • et al.
        Nonsurgical removal of urocystoliths in dogs and cats by voiding urohydropropulsion.
        J Am Vet Med Assoc. 1993; 203: 660-663
        • Lulich J.P
        • Osborne C.A
        • Sanderson S.L
        • Ulrich L.K
        • Koehler L.A
        • Bird K.A
        • et al.
        Voiding urohydropropulsion. Lessons from 5 years of experience.
        Vet Clin North Am Small Anim Pract. 1999; 29: 283-291
        • Kruger J.M
        • Osborne C.A
        • Ulrich L.K
        Cystocentesis. Diagnostic and therapeutic considerations.
        Vet Clin North Am Small Anim Pract. 1996; 26: 353-361
        • Seguin M.A
        • Vaden S.L
        • Altier C
        • Stone E
        • Levine J.F
        Persistent urinary tract infections and reinfections in 100 dogs (1989–1999).
        J Vet Intern Med. 2003; 17: 622-631
        • Krawiec D.R
        • Heflin D
        Study of prostatic disease in dogs: 177 cases (1981–1986).
        J Am Vet Med Assoc. 1992; 200: 1119-1122
        • Read R.A
        • Bryden S
        Urethral bleeding as a presenting sign of benign prostatic hyperplasia in the dog: a retrospective study (1979–1993).
        J Am Anim Hosp Assoc. 1995; 31: 261-267
        • Ling G.V
        • Nyland T.G
        • Kennedy P.C
        • Hager D.A
        • Johnson D.L
        Comparison of two sample collection methods for quantitative bacteriologic culture of canine prostatic fluid.
        J Am Vet Med Assoc. 1990; 196: 1479-1482
        • Rogers K.S
        • Walker M.A
        • Dillon H.B
        Transmissible venereal tumor: a retrospective study of 29 cases.
        J Am Anim Hosp Assoc. 1998; 34: 463-470
        • Hostutler R.A
        • Chew D.J
        • Eaton K.A
        • DiBartola S.P
        Cystoscopic appearance of proliferative urethritis in 2 dogs before and after treatment.
        J Vet Intern Med. 2004; 18: 113-116
        • Forrester S.D
        • Troy G.C
        • Dalton M.N
        • Huffman J.W
        • Holtzman G
        Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both.
        J Vet Intern Med. 1999; 13: 557-560
        • Grossfeld G.D
        • Wolf J.S
        • Litwin M.S
        • Hricak H
        • Shuler C.L
        • Agerter D.C
        • et al.
        Asymptomatic microscopic hematuria in adults: summary of the AUA best practice policy recommendations.
        Am Fam Physician. 2001; 63: 1145-1154
        • Grossfeld G.D
        • Litwin M.S
        • Wolf Jr., J.S
        • Hricak H
        • Shuler C.L
        • Agerter D.C
        • et al.
        Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy–part II: patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up.
        Urology. 2001; 57: 604-610
        • Grossfeld G.D
        • Litwin M.S
        • Wolf J.S
        • Hricak H
        • Shuler C.L
        • Agerter D.C
        • et al.
        Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy–part I: definition, detection, prevalence, and etiology.
        Urology. 2001; 57: 599-603
        • Hiatt R
        • Ordonez J
        Dipstick urinalysis screening, asymptomatic microhematuria, and subsequent urological cancers in a population-based sample.
        Cancer Epidemiol Biomarkers Prev. 1994; 3: 439-443
        • Mutsaers A.J
        • Widmer W.R
        • Knapp D.W
        Canine transitional cell carcinoma.
        J Vet Intern Med. 2003; 17: 136-144
        • Henry C.J
        Management of transitional cell carcinoma.
        Vet Clin North Am Small Anim Pract. 2003; 33: 597-613
        • Crow S.E
        Hematuria: an algorithm for differential diagnosis.
        Compend Contin Educ Pract Vet. 1980; 2: 211-218
        • Grauer G.F
        Urinary tract disorders.
        in: Nelson R.W Feldman E.C Small animal internal medicine. 3rd edition. Mosby, St. Louis2003: 572-575
        • Lage A.L
        Diagnostic approach to canine and feline hematuria.
        in: Kirk R Current veterinary therapy (small animal practice). vol. X. WB Saunders, Philadelphia1989: 1117-1123
        • Kruger J.M
        • Osborne C.A
        • Goyal S.M
        • Wickstrom S.L
        • Johnston G.R
        • Fletcher T.F
        • et al.
        Clinical evaluation of cats with lower urinary tract disease.
        J Am Vet Med Assoc. 1991; 199: 211-216
        • Osborne C.A
        • Stevens J.B
        Urine sediment: under the microscope.
        in: Osborne C.A Stevens J.B Urinalysis: a clinical guide to compassionate patient care. Bayer Corporation, Shawnee Mission1999: 125-150
        • Ruiz de Gopegui R
        • Feldman B.F
        Platelets and von Willebrand's disease.
        in: Ettinger S.J Feldman E.C Textbook of veterinary internal medicine. WB Saunders, Philadelphia2000: 1817-1828
        • Brooks M
        Coagulopathies and thrombosis.
        in: Ettinger S.J Feldman E.C Textbook of veterinary internal medicine. WB Saunders, Philadelphia2000: 1829-1841
        • Meinkoth J.H
        • Cowell R.L
        Recognition of basic cell types and criteria of malignancy.
