Urine is usually a nice yellow color. It’s clear, not cloudy, and doesn’t smell too bad unless of course it is from an intact male cat that has just nervously peed down your leg. Figures, right?
You have been caring for a very sick dog with liver issues for a few days. Blood work showed elevated liver enzymes and hyperbilirubinemia, although the patient did not appear icteric. He has been on I.V. fluids and a wealth of other treatments and so far his urine, although concentrated hasn’t looked too bad. This morning it looks like this.
Urine is usually a nice yellow color. It’s clear, not cloudy, and doesn’t smell too bad unless of course it is from an intact male cat that has just nervously peed down your leg. Figures, right?
You have been caring for a very sick dog with liver issues for a few days. Blood work showed elevated liver enzymes and hyperbilirubinemia, although the patient did not appear icteric. He has been on I.V. fluids and a wealth of other treatments and so far his urine, although concentrated hasn’t looked too bad. This morning it looks like this.
Bilirubinuria
No, this is not your doctor’s morning coffee I.V. drip, it is severe bilirubinuria in a urine collection system (UCS). Bilirubinuria is the presence of bilirubin in the urine; in this case a lot of bilirubin is present. A UCS line was attached to a redder rubber urinary catheter due to this patient’s increasing lack of mobility and this was the urine produced by the patient overnight. The most common causes of bilirubinuria are diseases of the liver. (Hepatitis, hepatic lipidosis (cats), cholangiohepatitis, ingested toxins such as acetaminophen, and leptospirosis to name a few.)
- Recheck blood work found worsening liver values, marked hypoproteinemia, hyperbilirubinemia, and new azotemia.
- The patient now had pitting edema and decreased urinary production.
- The patient was given a plasma transfusion but continued to decline rapidly and the decision was made to humanely euthanize.
Despite the high bilirubin count, the patient’s mucous membranes never appeared jaundiced. I think cats appear jaundiced much faster than dogs. If there are any doctors or technicians that should have been doctors in the forum I would love to know if you agree about cats appearing jaundiced faster than dogs and why that may be? Thanks!
Comments
One would also need to
One would also need to consider hemoglobinuria/met-hemoglobinuria as a possible cause for that urine color; which can occur with severe hemolytic disease/acetaminophen toxicity
One would also need to
One would also need to consider hemoglobinuria/met-hemoglobinuria as a possible cause for that urine color; which can occur with severe hemolytic disease/acetaminophen toxicity
Thanks Dr. Lobetti! What do
Thanks Dr. Lobetti! What do you think of the notion of cats appearing icteric before dogs do?
Thanks Dr. Lobetti! What do
Thanks Dr. Lobetti! What do you think of the notion of cats appearing icteric before dogs do?
Cannot find any reference to
Cannot find any reference to this. Possibly that icterus is easier seen in cats than dogs because of the paler nature of their mucus membranes
Cannot find any reference to
Cannot find any reference to this. Possibly that icterus is easier seen in cats than dogs because of the paler nature of their mucus membranes
This is probably why. I may
This is probably why. I may also just be more used to seeing it in cats, due to the high number of hepatic lipidosis cases we seem to have in our clinic. Thanks again Dr. Lobetti.
This is probably why. I may
This is probably why. I may also just be more used to seeing it in cats, due to the high number of hepatic lipidosis cases we seem to have in our clinic. Thanks again Dr. Lobetti.