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Clinical lab diagnostics of small animals > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

Urine turbidity means

A

cloudiness, is subjective

Evaluated as: Clear, slightly cloudy, cloudy, opaque

Cloudiness is caused by:
Elevated RBC and WBC
Bacteria
Crystals
Semen

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2
Q

Strong smell to urine can indicate

A

Strong smell of ammonia – can indicate bacteriuria.

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3
Q

An acetone smell to urine can indicate

A

ketoacidosis

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4
Q

Urine special gravity (USG) Measures

A

the solute concentration in urine

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5
Q

Urine special gravity (USG) is used to assess

A

the tubular function of the kidneys and the kidneys ability to concentrate urine.

Ability to concentrate urine decreases when 2/3 of the tubules are damaged.

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6
Q

Normal USG
Dogs
Cats

A

Dogs 1.015 – 1.045
Cats 1.035 – 1.060

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7
Q

Using urine Concentration (USG) in evaluation of kidney function with azotemia.

A
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8
Q

Isosthenuria =

A

USG same as in plasma (1.008 – 1.012)

Usually happens with Renal azotemia – kidneys can’t concentrate nor dilute urine.

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9
Q

Hyposthenuria

A

USG ＜1.008

Kidneys CAN dilute urine

But they can’t CONCENTRATE urine (aka remove excess water) – ADH deficiency (diabetes insipidus).

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10
Q

Most common chemical parameters measured from urine: (6)

Inaccurate or unimportant parameters, but are included on dipsticks: (4)

A

pH, protein, glucose, ketones, bilirubin, heme

Inaccurate or unimportant parameters, but are included on dipsticks: leukocytes, USG, nitrites, urobilinogen.

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11
Q

Cats and dogs urine pH

A

Cats and dogs – acidic urine (pH 5,5 – 7,0)

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12
Q

Urine pH can be affected by (5)

A

Acid-base balance
Pathological changes in kidney tubules

Bacteria in urine
Diet
Temperature

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13
Q

Struvite crystals are usually found in what pH urine?
And Oxalate?

A

Struvite in alkaline urine
Oxalate in acidic urine

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14
Q

Glucosuria – glucose appears in urine when?
when dog & cat mmol/L?

A

when blood glucose levels exceed the renal threshold of glucose reabsorption.

when BG dogs 9,9 mmol/l
when BG cats 16,5 mmol/l

Always evaluate the blood glucose levels as well. Caused by Diabetes mellitus, Addison’s, acromegaly, kidney diseases, stress (cats)

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15
Q

Describe Proteinuria

A

Mainly ALB
Small amount can be normal (dehydrated animals).

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16
Q

Describe UPC.

A

urine protein and creatinine ratio

More accurate evaluation of proteinuria for renal causes.

Measured from the supernatant (sediment spun and segregated, skim supernatant off top).

Have to exclude pre- and post-renal causes.
Normal UPC＜0,5
Abnormal UPC >1,0

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17
Q

Name Pre-renal causes of proteinuria. (2)

A

hemoglobinuria,
myoglobinuria (transient)

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18
Q

Name 2 renal causes of proteinuria.

A

protein losing nephropathy (PLN), glomerular diseases.

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19
Q

Name post-renal causes of proteinuria. (2)

A

blood contamination,
bacteria.

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20
Q

What ketones are commonly measured from urine? (2)

A

Acetoacetate, acetone
(Does not measure alpha-hydroxybutyrate)

Ketonuria appears before ketonemia

Dipstick can be used to measure ketones in plasma/serum as well.

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21
Q

Ketonuria is caused by

A

negative energy balance, fat is being used instead of glucose and thus ketones.

Diabetic ketoacidosis, unregulated diabetes.
Malnutrition, carbohydrate-poor diet.
Constant hypoglycemia.

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22
Q

BLD on dipsticks, measures what exactly?

A

Heme which is in both hemoglobin and myoglobin.

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23
Q

Heme in urine can be (origin): (3)

A
  • Hematuria (RBC) – confirm with microscope.
  • Intravascular hemolysis (hemoglobin)
  • Muscle damage (myoglobin)
24
Q

How can you tell the difference between Hemo-/myoglobinuria vs hematuria?

A

When centrifuged, in hemo- & myoglobinuria, the urine stays red/brown.

In hematuria, the urine goes clear, erythrocytes segregate to the sediment.

Other helpful tips:
- Hb makes the plasma red.
- Myoglobin also elevates CK and AST in blood.

25
Q

Bilirubinuria only appears only with what form of bilirubin

A

conjugated form

In bilirubinuria, urine is dark yellow or greenish.

