Nama : Mohammad Fajar Arief Sumarno

Kelompok : 6

NIM : 200130100011048

TUGAS RESEPTIR (GINJAL)

PENULISAN RESEP BERDASARKAN LAPORAN KASUS
"Feline Cystitis in Himalayan Cat"

A. Sinyalemen
Molly merupakan kucing Himalaya jantan, umur 2 tahun. Molly datang ke Klinik
Hewan Pendidikan Fakultas Kedokteran Hewan Universitas Brawijaya Malang bersama
pemiliknya yakni Bapak Andy pada tanggal 9 Januari 2017 dengan keluhan
muntah,anoreksia dan lesu. Sebelumnya pada tanggal 18 November 2016 Molly dating
dengan keluhan tidak bisa buang air kecil (disuria) dalam waktu kurang dari 2 hari.
B. Anamnesa dan Pemeriksaan
Berdasarkan anamnesa, hewan menunjukkan muntah, anoreksia, lesu dan
sebelumnya mengalami disuria. Kondisi umum kucing: suhu: 37,6 C, denyut nadi 104 kali
/menit dan frekuensi pernapasan 28 kali / menit. Pemeriksaan fisik pada palpasi abdomen
menunjukkan adanya distensi pada kandung kemih. Kandung kemih hasil kateterisasi
menunjukkan adanya kesulitan masuk yang menandakan urolit. Hasil kateterisasi VU ada
darah dalam jumlah besar urin (Gambar. 1). Hasil pemeriksaan hematologi dan kimia darah
menunjukkan trombositopenia (89.0 x10 / μL, range 300-800x10 / μL), peningkatan kadar
SGPT (172.3 U / L, range 8.3-52.5 U / L), SGOT (95.8 U / L) , kisaran9,2-39,5U / L) dan
uremia (50,0 mg / dL,kisaran 20,0-30,0 mg / dL).

Gambar 1. Menunjukkan hematuria dalam urin (mengandung darah)

 Pemeriksaan urinalisis (Verity ®) menunjukkan pH 9.0 (kisaran 6.0-7.5), leukosit
(+), nitrit (-), urobilinogen (-), protein 100 (kisaran 15-30 mg / dL), darah (+), berat jenis
1,01 (kisaran 1,036- 1,060), keton (-), bilirubin (-) dan glukosa (-).

Gambar 2. (a) Pemeriksaan radiografi: distensi VU terisi penuh dengan urin dan tidak
ditemukan massa radiophaque.
(b) Pemeriksaan USG: penebalan dinding kandung kemih dan ditemukan
beberapa butir atau kristal sedimentasi yang hyperechoic.

Pemeriksaan makroskopik urin menunjukkan warna merah (hematuria), pekat ,

keruh dan terdapat kristal jenis struvite. Pemeriksaan radiografi menunjukkan kandung
kemih dalam keadaan penuh dan tidak ditemukan massa radiophaque (Gambar 2a).
Pemeriksaan USG kandung kemih menunjukkan penebalan dinding kandung kemih dan
ditemukan beberapa butir atau kristal sedimentasi yang hyperechoic (Gambar. 2b).

