Urinalysis

Question 1

Three parameters that are observed from urine sample

Answer 1

1. Physical changes (turbidity, odor, concentration, color)
2. Chemical (pH, protein, glucose, biliruin, ketones)
3. Sediment
   Native - crystals, casts
   Cytology - blood cells, bacteria, other cells

Question 2

Cloudiness in urine could be caused by

Answer 2

Elevated RBC and WBC
Bacteria
Crystals
Semen

Question 3

Concentration (USG) is used to

Answer 3

Urine specific gravity

Used to assess tubular function of kidneys and the kidneys ability to concentrate urine (ability decreases when 2/3rd of the tubules are damaged

Question 4

How is USG measured?

Answer 4

By using a refractometer

Question 5

Normal USG values for dog and cat

Answer 5

Dogs - 1.015-1.045
Cats - 1.035-1.060

Question 6

How can USG be used in a patient with azotemia?

Answer 6

Can be used to evaluate kidney function and localize the cause for azotemia

Adequate concentrating ability –> pre-renal azotemia
Inadequate concentrating ability –> renal azotemia

Question 7

What’s measured with dipsticks?

Answer 7

pH
Protein
Glucose
Ketones
Bilirubin
Heme

(leukocytes, USG, nitrits, urobilinogen are inaccurate or unimportant)

Question 8

Normal pH in dogs and cats

Answer 8

acidic pH 5,5-7,0

Question 9

What crystals are found in acidic urine? Alkaline?

Answer 9

Acidic urine - Struvites
Alkaline urine - Oxalates

Question 10

Glucosuria is caused when…

Answer 10

blood glucose levels exceeds the renal threshold (dogs 9,9mmol/l, cats 16,5mmol/l)

Can be caused by diabetes mellitus, hyperadrenocorticism, acromegaly, kidney disease, stress (cats)

Question 11

Causes for proteinuria

Answer 11

Pre-renal - hemoglobinuria, myoglobinuria

Renal - Protein-losing nephropathy, glomerular diseases

Post-renal - blood contamination, bacteria

Question 12

What could cause ketonuria?

Answer 12

Negative energy-balance
-Diabetic ketoacidosis
-Malnutrition, carbohydrate-poor diet
-Constant hypoglycemia

Question 13

Three possible causes for heme in urine

Answer 13

-Hemauria (heme from blood)
-Intravascular hemolysis (heme from hemoglobin)
-Muscle damage (heme from myoglobin)

Question 14

Bilirubin in urine?

Answer 14

Bilirubinuria
Urine is dark yellow or greenish

Main causes - hepatobiliary diseases and extravascular hemolysis

Small amount of bilirubin is normal in dogs

Question 15

Leukocytes in dipstick?

Answer 15

Dipstics are designed to measure human leukocytes so it’s inaccurate –> confirm with microscope

Question 16

What do you check with microscope from unstained native sample?

Answer 16

Crystals and casts

Question 17

What do you check with microscope from a stained sample?

Answer 17

Erythrocytes
Leukocytes
Epithelial cells
Microorganisms

Question 18

What are casts?

Answer 18

Structures that are produced in kidney tubules from different proteins and cells.
Some can be normal, some can indicate disease.

Question 19

Causes of hematuria

Answer 19

-Urinary tract: inflammation, trauma, neoplasia
-Parasites
-Coagulopathies (rodenticides, thrombocytopenia)
-Kidney infarction
-Genital tract
-Iatrogenic (method of collection)

Question 20

Epithelial cells in urine?

Answer 20

Small amounts can be normal, larger amounts are indicative of a disease.

Different kind of cells are connected to different places, for example
Squamous epithelial cells –> lower urinary tract
Transitional epithelial cells –> renal pelvis and proximal urethra

Question 21

Pyuria

Answer 21

Bacteria + degenerated inflammatory cells

Bacterial cystitis, pyelonephritis, prostatis

Question 22

Main bacteria found in urine?

Answer 22

E. coli
Proteus spp.
Staphylococcus spp.
Streptococcus spp.

Question 23

Fungi in urine?

Answer 23

Usually a sign of contaminated or old urine

If fresh and collected with a sterile method –> primary kidney or bladder fungal disease

Question 24

Parasites in urine?

Answer 24

Capillaria plica, Capillaria feliscati (bladder worm)
Dioctophyma renale (kidney worm)