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1270 Pollakiuria and Stranguria Polyphagia

Pollakiuria and Stranguria
VetBooks.ir Differential Diagnosis Key Feature(s)

Bladder neoplasia (e.g., transitional cell carcinoma) Scottish terrier predisposed; +/− RBC, WBC, atypical epithelial cells on UA (avoid cystocentesis); mass effect (most
often trigone area) on ultrasound or contrast cystogram; traumatic/diagnostic catheterization for cytology (unless
atypia identified on UA); BRAF gene mutation (urine assay)
Cystic calculi RBC, WBC, +/− crystals on UA; culture may be positive (particularly with struvite stones); radiographs (i.e., struvite,
calcium based); ultrasound or contrast cystogram for radiolucent stones (e.g., urate)
Cystitis, bacterial or fungal WBC, RBC, and bacteria/fungi on UA; culture positive; imaging normal, bladder wall thickening, or emphysematous
cystitis
Cystitis, nonbacterial ± History of causative insult (e.g., cyclophosphamide); RBC +/− WBC, no bacteria on UA; bacterial culture negative;
imaging variable (e.g., normal, thickened, polypoid, emphysematous)
Feline lower urinary tract signs/idiopathic cystitis Often indoor cat; RBC but no WBC or bacteria on UA; culture negative; imaging normal or bladder wall thickening
Prostatic disease Male castrated (prostatic carcinoma) or intact (prostatitis, benign prostatic hyperplasia, cyst, abscess, carcinoma);
variable urine sediment exam; abnormal rectal ± abdominal palpation; prostatomegaly on radiographs; size/
parenchymal abnormalities on US; prostatic wash or ejaculate for cytology and culture
Urethral disease +/− RBC or WBC on UA; culture negative; urethra prominent on rectal exam; contrast urethrogram shows
obstruction (stone, mass) or irregular tissue (inflammation, neoplasia). Causes include neoplasia (transitional cell
carcinoma, squamous cell carcinoma), urethrolithiasis, trauma, urethrorectal fistula, urethral prolapse, urethritis
RBC, Red blood cells; UA, urinalysis; WBC, white blood cells.

Polyarthritis, Inflammatory

Infectious Immune Mediated Type III (enteropathic)
Ehrlichia ewingii Rheumatoid arthritis (erosive) Type IV (malignancy associated)
Anaplasma phagocytophilum Periosteal proliferative polyarthritis (erosive, cats) Miscellaneous
Rickettsia rickettsii Polyarthritis of greyhounds (erosive) Vaccination “reactions”
Borrelia burgdorferi Systemic lupus erythematosus Plasmacytic/lymphocytic synovitis
Mycoplasma spp (erosive or nonerosive) Polyarthritis/polymyositis Drug induced:
West Nile virus Steroid-responsive meningitis-arteritis Sulfonamides (Doberman pinschers)
Septic arthritis (more often a monoarthropathy) Akita dogs juvenile arthritis Erythropoietin
Leishmaniasis Shar-pei fever (swollen hock syndrome) Penicillins
Feline syncytium-forming virus/feline leukemia Polyarteritis nodosa Phenobarbital
virus Idiopathic immune-mediated polyarthritis (IMPA) Lincomycin
Calicivirus-associated (cats) Type I (idiopathic)
Type II (infection associated)

Polyphagia

Differential Diagnosis Item Key Feature(s)
Common
Drug induced/iatrogenic Any age; phenobarbital, glucocorticoids, progestins, benzodiazepines, antihistamines and appetite stimulants (cyproheptadine,
mirtazapine), exogenous insulin. Determined by history.
Intestinal parasitism Fecal flotation/fresh saline smear, fecal ELISA
Hyperadrenocorticism (HAC) 46%-57% of dogs with HAC are polyphagic, without concurrent weight loss; confirmed with ACTH stimulation test or low-dose
dexamethasone suppression test.
Diabetes mellitus Concurrent weight loss, polyuria/polydipsia very common; diagnosis with persistent hyperglycemia, glucosuria, +/− elevated
fructosamine (for confirmation in cats)
Exocrine pancreatic insufficiency Weight loss, steatorrhea, or diarrhea present; German shepherd most common breed but others affected; diagnosis confirmed
with low 12-hour-fasted serum TLI.

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