Section: Veterinary Care In-depth
Diagnosis In-depth
Diagnostic tests needed to determine the cause of dysuria include:
Urinalysis to identify crystals, abnormal cells or evidence of inflammation
Urine culture and sensitivity to identify the presence of infection
Plain abdominal radiographs to assess for the presence of cystic calculi or bladder stones
Contrast cystourethrogram. A radiographic dye study to evaluate for the presence of calculi in either the bladder or urethra. This study will also establish the presence of filling defects that may be masses, areas of inflammation or strictures.
Abdominal ultrasound to assess the kidneys, ureters, bladder and proximal urethra
A rectal exam to assess the size and thickness of the pelvic urethra evaluating for masses, prostatic enlargement, or stones
Blood tests such as a complete blood count and serum chemistry profile to assess for changes suggesting infection or elevations in kidney values
Treatment In-depth
The course of treatment will be dictated by the underlying cause of the problem.
Dysuria caused by the presence of a stone in the urethra may require a technique referred to a retrograde urohydropropulsion. This is when a catheter is advanced to meet the stone and sterile water is flushed under pressure to dislodge the stone and either flush it out of the urethra or back into the bladder.
The presence of stones in the bladder may require either surgery to remove them or in with some types a special diet to dissolve the stones.
Antibiotics to treat for bacterial infection may be required for a short period of time (two weeks) with a first infection or up to three months with recurrent infections.
With granulomatous urethritis the use of steroids to decrease the inflammation and perhaps an antispasmotic agent/smooth muscle relaxant such as prazosin will be necessary.
Some tumors of the bladder or urethra will require surgery to remove and those that are not amenable to surgery will require chemotherapy drugs or nonsteroidal anti-inflammatory drugs.
Follow-up
Follow-up may require long-term medical management. Also subsequent radiographs may need to be taken or repeat ultrasound examinations. Frequent examinations of the urine and repeat cultures will be required to monitor for infections and response to antibiotic management.