C. Diagnosa
Berdasarkan hasil anamnesa, pemeriksaan fisik dan laboratorium kucing
mengalami Cystitis.
Cystitis adalah peradangan pada kandung kemih yang ditandai dengan nyeri di
perut, disuria, dan hematuria. Gejala klinis lain: depresi, lemas, muntah, nafsu makan
menurun, biasanya disertai infeksi saluran kemih bawah, penyumbatan parah (debris dan
kristal), uremia, hematuria, sering menjilati daerah kelamin dan kematangan saat buang air
kecil karena sakit (Nelson et al ., 2003).
Muntah pada kasus sistitis yang disebabkan oleh rangsangan dari chemoreceptor
trigger zone (CTZ) oleh toksin ureum, peningkatan sekresi asam lambung, serta iritasi
gastrointestinal oleh toksin urea (Vaden, 2010). Peningkatan urea dalam darah dapat
menyebabkan gastropati uremik pada mukosa lambung, yang menyebabkan hormon
lambung untuk memicu produksi asam lambung meningkat (Elliot dan Grauer, 2007).
Disuria disebabkan oleh debris atau kristal (struvite) yang menghambat aliran pengeluaran
urin. Kondisi disuria berhubungan langsung dengan kondisi distensi kandung kemih yang
menyebabkan urin di dalam kandung kemih tidak dapat dikeluarkan secara normal.
Hematuria pada kondisi cystitis juga dapat dikaitkan dengan peradangan kandung kemih
serta trauma yang disebabkan oleh kristal struvite (urolhitiasis).
Pemeriksaan hematologi dan kimia darah menunjukkan kondisi trombositopenia,
peningkatan kadar serum glutamat oksaloasetat transaminase (SGPT), serum glutamat
piruvat transaminase (SGOT) dan uremia. Tingkat trombositopenia di bawah 20.000
berhubungan dengan perdarahan spontan dalam jangka panjang dan peningkatan waktu
perdarahan petechiae / ecchymoses (Kemenkes RI, 2011). Peningkatan kadar SGPT dan
SGOT dikaitkan dengan gangguan ginjal. Kadar SGPT juga ditemukan di jantung, otot dan
ginjal (Kemenkes RI, 2011). SGOT ditemukan di jantung, hati, otot rangka, ginjal, otak,
limpa, pankreas dan paru-paru (Kemenkes RI, 2011). Peningkatan urea secara signifikan
dalam darah yang menandakan adanya gangguan ginjal. Produk urea akan dikeluarkan
melalui ginjal, bila ginjal mengalami kerusakan maka akan terjadi penumpukan urea dalam
sirkulasi darah (Scotham dan Scott, 2008).
Pemeriksaan urinalisis menunjukkan pH urin 9.0 dalam urin basa (normal 6,5
hingga 7,0). Kondisi urine yang bersifat basa yang menyebabkan terbentuknya kristal-
kristal, seperti struvite. Hal ini sesuai dengan hasil pemeriksaan mikroskopis ditemukan
kristal struvite. Ion MgO dan ion MgSO4 pada makanan kucing kering akan membuat urine
menjadi basa. Urin basa akan membuat ion Mg, dan amonium fosfat akan mengkristal
menjadi kristal struvite. Kristal akan membuat obstruksi kandung kemih, uretra dan ureter.
Infeksi bakteri dapat meningkatkan pembentukan struvite karena bakteri yang menginfeksi
akan menghasilkan urease yang akan membuat pH urin menjadi basa.
Pemeriksaan makroskopis urin menunjukkan adanya warna merah pada urin yang
disebabkan oleh peradangan dan obstruksi kandung kemih, ureter, dan uretra yang
mengandung hemoglobin (Wijaya, 2014). Urin keruh dapat disebabkan oleh nidus, bakteri,
endapan seperti epitel, leukosit dan eritrosit dalam jumlah banyak (Wijaya, 2014).
Proteinuria dapat mengindikasikan adanya cedera pada membrane glomerulus
yang menyebabkan kegagalan filtrasi protein dimana protein masuk ke dalam urin.
Protenuria pada kucing selalu dihubungkan dengan pengalaman hemoragik akibat trauma
atau inflamasi dan periuria pada kucing (Nelson dan Couto, 2003). Nilai darah yang positif
pada hasil reaksi dipstik disebabkan oleh trauma atau inflamasi patologis, urolitiasis dan
 penyakit saluran kemih. Penurunan densitas spesifik urin, dapat disebabkan oleh
terganggunya regulasi reabsorsi pada tubulus yang menyebabkan peningkatan reabsorpsi zat
tertentu pada tubulus proksimal, lengkung Henle, tubulus distal atau tubulus collectivus,
yang menyebabkan zat yang dikeluarkan akan berkurang dan urine kepadatan spesifik lebih
rendah (Damayanti et al ., 2015).
Pemeriksaan radiografi menunjukkan distensi pada kandung kemih dan tidak
ditemukan adanya kristal yang bersifat radiophaque. Pemeriksaan USG menunjukkan
penebalan dinding kandung kemih dan ditemukan massa hyperechoic. Penebalan dinding
kandung kemih bisa disebabkan oleh reaksi peradangan akibat trauma atau patologis. Ini
memiliki korelasi yang sama dengan Widmer et al . (2004) sistitis dapat membuat penebalan
dinding kandung kemih. Massa hyperechoic di kandung kemih menunjukkan adanya kristal
di kandung kemih.

