VET Talks is a project by the IVSA Standing Committee on Veterinary Education (SCoVE).
This VET Talks is by Dr Sheena Warman, BSc, BVMS, DSAM, DipECVIM-CA, SFHEA, MRCVS, Senior Clinical Fellow in Small Animal Medicine, University of Bristol (UK)
You can access the summary fact-sheet for this VET Talk lecture on the link below: https://drive.google.com/open?id=0BwwLXT4yyeT0cHJpNHZNMG4xWXc
SSCoVE Home Page: http://www.ivsa-committees.org/blank
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The Diagnosis Of Canine Diabetes Insipidus
Diabetes insipidus is a hormonal condition characterized by the inability of the kidneys to concentrate urine. Antidiuretic hormone (ADH) operates on the kidney to regulate the amount of water excreted in the urine. When the body requires water, ADH levels rise. As a result, the kidney retains the water and prevents it from being passed through the urine; Conversely, when the body has excess water, the kidney permits surplus water to pass into the urine.
When antidiuretic hormone (ADH) is supplied directly to the pet, the vasopressin test determines the kidneys’ ability to concentrate urine. In addition, the value of plasma osmolality — this value indicates the amount of water in the blood. When the pet is denied water, the modified water deprivation test assesses the body’s ability to produce urine.
A veterinarian can diagnose the condition of primary polydipsia or psychogenic thirst if a pet can concentrate urine while dehydrated. The brain produces insufficient ADH hormone; without ADH, the kidneys lose a significant amount of water through the urine, and the pet must consume excessive amounts of water to compensate. Nephrogenic diabetes insipidus is the most likely diagnosis because the brain produces adequate amounts of the hormone in this situation, but the kidney cannot respond.
A pet with diabetes insipidus will have a high plasma osmolality. This is because, in the absence of ADH, the kidneys would lose vast amounts of water, leaving the body dehydrated. Conversely, a pet suffering from primary polydipsia/psychogenic thirst will typically have a low plasma osmolality due to the amount of water consumed.
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The term Pollakiuria comes from ancient greek and indicates the need to urinate very often.
What are the causes of this disorder?
Urinary infections, urinary stones, cystitis, pain and spasmodic contraction of the bladder muscles, etc..
In woman hormones can affect the frequency of urination for example during pregnancy or during menopause.
Diabetes and mental illness can increase the number of urination as well.
In this video we suggest some of the most apropriate solutions to deal with this disorder.
https://www.med4.care/?lang=en — Med4Care English website.
https://www.med4.care/necessita-urinare-troppo-spesso-cause-soluzioni-pollachiuria/ — Our italian article about Pollakiuria. Video Rating: / 5
Is your child peeing a lot? Is he/she visiting the bathroom frequently? It could be a case of an overactive bladder which can results in frequent urination. This video will give you all the important information about frequent urination in kids, including it’s causes, signs and remedies.
You might have observed that your child demands a lot of pee breaks at public placed without being able to control, the urge to pee. Instead of showing your anger to them, you, as parents, should try to figure out why this is happening. There can be various causes that can trigger such kind of situation.
While frequent urination is not always a serious problem, it isn’t quite normal either. You must consider visiting your child’s paediatrician if this condition does not reduce or phase away. Certain preventive measures can be taken to control your child’s overactive bladder to lessen the chances of frequent urination.
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Any information provided in this video is for informational purposes only and should not be considered as a substitute for advice from doctor or any health professional. We strongly recommend seeking medical advice before proceeding.
Polyuria is a condition where the body urinates more than usual and passes excessive or abnormally large amounts of urine each time you urinate.
Polyuria is defined as the frequent passage of large volumes of urine – more than 3 litres a day compared to the normal daily urine output in adults of about 1 to 2 litres.
It is one of the main symptoms of diabetes (both type 1 and type 2 diabetes) and can lead to severe dehydration, which if left untreated can affect kidney function.
Causes of polyuria
Polyuria is usually the result of drinking excessive amounts of fluids (polydipsia), particularly water and fluids that contain caffeine or alcohol.
It is also one of the major signs of diabetes mellitus. When the kidneys filter blood to make urine, they reabsorb all of the sugar, returning it to the bloodstream.
In diabetes, the level of sugar in the blood is abnormally high. Not all of the sugar can be reabsorbed and some of this excess glucose from the blood ends up in the urine where it draws more water.
This results in unusually large volumes of urine.
Other causes of polyuria include:
Diabetes inspidus – a condition unrelated to diabetes mellitus that affects the kidneys and the hormones that interact with them, resulting in large quantities of urine being produced
Kidney disease
Liver failure
Medications that include diuretics (substances that increase the excretion of water from the body/urine)
Chronic diarrhoea
Cushing’s syndrome
Psychogenic polydipsia – excessive water drinking most often seen in anxious, middle-aged women and in patients with psychiatric illnesses
Hypercalcemia – elevated levels of calcium in the blood
Pregnancy
Polyuria as a symptom of diabetes
As well as being one of the symptoms of undiagnosed diabetes, polyuria can also occur in people with diagnosed diabetes if blood glucose levels have risen too high.
If blood glucose levels become too high, the body will try to remedy the situation by removing glucose from the blood through the kidneys. When this happens, the kidneys will also filter out more water and you will need to urinate more than usual as a result.
