Problem-oriented approach to Dysuria

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Problem-oriented approach to Dysuria

• Jill McClure, DVM,MS
• Diplomate ACVIM, ABVP

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People never change if they are never challenged.

• I did say that.
• Jill McClure, DVM, MS

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Dysuria

• abnormal urination or micturition
• stranguria - slow, painful attempts
• pollakiuria - frequent passage
• polyuria - larger-than-normal volume
• diuresis - increased production
• incontinence - failure of voluntary control

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Minimum database for Dysuria

• History
• diet
• previous disease
• rabies exposure
• sexual activity
• estrus cycle
• fecal passage
• drug therapy
• u-g or rectal exams

• Physical exam
• CNS signs
• smegma
• pendulous abdomen
• oral ulcers
• rectal exam
• 3o perineal laceration

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Minimum database for Dysuria

• Laboratory exam
• urinalysis
• CBC
• BUN, creatinine

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Expanded database for Dysuria

• Urethroscopy
• Bacterial culture
• Biopsy
• Stone analysis
• Toxic substances - cantharidin
• Radiography

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Pollakiuria/Stranguria
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Pollakiuria/Stranguria
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Pollakiuria/Stranguria
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Pollakiuria/Stranguria

• Inflammation
• bacterial cystitis

• Traumatic
• ruptured bladder
• urolithiasis

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Pollakiuria/Stranguria

• Toxic
• Cantharidin
• Nutritional
• meconium impaction

• Idiopathic
• beans
• Malformations
• pneumovagina
• urine pooling

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Urinary Incontinence

• History
• respiratory disease
• diet
• foaling date
• flaccid penis/tail

• Physical Exam
• cranial nerves
• ataxia
• tail tone, perineal sensation
• status of bladder

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Urinary Incontinence

• Laboratory
• CBC
• UA

• Expanded lab
• CSF
• contrast radiography
• serology
• cystoscopy

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Urinary Incontinence
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Urinary Incontinence
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Urinary Incontinence

• Infectious
• EHV-1
• Trauma
• post-parturient

• Toxic
• Sorghum
• Idiopathic
• neuritis of the cauda equina