Practical Matters: Evaluate the urinary tract in patients with hyperadrenocorticism or diabetes mellitus

Practical Matters: Evaluate the urinary tract in patients with hyperadrenocorticism or diabetes mellitus

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Nov 01, 2005


Scott R. Helms, DVM, DABVP
Veterinarians often overlook the urinary tract when evaluating patients for endocrine diseases. However, it is important to perform a full urinalysis and submit a sample for culture in every patient with hyperadrenocorticism or diabetes mellitus. Submit a urine culture regardless of the sediment findings. In one retrospective study, a urinary tract infection occurred in about 42% of dogs with diabetes mellitus, hyperadrenocorticism, or both. Of the dogs with a urinary tract infection, less than 5% had clinical signs of an infection. Only 19% of dogs with positive culture results had pyuria or bacteriuria.1 Furthermore, in dogs, both of these endocrine diseases can be associated with proteinuria. In another retrospective study, 52% of dogs with diabetes mellitus had proteinuria.2 Several studies have also suggested that proteinuria is common in dogs with hyperadrenocorticism.3-5

In patients with hyperadrenocorticism or diabetes mellitus, a complete urinalysis and culture are essential to help rule out postrenal proteinuria as a contributing factor. If the urine sediment is normal and the culture results are negative, complete a urinary protein/creatinine ratio to evaluate for possible renal proteinuria.

REFERENCES

1. Forrester SD, Troy GC, Dalton MN, et al. Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both. J Vet Intern Med 1999;13:557-560.

2. Hess RS, Saunders HM, Van Winkle TJ, et al. Concurrent disorders in dogs with diabetes mellitus: 221 cases (1993-1998). J Am Vet Med Assoc 2000;217:1166-1173.

3. Ortega TM, Feldman EC, Nelson RW, et al. Systemic arterial blood pressure and urine protein/creatinine ratio in dogs with hyperadrenocorticism. J Am Vet Med Assoc 1996;209:1724-1729.

4. Hurley KJ, Vaden SL. Evaluation of urine protein content in dogs with pituitary-dependent hyperadrenocorticism. J Am Vet Med Assoc 1998;212:369-373.

5. Waters CB, Adams LG, Scott-Moncrieff JC, et al. Effects of glucocorticoid therapy on urine protein-to-creatinine ratios and renal morphology in dogs. J Vet Intern Med 1997;11:172-177.

Scott R. Helms, DVM, DABVP
Unifour Veterinary Referrals
126 Highway 321 S.W.
Hickory, NC 28602