Page 2772 - Cote clinical veterinary advisor dogs and cats 4th

1442 Polyuria and Polydipsia

Polyuria and Polydipsia
VetBooks.ir Step 1. Verification

a) Water consumption 100 mL/kg body weight/d, or
b) Urine production 50 mL/kg body weight/d, and
c) Random urine specific gravity 1.012

Step 2. History and physical examination
a. Intact female: b. Lymphadenopathy: c. Weight loss, polyphagia, d. Symmetric alopecia, e. Medications: f. Normal
Rule out pyometra Rule out hypercal- restlessness, tachycardia: potbellied appearance, Rule out glucocorticoids
cemia Rule out hyperthyroidism calcinosis cutis, Rule out diuretics
Rule out diabetes mellitus thin skin, muscle Rule out phenobarbital
weakness, Rule out salt supplementation
hepatomegaly:
Rule out hyperadreno-
corticism

Step 3. Urinalysis
a. Glycosuria b. Pyuria, bacteriuria c. Significant proteinuria d. Normal
Rule out pyelonephritis Rule out renal dysfunction
Blood glucose Rule out hyperadrenocorticism Rule out pyometra
Rule out pyometra
Euglycemia: Hyperglycemia
Rule out primary renal ( 200 mg/dL):
glucosuria Rule out diabetes mellitus

Step 4. Evaluation of urine specific gravity
a. If SG 1.006 b. If SG 1.030 c. Urine SG 1.006-1.030 is not
consider CDI, patient does not have conclusively normal or abnormal;
NDI, PP, hyperadrenocorticism polydipsia/polyuria; proceed with database
consider pollakiuria

Step 5. Obtain database
d. Abdominal radiographs/ e. Urine culture and
a. Hemogram: b. Serum biochemistry panel: c. Serum electrolytes: ultrasonography: sensitivity
Rule out pyelonephritis Rule out kidney disease Rule out Rule out pyometra Rule out pyelonephritis
Rule out pyometra Rule out hyperadrenocorticism hypoadrenocorticism Rule out hyperadrenocorticism
Rule out hypercalcemia Rule out hypokalemia Rule out hepatic insufficiency
Rule out hepatic insufficiency Rule out kidney disease
Rule out pyelonephritis

Step 6.

a. Suggestive of hyperadrenocorticism b. Suggestive of another diagnosis c. Normal
1. ACTH stimulation test
2. Low-dose dexamethasone suppression test

Step 7. DDAVP (vasopressin analog response test) Modified water deprivation test
Rule out CDI Rule out central diabetes insipidus
Rule out nephrogenic diabetes insipidus
Rule out primary (neurologic) or psychogenic
(behavioral) polydipsia
CDI, Central diabetes insipidus; NDI, nephrogenic diabetes insipidus; PP, primary or psychogenic polydipsia; SG, specific gravity.
(Modified from Feldman EC, Nelson RW: Canine and feline endocrinology and reproduction, ed 3, St. Louis, 2004, Saunders.)

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