What is your diagnosis? Urine from a dog

Abstract

stranguria, and hematuria. The previous history included a urinary tract infection 2 months prior, diagnosed via bacterial culture (Escherichia coli, 50-100 × 10 3 CFU/mL) that was susceptible to amoxicillin-clavulanic acid (Clavamox; Zoetis), which was prescribed (12.5 mg/kg BID for 30 days) with no improvement. On presentation, the patient had a thin body condition (3/9) with no other abnormal findings. An abdominal ultrasound revealed marked thickening of the urinary bladder wall with multiple nodular masses, bilateral hydroureter (left worse than the right), and severe left hydronephrosis. Cystocentesis was performed, and the urine was grossly red-brown and turbid with a urine specific gravity of 1.016. The pH was 7.5 with moderate proteinuria, 50+ RBCs/hpf, 0-2 WBCs/hpf, and 5-9 epithelial cells/ hpf. Cytocentrifuge preparations of the urine were air-dried, fixed, and stained using a modified Wright stain (Hematek 3000; Siemens Medical Solutions USA, Inc.) (Figures 1 and 2).