November 2018 Case of the Month

Crystalluria in a Dog

Case information

A 1-year-old intact male English Mastiff was presented to Emergency Medicine at the Cornell University Hospital with a one week history of pollakiuria and stranguria. Four days prior to presentation, the dog had been started on oral prazocin (an α-1 adrenergic blocker) with no improvement. Hematuria, coughing, sneezing, or diarrhea were not reported. The patient had vomited food material and was inappetent in the 2 days prior to presentation. On physical examination, the patient was 5% dehydrated and was noted to be arching the lumbar spine. No abnormalities were noted on abdominal palpation. No abnormalities were detected on a hemogram and mild electrolyte changes (sodium 154 mEq/L, reference interval, 143-150 mEq/L; chloride 115 mEq/L, reference interval, 106-114 mEq/L) were evident on a biochemical panel. Abdominal radiographs were also obtained (Figure 1). Urine collected by cystocentesis was medium yellow, slightly cloudy with a urine specific gravity of 1.014, pH of 8.5, and trace protein on a dipstick. On urine sediment examination, moderate numbers of sperm and the crystals pictured below (Figures 2-3) were seen.

Evaluate the provided cytologic images (Figures 1-3) and answer the following questions:

  1. What differential diagnosis would you have for this patient based on the history and imaging results?
  2. What is your main differential diagnosis based on the crystalluria and what is unusual about the urinalysis in this case?
  3. What additional treatment and tests would you recommend?

Figure 1: Left lateral caudal abdominal radiograph

Figure 2: Urine sediment, unstained, 50x objective

Urine sediment, unstained, 100x objective.
Figure 3: Urine sediment, unstained, 100x objective

Answers on next page.

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