D. Pengobatan Penyakit
Pengobatan pertama adalah dengan kateterisasi melalui penis ke dalam kandung
kemih dan pembilasan (keluar urine / dalam cairan saline normal, ulangi sampai hasil
pembilasan terlihat jernih) vesica urinaria, terapi cairan menggunakan Ringer's Lactate,
antivomiting agent (Ranitidine, 2.5 mg / kg im q24h), analgesik (Ketoprofen, 2 mg / kg im
q24h) dan penguat pertumbuhan dan peningkatan daya tahan tubuh, yaitu Hematopan dan
Biodin setiap 0,15 mL im q24h.
Terapi harian menggunakan antibiotik (Doxycycline, 10 mg / kg po q12h), agen
kristal rusak (Keji Beling , 1⁄2 capsul / day po) dan vitamin A (10.000 IU / day po), injeksi
analgesik (Ketoprofen, 2 mg / kg im q12h) dan pemacu pertumbuhan serta meningkatkan
daya tahan tubuh (Hematopan ® dan Biodin ® im q24h) serta pemberian makanan diet
Royal Canine Urinary s / o untuk kucing. Perawatan selama 7 hari menunjukkan perubahan
yang signifikan, yaitu kencing normal dan tidak hematuria

Penghitungan Dosis Pemberian Obat

Pemberian Obat = Dosis Obat x BB/ Sediaan Obat pasaran
- Ringer’s Lactate = (40-60 ml/kg/hari (kebutuhan cairan kucing ) x 6 kg):500 ml
(sediaan RL pasaran)
= 240 ml/hari atau ½ botol RL (Intravena)
- Ranitidine = (2.5 mg/kg BB/hari x 6 kg): 50mg/2ml (Sediaan ampul inj. pasaran)
= (15 mg/hari): 25mg/ml = 0.6 ml/hari (injeksi IM)
- Ketoprofen = (2 mg/kgBB/hari x 6 kg): 50 mg/ml (Sediaan ampul inj. pasaran)
= 12 mg/hari : 50mg/ml = 0,24 ml/hari (injeksi IM)
- Doxycycline = (10 mg/kgBB/12 jam x 6 kg) : 100mg/tablet (sediaan pasaran)
= 60mg/12jam:100mg/tablet = 0,6 tablet/12 jam
- vit. A = (10.000 IU/hari x 6 kg): 6000IU/tablet (sediaan pasaran)
= 1,67 tablet/hari atau 1 ½ tablet/hari
- Hematopan (Hematodin inj. 50ml) = 0,5 ml/kgBB/hari (dosis tertera di obat) x 6 kg = 3
ml/hari
- Biodin inj. 100 ml = 1 ml/kg BB/hari (dosis tertera di obat) x 6 kg = 6 ml/kgBB/hari.
- Keji Beling = 1/2 tablet/hari
Penulisan Resep Obat
drh. Mohammad Fajar Arief Sumarno
Telp. 085707735550
Alamat. Jl. JoyoTambaksari 31D, Merjosari, Kel. Lowokwaru, Malang
Malang, 24 Februari 2021
R/ Ringer’s Lactate 500ml botol No. IV
s.i.m.m
…………………………………………………………………………………...
Paraf
R/ Renitidine 50mg/2ml amp No. IV
s.i.m.m.
……………………………………………………………………………………..
Paraf
R/ Ketoprofen 50/ml amp No. II
s.i.m.m
……………………………………………………………………………………………
Paraf
R/ Doxycycline 100 mg tab No. VII
s.2.d.d tab ½ PO
……………………………………………………………………………………………
Paraf
R/ Vit A 6000 IU tab No. XI
s.1.d.d tab 1½ PO
……………………………………………………………………………………………
Paraf
R/ Keji Beling tab No. IV
s.1.d.d tab ½ PO
……………………………………………………………………………………………
Paraf
 R/ Hematodin inj. 50ml botol No I
s.i.m.m
……………………………………………………………………………………………
Paraf

R/ Biodin inj. 100ml botol No I

s.i.m.m
……………………………………………………………………………………………
Paraf

Pro : Molly (6 kg)