26
Q

Main causes of bilirubinuria (2)

A

hepatobiliary system diseases and extravascular hemolysis

Small amount of bilirubin is normal in dogs:
- Lower renal threshold
- Dehydration

27
Q

Why are leuk unreliable when read on dipsticks in vet med?

A

Dipsticks are designed to measure human leukocytes, thus inaccurate parameters in dogs and cats.

Always confirm with microscope if leuk pos. in dog and cat.

28
Q

Crystalluria =

A

when urine is oversaturated with compounds that form crystals (magnesium, phosphate etc.).

Can be seen in healthy animals in small amounts.

Affected by –
- Urine pH
- Diet
- Bacteria in urine
- Storage conditions of the urine sample

Are identified by the shape and urine pH.

29
Q

Acidic urine – crystals (5)

A

Ammonium biurate crystals
Bilirubin crystals

Calcium oxalate
Cystine

Urate

30
Q

Alkaline urine - crystals (4)

A

Amorphic crystals

Calcium phosphate
Calcium carbonate
(NB! calcium OXALATE are acidic)

Struvite

31
Q

identify + pH

A

Calcium oxalate crystals
Acidic urine

32
Q

identify + pH

A

Ammonium biurate crystals
Acidic urine

33
Q

identify + pH

A

Urate crystals
Acidic urine

34
Q

identify + pH

A

Cystine crystals
Acidic urine

35
Q

identify + pH

A

Bilirubin crystals
Acidic urine

36
Q

identify + pH

A

Struvite crystals
Alkaline urine

37
Q

identify + pH

A

Calcium phosphate crystals
Alkaline urine

38
Q

identify + pH

A

Amorphic crystals
Alkaline urine

39
Q

identify + pH

A

Calcium carbonate crystals
Alkaline urine

40
Q

Casts are

A

Structures produced by kidney tubules from mucoproteins + different cells from the renal tubules.

41
Q

Hyaline cylinders consist of? (3)
They indicate?

A

pure mucoprotein, hard to find, no cells.

A few in a sample are normal, but a lot of them being present can indicate kidney damage.

42
Q

Cellular/granular cylinders/casts consist of? (3)
They indicate?

A

leukocytes, epithelial cells, erythrocytes

Ischemic or nephrotoxic damage in the tubules, acute.

43
Q

Lipid cilinders consist of?
They indicate?

A

lipid droplets

Can be normal.

44
Q

What are wax cylinders?
They indicate?

A

they are end-stage granular casts

Chronic kidney damage

45
Q

Epithelial cylinder/cast indicate? (2)

A

acute injury, pyelonephritis

46
Q

Hemoglobin cylinders/casts indicate?

A

Kidney hemorrhage

47
Q

Urinalysis: What number of leukocytes in one view are indicative of inflammation?

A

5 or more

Pyuria = bacteria + degenerated inflammatory cells in urine.

Can be due to:
Bacterial cystitis
Pyelonephritis
Prostatitis

48
Q

Origin of Squamous epithelial cells

A

lower urinary tract

Sample collected with catheter or free catch.

49
Q

Origin of Transitional epithelial cells in a urine sample. (2)
And they indicate?

A

renal pelvis and proximal urethra

One-two is normal, more can indicate inflammation, neoplasia.

50
Q

Renal tubular epithelial cells in a urine sample indicate?

A

Moderate to severe amount of tubular damage.

51
Q

Main bacteria found in urine (4)

A

E.coli,
Proteus spp,

Staphylococcus spp,
Streptococcus spp

52
Q

If you don’t see any leukocytes but you do see bacteria in a urine sediment microscopy - this means?

A

your sample may be contaminated (ie. free catch sample)

where there is bacteria, there must be inflammatory cells

EXCEPTIONS: With DM, immune deficiency or pyelonephritis – inflammatory cells may not be present.

53
Q

Bacteria seen with microscopy need to be confirmed with

A

urine culture – gold standard

Quick culture tests in the clinic – Uricult, Flexicult etc.

If there’s growth then confirmation in the lab with bacteriology + antibiogram. AB treatment corrected if necessary.

54
Q

Fungi in the urine sample is usually a sign of

A

contaminated or old urine

However, if collected with a sterile method and is fresh – could be primary kidney or bladder fungal disease.

55
Q

Name 2 parasites of the urinary tract.

A

Capillaria plica, Capillaria feliscati (bladder worm)

Dioctophyma renale (kidney worm)

Clinical lab diagnostics of small animals (8 decks)

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