Ch. 27 Physical Examination of Urine Flashcards
What are the physical properties of urine?
volume, color, odor, transparency, and USG
Pollakiuria
frequent urination
Polyuria
increased urine production
Polydipsia
increased water intake
Oliguria
decreased urine production
anuria
lack of urine production
what is the normal urine output per day for dogs/cats?
20-40ml/kg per day
What conditions is polyuria associated with?
DM, nephritis, diabetes insipidus, pyometra, and liver disease
also w/ admin of diuretics, corticosteroids, or fluids
What is oliguria associated with?
restricted water access, env. temp increases
acute nephritis, fever, shock, heart disease, and dehydration
what conditions is anuria associated with?
UO, urinary bladder rupture, and renal shutdown
What drug is orange urine associated with?
tetracycline
What is brown-green urine associated with?
bile pigments in the urine
Normal equine/rabbit urine is clear: true or false?
FALSE, it is normally cloudy due to a high concentration of calcium carbonate crystals and mucus
When time of day is best if you are trying to obtain the most concentrated urine sample on a patient?
mid morning
Hypersthenuria
increased USG
Hyposthenuria
decreased USG
renal dz, polydipsia, DM, etc
isosthenuria
when the USG approaches that of glomerular filtrate (1.009-1.012)
often seen in animals with CKD
urine with the USG has NOT been concentrated or diluted by the kidneys
In an animal with kidney disease, the closer the USG is to isothenuric, the more kidney function has been lost - true or false?
TRUE
What is pH?
a measure of the degree of acidity or alkalinity of urine (the hydrogen ion concentration)
What determines alkaline urine?
pH > 7
What determines acidic urine?
pH < 7
What does the pH of a healthy animal largely depend on?
their diet
What types of animals have alkaline urine?
acidic urine?
alkaline or acidic urine depending on diet?
Herbivores
Carnivores
Omnivores
Stress can increase the pH and cause a transient glucosuria especially in cats- true or false?
TRUE
What are factors that may cause a DECREASED pH (cause acidic urine)?
fever, starvation, high protein diet, acidosis, excessive muscular activity, and admin of certain drugs
What factors may cause an INCREASED urine pH (cause alkaline urine)?
alkalosis, high-fiber (plant based) diet, UTI with urease bacteria, use of certain drugs, or urine retention (as seen with UO or bladder paralysis)
What can happen if the urine pH is too high or too low?
crystals/uroliths can form
What should the protein be in a normal healthy animal’s urine?
none to trace
What types of urine collection can lead to trace protein readings?
voided or expressed samples
High protein on a test strip should be confirmed with what test?
the sulfosalicylic acid turbidity test
microalbuminuria can be tested with a reagent test strip: true or false?
FALSE
ELISA needed to test levels of albumin in urine < 30mg/dL
What common conditions can lead to proteinuria?
acute and chronic renal disease
What is the urine protein creatinine ratio used for?
to confirm significant amounts of protein in the urine
proteinuria
presence of protein in urine
A trace protein finding in a dilute sample can be significant compared to a trace protein finding in a concentrated sample: true or false?
TRUE - since the sample is dilute the protein is actually higher than the reading
With acute renal disease what would be found in the urine sample?
Marked proteinuria, WBCs, casts
With chronic renal disease what would be found in the urine sample?
Degree of proteinuria is less than with acute renal disease but samples are often more dilute
Multiple myeloma (cancer of the plasma cells) may produce large quantities of what proteins?
Bence Jones proteins
Glucosuria
presence of glucose in urine
When glucose in the blood exceeds the renal threshold, it spills into the urine- true or false?
TRUE
What is the main condition associated with glucosuria?
DM
What are other causes of glucosuria besides DM?
excitement/stress (esp in cats), a high carb meal before testing
rarely with hyperthyroidism, Cushing’s, and chronic liver dz
certain drugs will falsely elevate glucose- vit C, morphine, aspirin, penicllin, cephalosporins
What are the 3 ketones?
acetone
acetoacetic acid
β -hydroxybutyric acid
How are ketones formed?
During the incomplete catabolism of fatty acids (when fatty acid metabolism is NOT accompanied by sufficient carbohydrate metabolism excess ketones are present in urine)
Ketonuria
presence of ketones in urine
Ketosis / Toxemia - when do these occur?
ketosis occurs in lactating cows
toxemia occurs in sheep when carrying twins or triplets
(both occur when energy requirements outweigh capacity of animal to ingest adequate feed)
Ketosis is associated with hypoglycemia and caused by insufficient carb intake Body fat is then metabolized which results in ______?
ketonemia / ketonuria
Why does ketonuria often occur in animals with DM?
because the animal lacks the insulin necessary for carbohydrate metabolism and fat is broken down instead to meet the animal’s energy requirements. This causes excess ketones to be excreted
Ketones are important sources of energy and are normally produced during fat metabolism. However too many ketones are toxic and cause ketonuria/ketonemia which lead to what?
central nervous system depression and acidosis (ketoacidosis)
What other conditions does ketonuria/ketonemia occur with?
high fat diets, starvation, fasting, long term anorexia, and impaired liver function
What bile pigments are detected in urine?
bilirubina and urobilinogen
Is conjugated or unconjugated bilirubin found in urine? Why one and not the other?
conjugated b/c it’s water soluble
not unconjugated b/s it’s not water soluble
Normal dogs (esp males) and cattle can occasionally have bili in their urine: true or false?
TRUE
Bilirubinuria is associated with what conditions?
bile duct obsruction (calculi in duct, tumors, obstruction of upper intestinal tract) acute enteritis pancreatitis liver dz hemolytic anemia (esp in dogs)
Hematuria
presence of intact RBCs in urine
Hemolgobinuria
presence of free hemoglobin in urine
Myoglobinuria
presence of myoglobin (a protein that leaks out of muscle when damage occurs) in urine