Pemilik : Andy

E. Pembahasan Tentang Pengobatan Yang Diberikan

Tindakan kateterisasi dan pembilasan adalah tindakan pengeluaran urin dari
kandung kemih dengan menggunakan kateter. Terapi cairan Ringer's Lactate dimaksudkan
untuk menggantikan cairan yang hilang dalam tubuh akibat dehidrasi dan pendarahan.
Ranitidine digunakan sebagai antagonis histamin (H blocker) yang berperan dalam
menurunkan sekresi asam lambung (Papich, 2011). Pemberian ketoprofen adalah obat yang
dikenal dengan NSAID (obat anti inflamasi non steroid ), yang berfungsi sebagai analgesik
dan anti inflamasi. Ketoprofen menghambat jalur siklooksigenase (COX) dan lipoksigenase
(Allen et al., 1998).
Pemberian Hematopan® dan Biodin® bertujuan untuk memacu pertumbuhan dan
hematopoietika, memperkuat otot dan daya tahan tubuh. Doxycycline merupakan antibiotik
bakteriostatik yang bekerja dengan cara menghambat pembentukan protein (Ramsey, 2008).
Keji Beling® a ekstrak tumbuhan Serococalycis Folium, Orthoriplunis Sonchi folium
folium dan berguna untuk mengobati batu saluran kemih, menghambat pembentukan batu
ginjal dan membersihkan batu empedu saluran kemih dan mengeluarkan air seni. Vitamin
A merupakan vitamin yang berperan dalam pengaturan ekspresi gen yang terdiri dari
tretinoin dan isotretinoin (Ramsey, 2008). Royal canine urinary s / o® sebagai makanan diet
berfungsi menciptakan kondisi saluran kemih yang dapat menghambat pembentukan kristal
struvite dan kalsium oksalat
 Advances in Health Sciences Research (AHSR), volume 5
1st International Conference in One Health (ICOH 2017)

Feline Cystitis in Himalayan Cat: a case report

Dodik Prasetyo1* and Gede Eko Darmono2
1)
Lecture of Veterinary Medicine Faculty at Brawijaya University, Malang, Indonesia
2)
Student of Veterinary Medicine Faculty at Brawijaya University, Malang, Indonesia
*
e-mail: drh.dodik_prasetyo@yahoo.com

Abstract
Molly is male Himalayan’s cat with age 2 years old. He comes to Education Animal Clinic of
Veterinary Medicine Faculty at University of Brawijaya Malang with owners. Molly comes with
complaints of vomiting and previously with dysuria less 2 days and found blood in urine drops.
Physical examination are present the temperature 37.6oC, pulsus frequency 104/minute and
respiration frequency 28/minute with the condition of mild dehydration. Abdominal palpation
shows distention on vesica urinary. Hematology and blood chemistry examination show
thrombocytopenia (89.0 x103/µL, range 300-800x103/µL), increase levels of SGPT (172.3 U/L,
range 8.3-52.5 U/L), SGOT (95.8 U/L, range9.2-39.5U/L) and uremia (50.0 mg/dL, range 20.0-
30.0 mg/dL).Urinalysis examination (Verity ®) show pH 9.0 (range 6.0-7.5), leukocytes (+),
nitrite (-), urobilinogen (-), protein 100 (range 15-30 mg/dL), blood (+), specific gravity 1.01
(range 1.036-1.060), ketone (-), bilirubin (-) and glucose (-). Macroscopic examination of urine
shows red color (hematuria), dense and cloudy. Microscopic examination of urine with crystals
of struvite types found in moderate. Radiography examination shows full of vesica urinaria. The
examination of ultrasonography on vesica urinaria showed thickening of the wall vesica urinaria
and sedimentation of crystals are hyperechoic. Treatment of cystitis use catheterization and
flushing with NS of vesica urinaria, fluid therapy use Ringer's Lactate, antivomiting agent
(Ranitidine, 2.5 mg/kg i.m. q24h), analgesics (Ketoprofen, 2 mg/kg i.m. q24h) and growth
booster and increase durability of the body, i.e. Hematopan ® and Biodin® each 0.15 mL i.m.
q24h. Daily therapy uses antibiotic (Doxycycline, 10 mg/kg p.o. q12h), wrecked crystal agent
(Keji Beling®, ½ capsul/day p.o.) and vitamin A (10.000 IU/day p.o.), injection of analgesic
(Ketoprofen, 2 mg/kg i.m. q12h) and growth boosters and increase durability of the body
(Hematopan ® and Biodin ® i.m. q24h) as well as diet feeding Royal Canine Urinary s/o® for
cat. Treatments for 7 days showed significant changes, that is normal urinary and does not
hematuria

