History

Shorty, a 9-year-old intact male boxer, came to us for a heart evaluation. Shorty had been collapsing (syncope) late at night. In addition, Shorty was urinating dark, bloody urine. This had been occuring for about 1 1/2 years, and the owner wanted a second opinion. She had been told that Shorty's problem was his heart.

Workup

Workup results were as follows:

• Physical exam
  • Temperature - 102.7 (normal)
  • HR - 144 (high normal)
  • Heart asculation - normal, no murmur, no pulse deficits
  • Lungs asculation - clear (normal)
  • Abdomen - difficult to palpate due to obesity
  • Gait - abnormal in pelvic limbs, weak in appearance
  • Prostate - not able to palpate
• Urinalysis
  • Specific gravity: -1.050 (good)
  • Ph - 6 (normal)
  • Blood - large
  • rest WNL
• Cytology of urine - numerous reb blood cells and bacteria cocci
• Thyroid: <0.5ug/dl (low)
• CBC - HCT (blood volume) - 31.3% (low)
• Comprehensive bloodwork - normal
• X-ray of chest - normal

• X-ray of abdomen - enlarged prostate

• Sent urine culture to lab

Diagnosis

We diagnosed Shorty with the following:

1. Anemia - due to chronic infection
2. Hypothyroid
3. Urinary tract infection

Shorty's heart was normal. All clinical signs were due to a low thyroid and urinary tract infection.

Treatment

We started Shorty on thyroid supplements for his low thyroid.  To cure his urinary tract infection, we put him on an antibiotic while we waited for urine culture results.

Follow-up

The culture results showed a large amount of bacteria.  We decided to continue the antibiotics for four weeks, culture the urine, and recheck the thyroid in one month.

As of the middle of May, Shorty had had no collapsing episodes.  He was doing much better.  His urine was starting to clear up; there was only a small amount of blood being seen.  The owner reported that he is feeling better and seems to have more energy.

Past Cases of the Month

Case 1
Case 2
Case 3
Case 4