        Vet Clin North Am Small Anim Pract. 2002; 32: 1209-1235
        • Borjesson D.L
        • Christopher M.M
        • Ling G.V
        Detection of canine transitional cell carcinoma using a bladder tumor antigen urine dipstick test.
        Vet Clin Pathol. 1999; 28: 33-38
        • Billet J.P
        • Moore A.H
        • Holt P.E
        Evaluation of a bladder tumor antigen test for the diagnosis of lower urinary tract malignancies in dogs.
        Am J Vet Res. 2002; 63: 370-373
        • Henry C.J
        • Tyler J.W
        • McEntee M.C
        • Stokol T
        • Rogers K.S
        • Chun R
        • et al.
        Evaluation of a bladder tumor antigen test as a screening test for transitional cell carcinoma of the lower urinary tract in dogs.
        Am J Vet Res. 2003; 64: 1017-1020
        • Littman M.P
        • Niebauer G.W
        • Hendrick M.J
        Macrohematuria and life-threatening anemia attributable to subepithelial vascular ectasia of the urinary bladder in a dog.
        J Am Vet Med Assoc. 1990; 196: 1487-1489
        • Prater R
        • Tvedten H
        Hemostatic abnormalities.
        in: Willard M.D Tvedten H Small animal clinical diagnosis by laboratory methods. WB Saunders, Philadelphia2004: 92-112
        • Pechman R
        The urethra.
        in: Thrall D Textbook of veterinary diagnostic radiology. WB Saunders, Philadelphia2002: 588-592
        • Park R
        • Wrigley R
        The urinary bladder.
        in: Thrall D Textbook of veterinary diagnostic radiology. WB Saunders, Philadelphia2002: 571-587
        • Leveille R
        Ultrasonography of urinary bladder disorders.
        Vet Clin North Am Small Anim Pract. 1998; 28: 799-821
        • Feeney D
        • Johnston G
        The kidneys and ureters.
        in: Thrall D Textbook of veterinary diagnostic radiology. WB Saunders, Philadelphia2002: 556-571
        • Brearley M.J
        • Cooper J.E
        The diagnosis of bladder disease in dogs by cystoscopy.
        J Small Anim Pract. 1987; 28: 75-85
        • Cannizzo K.L
        • McLoughlin M.A
        • Chew D.J
        • DiBartola S.P
        Uroendoscopy. Evaluation of the lower urinary tract.
        Vet Clin North Am Small Anim Pract. 2001; 31: 789-807
        • Chew D.J
        • Buffington T
        • Kendall M.S
        • Osborn S.D
        • Woodsworth B.E
        Urethroscopy, cystoscopy, and biopsy of the feline lower urinary tract.
        Vet Clin North Am Small Anim Pract. 1996; 26: 441-462
        • McCarthy T.C
        Cystoscopy and biopsy of the feline lower urinary tract.
        Vet Clin North Am Small Anim Pract. 1996; 26: 463-482
        • Senior D.F
        Cystoscopy.
        in: Tams T Endoscopy. Mosby, St. Louis1999: 447-459
        • Borjesson D.L
        Renal cytology.
        Vet Clin North Am Small Anim Pract. 2003; 33: 119-134
        • Valli V.E
        • Norris A
        • Jacobs R.M
        • Laing E
        • Withrow S
        • Macy D
        • et al.
        Pathology of canine bladder and urethral cancer and correlation with tumour progression and survival.
        J Comp Pathol. 1995; 113: 113-130
        • Hager D.A
        • Nyland T.G
        • Fisher P
        Ultrasound-guided biopsy of the canine liver, kidney, and prostate.
        Vet Radiol. 1985; 26: 82-88
        • Lamb C.R
        • Trower N.D
        • Gregory S.P
        Ultrasound-guided catheter biopsy of the lower urinary tract: technique and results in 12 dogs.
        J Small Anim Pract. 1996; 37: 413-416
        • Melhoff T
        • Osborne C
        Catheter biopsy of the urethra, urinary bladder, and prostate gland.
        in: Kirk R Current veterinary therapy. vol. VII. WB Saunders, Philadelphia1977: 1173-1175
        • Anderson W.I
        • Dunham B.M
        • King J.M
        • Scott D.W
        Presumptive subcutaneous surgical transplantation of a urinary bladder transitional cell carcinoma in a dog.
        Cornell Vet. 1989; 79: 263-266
        • Gilson S.D
        • Stone E.A
        Surgically induced tumor seeding in eight dogs and two cats.
        J Am Vet Med Assoc. 1990; 196: 1811-1815
        • Nyland T.G
        • Wallack S.T
        • Wisner E.R
        Needle-tract implantation following ultrasound-guided fine-needle aspiration biopsy of transitional cell carcinoma of the bladder, urethra, and prostate.
        Vet Radiol Ultrasound. 2002; 43: 50-53
        • Harris C.H
        • Krawiec D.R
        • Gelberg H.B
        • Shapiro S.Z
        Canine IgA glomerulonephropathy.
        Vet Immunol Immunopathol. 1993; 36: 1-16