Keywords: cystitis, dysuria, hematuria, struvite, vesica urinaria

1. INTRODUCTION
Cystitis is an inflammation of the bladder that often occurs in pet animals, as part of the
infection in the urinary tract. Clinical symptoms of cystitis, which dysuria and hematuria. Cystitis
causes thickening of the urinary bladder wall (Widmer et al., 2004). The incidence of cystitis in
cats in Indonesia has not been published in full. An average of 6 cases of diseases of the urinary
tract in cats every month was reported (Fauziah, 2015). The main problems of the urinary tract
diseases are found: Feline Interstitial Cystitis (FIC) of 55% -69% and Urolithiasis of 13% -28%
(Hostutler et al., 2005). Diagnosis of cystitis can be obtained through anamnesis, abdominal
palpation, physical examination, clinical signs, urinalysis, hematology and blood chemistry
examinations, uroendoscopy, and ultrasonography (USG) and radiography (Widmer et al., 2004).
Cystitis diagnose are associate with the way to treat this diseases as right as efficient and
appropriate with the cause of cystitis.

Copyright © 2018, the Authors. Published by Atlantis Press. 286

This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
 Advances in Health Sciences Research (AHSR), volume 5

2. MATERIAL AND METHOD

Molly: a male Himalayan’s cat, 2 years old. Molly comes to Education Animal Clinic of
Veterinary Medicine Faculty at University of Brawijaya Malang with owners Mr. Andy on January
9, 2017 with complaints of vomiting, anorexia and lethargy. Earlier on November 18, 2016 came
with a complaint cannot urination (dysuria) in less than 2 days.
Physical examination and laboratory examination as methods are performed, palpation on
the abdominal area, the catheterization of vesica urinary via penis, urinalysis examinations,
hematology and blood chemistry examinations, ultrasound and radiography.

3. TREATMENT AND RESULT

Anamnesa animal shows vomite, anorexia, lethargy and previously experienced was
dysuria. General condition of cat: temperature: 37,6oC, pulse 104 beats/ minute and frequency of
breathing 28 times / minute. Physical examination of the abdomen palpation showed distension in
the bladder. Urinary bladder was catheterization showed difficulty to enter that indicates urolit. The
result of VU catheterization was present of blood in large quantities of urine (Fig. 1). Hematology
and blood chemistry as laboratory examination show thrombocytopenia (89.0 x103/µL, range 300-
800x103/µL), increase levels of SGPT (172.3 U/L, range 8.3-52.5 U/L), SGOT (95.8 U/L,
range9.2-39.5U/L) and uremia (50.0 mg/dL, range 20.0-30.0 mg/dL).

Fig.1. Showed hematuria in urine (containing blood) and flakes like nidus on sediment.

Urinalysis examination (Verity ®) show pH 9.0 (range 6.0-7.5), leukocytes (+), nitrite (-),
urobilinogen (-), protein 100 (range 15-30 mg/dL), blood (+), specific gravity 1.01 (range 1.036-
1.060), ketone (-), bilirubin (-) and glucose (-). Macroscopic examination of urine shows red color
(hematuria), dense and cloudy. Microscopic examination of urine with crystals of struvite types
found in moderate
Radiographic examination showed urinary bladder in a state of full and cannot be found
radiophaque mass (Fig. 2a). Ultrasound examination of the urinary bladder reveals thickening of
the bladder wall and found a few grains or crystals sedimentation are hyperechoic (Fig. 2b)

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(a) (b)
Fig. 2. (a) Radiographic examination: distention of VU full fills with urine and not found
radiophaque mass. (b) USG examination: thickening of the bladder wall and found a few grains or
crystals sedimentation are hyperechoic.

