Hemoglobinuria

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Sections available in full article Introduction, Presenting signs, Acute presentation, Geographic incidence, Breed predisposition, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Differential diagnosis, Treatment, Initial symptomatic treatment, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Melissa Wallace DVM DipACVIM

Introduction

  • Presence of free hemoglobin in the urine.
  • Cause : hemoglobin filtered by the glomeruli (true hemoglobinuria) or hemoglobin released by lysis of erythrocytes in urine (hematuria).
  • Signs : reddish discoloration of urine.
  • Diagnosis : blood reaction on urine test strip; lack of erythrocytes in urine sediment; investigation of cause.
  • Treatment : depends on cause.
  • Prognosis : depends on cause.

Diagnosis

Clinical signs

  • Reddish colored urine.
  • Signs of hemolytic anemia:
    • Pale mucous membranes.
    • Rapid respiratory rate.
    • Tachycardia.
    • Weak pulse.
  • Icterus.
  • Lymphadenopathy.
  • Splenomegaly.
  • Hepatomegaly.
  • Hypoxemia.

Diagnosis

Differential diagnosis

  • Hematuria Hematuria.
  • Myoglobinuria Myoglobinuria.
  • Other causes of discolored urine Discolored urine.

Sequelae

Prognosis

  • Depends on underlying cause, and severity of hemolysis.

Expected response to treatment

  • Resolution of hemoglobinuria.
  • Resolution of anemia.

Reasons for treatment failure

  • Severe hemolytic crisis.
  • Underlying cause not diagnosed or misdiagnosed.
  • Inappropriate or insufficient therapy for underlying cause.
  • Inadequate fluid therapy leading to renal tubular damage.

Sources

Publications

Refereed papers

  • Lobetti R G, Reyers F & Nesbit J W (1996) The comparative role of hemoglobinuria and hypoxia in the development of canine babesial nephropathy. J South African Med Assoc 67 (4), 188-198.
  • Lobetti R G & Reyers F (1996) Met-hemoglobinuria in naturally occurring Babesia canis infection. J South African Med Assoc 67 (2), 88-90.

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