Evening Dietary Protein Intake in the Pathogenesis of Nocturnal Polyuria
Alwis U1, Monaghan T2, Delanghe J1, Everaert K1
1. Ghent University, 2. SUNY Downstate Health Sciences University
KEYWORDS: Nocturia, Prevention, Quality of Life (QoL)
Recent research has shown that nocturnal polyuria (NP) is a heterogeneous condition that may be driven by excess nocturnal free water and/or sodium clearance. Consistently, behavioral and pharmacologic interventions targeting both nocturnal free water and sodium production have garnered considerable traction in the management of nocturia owing to NP. Relatively less attention has been afforded to urea—the most abundant urinary solute—despite the fact that urinary urea excretion is known to be highly interrelated with dietary protein intake [1]. Mechanistically, the body maintains a low concentration level of urea in both plasma and extracellular fluid, which lends to a daily urea excretion approximately two times greater the total body urea pool (and thus proportionally far greater than sodium, wherein daily excretion reflects approximately one-fifteenth of the total body sodium pool) [1]. Accordingly, it stands to reason that excretion of a large quantity of urea, as would be expected in patients following significant dietary protein intake, may reflect an additional important mediator in the pathogenesis of NP. This study aims to explore the association between NP and estimated dietary protein intake.
Read the full abstract text here: https://www.ics.org/2020/abstract/498
Dr. Blaivas explains that getting up in the middle of the night to urinate is called nocturia. Reasons for nocturia include the bladder not holding enough to allow the patient to sleep through the night, and the patient’s kidney potentially making more urine than the bladder can hold. Nocturnal polyuria is when too much urine is produced overnight, therefore causing the patient to get up in the middle of the night to urinate.
Jerry Blaivas, MD: Getting up in the middle of the night to urinate is called nocturia. Nocturia is very very common, in fact most people get up once or twice at night to urinate starting in the teenage years even.
If you think about it, there is only two possible reasons why someone would get up in the middle of the night to urinate. One is that their bladder does not comfortably hold enough to allow them to sleep through the night, and, two, you make more urine, that it is to say your kidney is making more urine then your bladder cannot comfortably hold overnight.
The second condition, we called nocturnal polyuria. The nocturnal means nighttime and poly means too much and uria means urine. So nocturnal polyuria means that you make too much urine overnight and that is probably the commonest cause of nocturia.
The most common cause of that even is just drinking too much before you go to sleep. So if you have a couple of beers or you have wine before dinner and then you take a glass of water with some pills, all of that fluid that you ingest will then overnight be converted by the kidneys to urine and then if you make more urine overnight than your bladder can hold, then of course you have to get up to urinate.
So nocturnal polyuria is the commonest cause and the other cause, the bladder not holding enough urine, has many many many causes. Probably the most common one is, temporary problem is, urinary tract infection. It can be caused by blockages by the prostate. It can be caused by bladder cancer, by all kinds of other irritable kind of conditions so thinking back then we have these two different causes, making too much urine at night or the bladder not holding enough at night. So, then what to do about it.
Well the first thing you need to do about it is to diagnose it. How do we diagnose it? Very – very simply! We have you keep a bladder diary, that is to say you record the time and amount of urine, time and amount of each urination that you make in a 24-hour period, then we simply see how much you urinate at night, how much you urinate for the 24-hours and through some mathematical formula, we can figure out if you are making too much urine at night.
Generally, people make less than a third of their urine during sleep hours. If you make more than that then you have this nocturnal polyuria and we look for the causes of that. I briefly alluded to what they were in the beginning but now to get more complete, the most common cause is simply drinking too much.
Probably the second most common cause is people that take medications at night that can have a diuretic like effect. Another cause is anything that causes your legs to swell up, so people with varicose veins or from prior surgery, if your leg swell up during the day that the swelling is actually fluid and when you lie down at night, your body resorbs that fluid, that fluid gets into your system and the kidneys make more urine.
Another common cause is something called sleep apnea, people who snore, best diagnosed by going to a sleep lab and if you have sleep apnea, then that is what causes the problem and the treatment of the sleep apnea is the problem.
The bladders that do not hold enough urine, again we first determine that by the bladder diary and then we look for the common causes, common causes of urinary tract infection, prostatic obstruction, dropped bladder in women, overactive bladder, sometimes bladder cancer, bladder stones, no matter what they cause though, once the diagnosis is clearly understood then treatment of the underlying condition that is causing the nocturia is very often effective, it is usually effective.
However, just having nocturia, just getting up at night to urinate by itself does not demand any treatment.
So if you get up once or twice at night or three times and you are not bothered by it, there is no need for any treatment at all. If there is a need for treatment, if you are bothered by it, rest assured there just about always an effective treatment.
Learn more about Dr. Blaivas: http://www.urologysite.com/Meet_Our_Doctors/Dr_Blaivas
This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided on this site solely at your own risk. If you have any concerns about your health, please consult with a physician.
As a pediatrician, you face many cases of polyuria in your clinic. Watch this video with us and you will know how to deal with polyuria cases.
When will you be able to depend only on urine osmolality, and when will you need water deprivation test?
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