The first medical treatment is use catheterization via penis into bladder and flushing (out
urine / in normal saline fluid, repeat it until the result of flushing looks clear) of vesica urinaria,
fluid therapy use Ringer's Lactate, antivomiting agent (Ranitidine, 2.5 mg/kg i.m. q24h),
analgesics (Ketoprofen, 2 mg/kg i.m. q24h) and growth booster and increase durability of the
body, i.e. Hematopan® and Biodin® each 0.15 mL i.m. q24h. Daily therapy uses antibiotic
(Doxycycline, 10 mg/kg p.o. q12h), wrecked crystal agent (Keji Beling®, ½ capsul/day p.o.) and
vitamin A (10.000 IU/day p.o.), injection of analgesic (Ketoprofen, 2 mg/kg i.m. q12h) and
growth boosters and increase durability of the body (Hematopan ® and Biodin ® i.m. q24h) as
well as diet feeding Royal Canine Urinary s/o® for cat. Treatments for 7 days showed significant
changes, that is normal urinary and does not hematuria

4. DISCUSSION
Cystitis is an inflammation of the bladder which signed pain in the abdomen, dysuria and
hematuria. Another clinical symptoms: depression, weakness, vomiting, decreased appetite, usually
accompanied bottom urinary tract infection, severe blockage (debris and crystals), uremia,
hematuria, often licking the genital area and maturation when urination due to illness (Nelson et al.
, 2003). Vomiting in case of cystitis caused by stimulation of the chemoreceptor trigger zone (CTZ)
by ureum’s toxin, a decrease in gastric secretion and increased gastric acid secretion, and
gastrointestinal irritation by toxins of urea (Vaden, 2010). The increasing of urea in the blood can
cause uremic gastropathy at the gastric mucosa, that makes gastric hormone to initiate production
of stomach acid increased (Elliot and Grauer, 2007). Dysuria is caused by debris or crystals
(struvite) which inhibits the flow of urine expenditure. Dysuria condition has direct relation with
distention condition of bladder that makes urine in the bladder cannot be removed outside
normally. Hematuria on cystitis condition can also associated with bladder inflammation and the
trauma it caused by struvite (urolhitiasis).
Hematology and blood chemistry examination showed the condition of
thrombocytopenia, elevated levels of serum glutamic oxaloacetate transaminase (SGPT), serum
glutamic piruvate transaminase (SGOT) and uremia. Thrombocytopenia level under 20,000 that is
associated with spontaneous bleeding in the long term and increase bleeding time of petechiae /

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ecchymoses (Kemenkes RI, 2011). Increasing levels of SGPT and SGOT were associated with the
kidneys disorders. SGPT levels are also found in the heart, muscle and kidney (Kemenkes RI,
2011). SGOT found in the heart, liver, skeletal muscle, kidney, brain, spleen, pancreas and lungs
(Kemenkes RI, 2011). Increasing of urea by significant in the blood which indicates the kidney
disorders. Urea product will be excreted through the kidneys, when the kidneys were damage, it
would result in the accumulation of urea in the blood circulation (Scotham and Scott, 2008).
Urinalysis examination shows urine pH 9.0 in an alkaline urine (normal 6.5 to 7.0).
Alkaline condition of urine which cause the formation of crystals, such as struvite. This is
consistent with the results of microscopic examination were found struvite crystals. MgO 2 ions and
MgSO4 ions on dry cat food will make the urine alkaline. Alkaline urine will make Mg ions, and
ammonium phosphate will be crystallizing to struvite crystals forms. Crystals will make
obstruction of the bladder, urethra and ureter. Bacterial infections can increase the formation of
struvite because the bacteria that infect will produce urease, it will make increasing of urine pH
becomes alkaline. Macroscopic examination of the urine show the presence of red color in the
urine, it caused by inflammation and obstruction of bladder, ureter, and urethra which contains of
hemoglobin (Wijaya, 2014). Turbid urine can be caused by a nidus, bacteria, sediment such as
epithelial, leukocytes and erythrocytes in large quantities (Wijaya, 2014).
Proteinuria can be indicating an injury of glomerular membrane that makes failure of
protein filtration which presence protein into the urine. Protenuria in cats always connected with
experience of hemorrhagic result of trauma or inflammation and periuria in cats (Nelson and
Couto, 2003). Positive blood values on the reaction dipstick result were caused by the trauma or
pathological inflammation, urolithiasis and urinary tract diseases. Decreasing of urine specific
density, it may caused by disturbance of reabsortion regulation in the tubulus that makes
increasing reabsorption of certain substances in the proximal tubule, loop of Henle, distal tubule or
tubulus collectivus, which causes the substances excreted will be reduced and the urine specific
density be lower (Damayanti et al., 2015). Radiographic examination show distension in the
bladder and not found any crystals that are radiophaque. Ultrasound examination showed a
thickening of the walls of the bladder and found a hyperechoic mass. Thickening of the walls of the
bladder can be caused by an inflammatory reaction due to trauma or pathological. This is having
same corellational with Widmer et al. (2004) cystitis can make thickening of the urinary bladder
wall. Hyperechoic mass in the urinary bladder showed the presence of crystals in the urinary
bladder.
Catheterization and flushing action are spending action of urine from the bladder using a
catheter. Fluid therapy Ringer's Lactate is intended to replace lost fluids in the body from
dehydration and bleeding. Ranitidine is used as an antagonist histamin 2 (H2 blockers) whose role
in lowering gastric acid secretion (Papich, 2011). Giving of ketoprofen are drugs known as
NSAIDs (non-steroidal anti-inflammatory drugs), which acts as an analgesic and anti-
inflammatory. Ketoprofen inhibits the cyclooxygenase pathway (COX) and lipoxygenase (Allen et
al., 1998). Giving Hematopan® and Biodin® aim to spur growth and hematopoietika, reinforcing
the muscles and endurance. Doxycycline is a bacteriostatic antibiotic that works by inhibiting the
formation of proteins (Ramsey, 2008). Keji Beling® a plant extracts Serococalycis Folium,
Orthoriplunis Sonchi folium folium and useful for treating urinary stones, inhibits the formation of
kidney stones and gallstones cleanse the urinary tract and release urine. Vitamin A is a vitamin that
plays a role in regulation of gene expression that consists of tretinoin and isotretinoin (Ramsey,

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2008). Royal canine urinary s / o® as a diet feeding has function to creating an urinary tract
conditions that can inhibit the formation of struvite and calcium oxalate crystals

REFERENCE
Allen, D.G., J.K. Pringle, D.A. Smith and W.K. Pasloske. 1998. Handbook of Veterinary Drugs
Second Edition. Lippincott-Raven Publisher. Philadelphia USA.
Damayanti, L., P. Trisunuwati dan S. Murwani. 2015. Efek Perasan Daun dan Tangkai Semanggi
Air (Marsilea crenata) Terhadap Kualitas Urin Pada Hewan Model Urolithiasis Tikus Putih
(Rattus norvegicus) [Skripsi].Program Studi Pendidikan Dokter Hewan Program Kedokteran
Hewan Universitas Brawijaya. Malang.
Elliot, J and G.F. Grauner. 2007. BSAVA Manual of Canine and Feline Nephrology and Urology.
British Small Animal Veterinary Association. USA.
Fauziah, H. 2015. Gambaran Cystitis melalui Pemeriksaan Klinis dan Laboratoris (Uji Dipstik dan
Sedimentasi Urin) pada Kucing di Klinik Hewan Makassar [Skripsi]. Program Studi
Kedokteran Hewan Universitas Hasanuddin. Makassar.
Hostutler, R.A., D.J. Chew and S.P. DiBartola. 2005. Recent Concept in Feline Lower Urinary
Tract Disease. Veterinary Clinics Small Animal. 35:147-170.
Nelson, R.W. and Couto, C.G. 2003. Small Animal Internal Medicine 3rd Edition, Mosby Inc.
Missoury, London. Scotham, S.L. and M.A.Scott. 2008. Fundamental of Veterinary Clinical
Pathology. Blackwell Publishing. USA.
Papich, M. G. 2010. Handbook of Veterinary Drugs 3rd ed. Small and Large Animal. Elseveier
Saunders.
Ramsey, I. 2008. BSAVA Small Animal Formulary. British Small Animal Veterinary Association.
England.
Vaden, S.L. 2010. Effective Management of Familial Renal Disease in Dogs and Cat. Proceedings
of the International SCIVAC Congress 2010. Italy.
Widmer, W.R., D.S. Biller and G.A. Larry. 2004. Ultrasonography of the Urinary Tract in Small
Animals. Journal of the American Veterinary Medical Association. 225(1):46-54.

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